Scheduling, pre-registration, and registration are all included for new and returning patients. In order to pre-register, patients must provide demographic data, including insurance information, and eligibility must be confirmed.
The patient attends appointments, and the doctor records the encounter in the patient's electronic health record (EHR). Patient history, encounter notes, diagnosis codes, follow-up data, orders, medicines, assessments, and lab results are all included in the record.
Based on clinical documentation, the medical coding team records the diagnosis (DX), healthcare common procedure coding system (HCPCS), and current procedural terminology (CPT) codes. Based on the payer and kind of procedure, the coder may also add a modifier (CPT code). To guarantee payment for the service or encounter, it is crucial to understand payer policies and claim specifications.
The billing team enters the claim's charges either on a CMS-1500/UB-04 form or in a medical billing system. The team then creates the claim in the provider's EHR and sends it to the clearinghouse either electronically or on paper (insurance may be government or commercial payers). The payer receives the claim from the clearinghouse, who may reject it. If the clearinghouse denies the claim, the billing team may locate and fix the underlying issue. The team can reprocess the claim and resend it to the payer once they have determined the cause.
The back-end staff will keep track of the date the practise submitted the claim and check on its status. This group includes billing specialists and accounts receivable. A follow-up occur at least once every 30 days until the payer pays the claim. The practise may occasionally need to make its claim follow-up process more frequent.
The payer gets the claims and either pays them out or rejects them. The payer supplies additional information, such as co-payments, deductibles, and reimbursements, along with specifics about the amount invoiced and/or denied.
The billing team will address rejections by locating the underlying issue and filing a revised claim, a reconsideration request, or an appeal. The billing team will then check on the status of the denial after that. The insurer will post payment if it reverses its first claim denial. The appeals procedure is repeated if the payer continues to reject the claim. The healthcare provider may opt to write off the claim as a loss if, after the entire procedure, the payer doesn't change its mind.
The billing department will input payer reimbursement into the medical billing system. This gives an overview of the financial situation of healthcare providers
Medical billing software records the data, and then prepares and sends the patient's medical bills. This process is more automatic thanks to modern billing software. All costs for which the patient is held responsible are included in the medical bill.
When they receive their account, many patients are unable or unwilling to pay the remaining balance on their medical costs. This is primarily the result of misunderstandings about benefits, rejected claims, expensive service costs, or other financial troubles. The healthcare practitioner then has the duty to get in touch with the patient and get the unpaid amount.
A plan is made to achieve long term success of the task to get it done on time
Training is given to the executives to get the work done on time and with 100% accuracy
The work is executed with the commitment to get it done as planed with accuracy
As per the plan all the work is finally completed and it is ready to deliver.
We are always there for you. Get quick assistance and delivery as and when you require. We are aware of your dislike of waiting and your expectation of a prompt reply. Your problems would be remedied if you had the right help and information. So Staunch KPS offers delivery and help on time.
We work with no errors left behind. Get your work done with 100% accuracy and Efficiency. Customers are more likely to trust us because of our accuracy and honesty, which helps to boost the standing of your business and encourage repeat business. Giving customers accurate service will make you, want to visit our business again and again since you will be treated well.
Data safety and security with high accuracy is committed by the company. Data security is required to safeguard your information from both un-authorised access and deletion. In order to prevent data loss, proper security measures are taken to protect the data and it's privacy. Data safety and privacy is very important in the business.
Get fare and flexible pricing choices from Staunch KPS. Instead of maintaining a fixed price point, flexible pricing is the choice you get at staunch KPS, this can guarantee that customers are receiving good value for their money.
Staunch KPS Provide all the out sourcing services
All the Medeical billing services is provided by Staunch KPS