Medical Billing in USA

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Medical Billing in USA

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Our Services

Credentialing Revenue Cycle Management AR Recovery Consultation

Credentialing

Credentialing is a tedious task that requires one to be extremely vigilant and persistent in order to get on board with commercial and public insurances. Healthcare professionals and businesses alike need someone credible to stay on top of the statutory and commercial requirements and a minor fault can lead to income delay. Broadly we break down credentialing in two types
– New Practice
– Existing Practice adding new payers.

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The general procedure for both types is same with minor differences, here is how it will unfold:

1
Documentation Gathering

We provide you a complete list of documents that must be made available in order to smoothly complete the process. We would also help you to attain any missing documents and provide a complete timeline for the whole process after viewing all documents.

2
Setting up Accounts

Once all required documents are in place, the credentialling process formally begins by creating accounts on multiple portals such as CASQ and PECOS, for existing businesses, accounts are checked and rechecked before moving forward. The accuracy and detail-oriented attitude while completing information in the initial forms determines the fluidity of the whole operation.

3
Waiting and Tracking

Although this might feel like an easy job, but being consistent is the key. Once the initial application is submitted, the insurances will take a somewhere between 45-90 days to process the application and might detect shortcomings in the application. A vigilant approach allows for swift resolution of errors, if determined, hence saving precious time.

4
Re-credentialing and Guidance

Once the whole process is completed and the medical provider is credentialled, keeping up with the statuary changes and fulfilling legal obligations of the contract in order to maintain the credentialling status would be challenging. Our expert would not only guide you about the regulations of each payer, we get you credentialled with, but we also keep track of any requirements the payer might have from time to time due to change of policy.

Revenue Cycle Management​

When you sign up with CareMD for full suite of RCM services, we take steps to realize your dream of a sustainable and consistent revenue stream. One that provides you the stability to focus on perfecting your art of curing patients and grow as a business

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We take a phase approach and gradually get the business to a seamless revenue stream by use of technology and specialized workforce.

1
On-Boarding

Once you sign, the first step is for us to familiarize ourselves with the structure of your organization and the challenges it presents. Then we sit down with you and present a plan and a realistic estimate of the time it will take for us to achieve a smooth revenue stream.

2
Digging Deep

Once the initial analysis is complete a sense of understanding develops on both sides, we start to distinctively identify and address problems causing AR, credentialing defects and coding issues. This allows for smooth processing of real time claims and separates previous ambiguities. Organizations facing revenue crunch would feel the pressure has eased and payments are flowing in at an increased pace.

3
Clearing AR

In this phase all claims stuck in AR due to past errors and mistakes are addressed. While we address your AR our predictive software creates a report on most common errors which allows our experts to create billing guidelines enabling error free claim submission.

4
Chasing Excellence

Once all past errors are cleared, we set on a never-ending path of chasing excellence. This includes coding guidelines to improve revenues, transparency of system and lower turn around times. We never settle for what we have and keep challenging ourselves to become more vigilant and caring for your business.

AR Recovery

Claims denied and rejected often become a sore eye when left untended for a while. A considerable revenue is lost and may hurt the profitability of a business. Healthcare professionals are very dwelled in their professional tasks that examining past errors and correcting them falls down the priority list.
This is where we come in, CareMD would seamlessly take care of all denials and rejections you face. We have the ability to gel ourselves as an extension of your existing billing function and take care of this hectic but incremental task differentiates us from our competitors.

Our talented AR professionals have the ability to tackle:
– In-network account receivables
– Out-of-network account receivables
– AR past timely filling

Consultation

1
Documentation Gathering

We provide you a complete list of documents that must be made available in order to smoothly complete the process. We would also help you to attain any missing documents and provide a complete timeline for the whole process after viewing all documents.

2
Setting up Accounts

Once all required documents are in place, the credentialling process formally begins by creating accounts on multiple portals such as CASQ and PECOS, for existing businesses, accounts are checked and rechecked before moving forward. The accuracy and detail-oriented attitude while completing information in the initial forms determines the fluidity of the whole operation.

3
Waiting and Tracking

Although this might feel like an easy job, but being consistent is the key. Once the initial application is submitted, the insurances will take a somewhere between 45-90 days to process the application and might detect shortcomings in the application. A vigilant approach allows for swift resolution of errors, if determined, hence saving precious time.

3
Re-credentialing and Guidance

Once the whole process is completed and the medical provider is credentialled, keeping up with the statuary changes and fulfilling legal obligations of the contract in order to maintain the credentialling status would be challenging. Our expert would not only guide you about the regulations of each payer, we get you credentialled with, but we also keep track of any requirements the payer might have from time to time due to change of policy.