SERVICES

Accounts Management

Seeking professional and budget-friendly solutions? You’ve come to the right place! 

Our team excels in delivering premium Medical Billing Services, guaranteeing adept management of your billing requirements. Bid farewell to the hassle of managing billing duties independently and entrust them to us for meticulous and effective handling. We take great pride in providing outstanding services that surpass all expectations. Count on us to optimize your billing procedures and enhance your revenue potential.

 Reach out today to experience firsthand why our unmatched services set us apart from the rest. Let’s collaborate towards achieving your goals!

Medical Coding

Ensuring procedure code accuracy is crucial for claims filing, directly impacting reimbursement precision. The American Medical Association (AMA) and Centers for Medicare & Medicaid Services (CMS) regularly update procedure codes to match evolving healthcare practices. These updates, often occurring quarterly and most significantly on January 1st each year, include additions, deletions, and revisions to Current Procedural Terminology (CPT) and Healthcare Common Procedure Code System (HCPCS) codes.

Our skilled coding team is integral to this process. We meticulously translate provider procedure descriptions into CPT and ICD codes or design superbill templates. This empowers physicians to accurately document the services provided to their patients. With our expertise, you can trust that your coding precisely reflects the care administered, facilitating smooth claims processing and optimizing reimbursement.

Medical Billing

While most insurance companies adhere to standardized billing guidelines, it’s important to acknowledge that certain payers may have unique requirements. This underscores the necessity of understanding that various aspects of medical billing can vary depending on the payer involved. Thus, it becomes essential to verify and comply with each payer’s specific guidelines to ensure the accuracy of claims submission.

Our team of skilled billers possesses extensive experience in navigating the intricacies of diverse payer requirements. With meticulous attention to detail, they craft clean claims and submit them in accordance with the guidelines set forth by each insurance company. The primary objective is to maximize reimbursement for our clients by adhering closely to the individual protocols of each payer.

Payment Posting

Our team understands that payment posting is not just about data entry; it’s a nuanced skill that requires a deep understanding of payer communications and nuances. When our experts handle payment posting accounts, they meticulously interpret Explanation of Benefits (EOBs), ensuring every crucial detail is accurately recorded:

  • They input the allowed amount, paid amount, and patient responsibility details with precision.
  • Contractual adjustments are calculated meticulously, making insurance follow-up processes more efficient.

As payment posting continues to evolve with the adoption of Electronic Remittance Advice (ERAs), our specialists provide adept support in ERA posting by meticulously verifying payments. They excel in managing various advanced electronic remittance scenarios, including denials, underpayments, overpayments, multiple adjustments, automatic cross-over, secondary remittance, reversals, and more.

Credentialing

Our seasoned team of EDI/credentialing/enrollment specialists plays a crucial role in ensuring that providers are seamlessly enrolled with insurance companies and maintain their credentials up-to-date. They meticulously handle CAQH re-attestation and ensure timely re-enrollment, guaranteeing uninterrupted participation in insurance networks.

With their wealth of experience in billing, our specialists are well-equipped to efficiently introduce physicians to new networks and payers. Some even possess the capability to expedite credentialing processes with government agencies. Leveraging their expertise and established connections, they negotiate favorable credentialing offers, taking into consideration market offerings and fee schedules from various payers.

Our specialists excel at analyzing the average fees charged by other specialists in your community and offer invaluable insights into your practice’s fee structure. Collaborating closely with you, they ensure that your fees remain competitive while maximizing reimbursement rates.

Pre-Authorization

Our skilled authorization team is dedicated to ensuring that all necessary prior authorizations are obtained as requested by the doctor’s office before confirming appointments with patients. This proactive approach streamlines the scheduling process, ensuring that patients have the necessary authorizations in place before their visit. By obtaining prior authorizations promptly, our aim is to minimize any potential delays and facilitate smooth and efficient patient care experiences.

Reporting

Generating medical billing reports is indispensable for evaluating the overall health of your practice. These reports provide invaluable insights into essential revenue cycle metrics, enabling you to assess performance effectively. They illuminate various aspects, including the timeliness of claim payments and reimbursement rates from insurance carriers for critical procedures.

Our proficient reporting team specializes in delivering a comprehensive range of reports tailored to meet the specific needs of doctors. From Aging and DWC (Date of Service to Write-off) reports to Credentialing, Collection Forecasting, and Collection Analysis reports, we offer thorough and insightful analyses. These reports empower doctors with actionable information, enabling them to make informed decisions and optimize practice operations. With our expertise, you can gain a deeper understanding of your practice’s financial landscape and take proactive steps towards achieving financial stability and growth.

Audit

Immaculate MBS establishes a benchmark for excellence in clinically-based hospital and provider bill auditing. Unlike re-pricing or unbundling software programs, our audits surpass mere computational scrutiny, yielding results that are both medically sound and legally defensible. Our meticulous auditing procedure encompasses a comprehensive review, identifying and rectifying potential errors across various fronts, including coding discrepancies, unbundling issues, code upgrades, and fee schedule deviations.

Furthermore, our dedicated Audit team conducts thorough reviews of coding practices and aging processes annually, furnishing detailed insights to doctors. By leveraging our expertise, healthcare providers can ensure accuracy, compliance, and optimal revenue generation while maintaining the highest standards of patient care.