1. Pre-certification & Insurance Verification

The patient list, a copy of the insurance card and demographic details are sent to us via email/fax or secure FTP. Our medical billing specialists call up the insurance company prior to the appointment. Pre-certification is done for specific lab tests, diagnostic tests and surgeries. The details are sent to the hospital/clinic in the prescribed format.

2. Patient Demographic Entry

Our medical billing specialists enter patient demographic details such as name, date of birth, address, insurance details, medical history, guarantor etc as provided by the patients at the time of the visit. For established patients, we validate these details and necessary changes, if any, are done to the patient records on the practice management system.

3. Charge Entry

The fee schedules are pre- loaded into the practice management system. CPT and ICD-10 codes are entered into the system. The billing specialists ensure that all details have been provided in the claim and ready to be filed.

4. Claims Submission

Claims are submitted electronically via the practice management system. At this stage, a thorough quality check is done by a senior billing specialist and then submitted. The rejection report received from the clearing house, if any, is analyzed and the necessary changes are done. These claims are then resubmitted.