We optimize the process from order intake to posting the payments and bring technology tools to improve end to end billing workflow.
Often times, HME/DME and home infusion providers are subjected to Medicare audit.
An accurate HCPCS Level II codes is very important to reduce denials and receive proper reimbursement.
Documentation from the provider on establishing the medical necessity is very critical in the billing process.
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Intake
Demographic data entry, order entry, indexing and filing of electronic medical records
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Eligibility and Benefits Verification
Verification of benefits, coverage, insurance data entry and documentation of verification notes.
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Prior Authorization
Request of initial prior authorizations via web portal, fax and associated follow up. We ensure that all necessary verification and authorizations are completed accurately and on time, safeguarding your revenue stream.
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Claims Submission
Hold Management: Review of all claims on hold, identify steps to cure holds, attempt to release or route for follow up via logging CMN’s, Orders, PAR’s or other medical documentation.
Billing Review: Pre-review of all claims ahead of transmission to identify missing or invalid claim elements.
Claims Transmissions: Batching of claims and submission to payer or clearinghouse. Direct entry to clearinghouse and paper claims.
Front End Rejections: Identify, research and resolve claims rejected by the clearinghouse/payer.
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Collections
Denial Management: Identification of denied claims, research, claim resubmissions and appeals. Feedback loop to establish corrective action for preventable denials.
AR Management: Follow-up on claims with no response and denial follow-ups.
Get In Touch
Speak to a VitalityRCM professional today to learn more about our services and how we can help you optimize your revenue cycle management.
Adress:
Los Angeles, CA 90014
Phone:
(424) 244-4888
Email:
Info@vitalityrcm.net
