Medical billing is the procedure of submitting and tracking down claims with health insurance providers to get paid for services provided by a healthcare practitioner. The medical billing process converts a medical service into a billing claim. In a healthcare facility, the medical biller has to monitor the claim and make sure the practice is paid for the services rendered by the providers. Knowledgeable billers at Vsynergize can boost the practice’s revenue performance. We will help you streamline the procedure, so you can focus on patient care, eliminate billing errors, increase cash flow, and save money.

Why Choose Vsynergize For Medical Billing Services?

Medical Coding

One of the main reasons for claim denials is medical coding errors.

Our team of CPC-certified medical coders are proficient in CPT, HCPCS coding, ICD-10 medical coding, Chart Audits and Code Reviews, and HCC medical coding. We Focus on Payer specific coding requirements, and continuous professional training in medical coding is given to all coders.

With our medical coding service, you get-

  • Accurate and error-free claims submitted to the insurance carriers
  • Separate audit team that audits all the coding done before claim submission.
  • Increased cash flow and reduced risk due to accurate coding 
  • Faster reimbursement with less or zero rework 

Accurate Medical Billing

With our prior experience in billing on various medical billing systems and specialities, we ensure zero errors, which otherwise may lead to the denial of the claims. The team gets the initial training needed to understand the speciality-specific nuances. Here’s how they address the problem and resolve it-

  • Unaccepted claims are sent to the client for clarification. 
  • Edits from the clearing house and payer are resolved, and claims are resubmitted. 
  • The finalized claims are audited by the Quality team and the clean claims are sent for transmission.

Error Free Billing leads to a greater first-pass percentage, faster reimbursements and cash flow increases due to reduced errors and zero missed charges.

Timely Payment Posting

The payments in place of claims received from the Payer and Patients are posted in the medical billing system to reconcile the claim. Incorrect and delayed payment postings will show incorrect Accounts Receivable amounts. A lot of time is wasted to correct them, and cash flows are affected due to delayed follow-ups on outstanding debts. 

Here’s our solution to it:

Insurance Payment Posting: EOB or ERA are received towards the payment of a claim. Payments received are immediately posted against a particular claim to reconcile them. The payment posting is handled as per client-specific rules for adjustments, write-offs, refund rules etc.

Patient Cash Posting:

Patients need to pay a part of the expenses including co-pays, deductibles and non-covered services. The provider can set a mandate for write-offs. Patients typically pay through checks or credit cards which need to be correctly accounted for against the claim. 

With our solution, you will get an accurate picture of outstanding AR, and cash flow will increase due to faster recoveries of outstanding amounts from patients and payers.

Accounts Receivable Management 

Accounts receivable management directly impacts the cash flow. Pending or Denied claims need to be analyzed and resubmitted. This results in delayed reimbursement, incorrect accounts receivable and a loss of focus on the follow-up of outstanding amounts.

Here’s how our Accounts Receivable Management service will counter it-

Insurance Follow-up:

A dedicated AR follow-up team for Payers take follow-ups via websites, fax, IVR and phone to ensure that claims are settled quickly.

Our team monitors the aging buckets of the AR’s claims followed between 25-45 days. Follow- ups are taken on the status of the claims, appeals and denial reasons of claims.

Old Accounts Receivable Management: 

The team analyzes the various accounts receivable reports to work on the AR management strategy to reduce bad debts and maximize AR collections. 

Analyzing and Rectifying Denials 

One of the major problems faced by providers is that a large proportion of rejected claims go unattended and are never resubmitted. Apart from this, claims are not analyzed to check why they are denied, and there are no trends or feedback loops on those denied claims. 

The Denial Management process uncovers and resolves the problem leading to denials and shortening the accounts receivables cycle. 

Here is how we rectify the error with our solution:

We establish a trend for individual payer codes and common denial reason codes. This trend tracking helps to reveal billing and medical coding process weaknesses.

Appeals for Denied Claims

Appeal letters are prepared and sent along with supporting documents, including Medical Records for processing via fax if necessary. 

Patient Follow-Up 

Our team calls patients to obtain demographics, insurance information and outstanding dues. Each patient account is meticulously tracked and followed up till the payment is received. Processes are laid out involving sending letters, statements, notices, making phone calls, etc. to expedite collections.