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We house a team of Certified Professional Coders (CPC) and Certified Professional Billers (CPB) who possess comprehensive knowledge spanning charge capture, billing, claims processing, and payment follow-up. Supported by cutting-edge billing technologies, our team utilizes its expertise to enhance the efficiency, accuracy, and timeliness of our urgent care billing processes. We cater to medical entities specializing in wound suturing/stitching, IV fluids for dehydration, urinary catheterization, and more. Here is how our experts streamline your urgent care billing process.
- Leverage advanced billing digital technologies such as EHR, EMR, and PMS to expedite electronic claims processing. Use electronic data interchange (EDI) to improve the process from billing to electronic payments.
- Prioritize patient details collection (demographics, medical history, physician referrals) and verify complete insurance information (coverage type, prior authorization status with effective and expiration dates, and claims address) at the patient registration level.
- Confirm if pre-authorization is required for any services and obtain advance approval from the payers when necessary.
- Align claims documentation with fee schedules and payment guidelines of diverse insurance programs such as Medicare, Medicaid, private health insurance (e.g., Blue Cross Blue Shield, Aetna, Cigna, UnitedHealthcare), Tricare (Military Health Insurance), Veterans Affairs (VA) Health Care, and Self-Pay Patients.
- Stay updated with the latest coding updates in ICD/10, CPT, and HCPCS Level II coding, E/M, procedure codes, place of service codes, diagnostic codes, vaccine administration codes, and others.
- Assign correct CPT codes to capture every aspect of urgent care medical services. These include office or outpatient visit codes (e.g., 99201-99215), diagnostic testing and imaging codes (e.g., 99281-99285), procedures like wound repair, injections, and minor surgeries (e.g., 11042-13160) to manage claims accurately.
- Maintain code specificity and regulatory guidelines for Fee-for-Service Billing, Episode-of-Care Billing, Value-Based Billing, Global Billing, and Telemedicine Billing.
- Examine claims by analyzing Explanation of Benefits (EOBs), identifying denial reasons, resolving any disputes, and initiating the appeals process as needed.
- Aid in reviewing Explanation of Benefits (EOBs) to verify details like premiums, coverage periods, deductibles, and co-payments for all parties involved – subscribers, policyholders, and beneficiaries.
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