- Revenue Cycle Management
- Audit Services
- Medical Billing and Coding Staffing services
- Ambulance Billing Services
Revenue Cycle Management
Physician practices, Hospitals, Health systems and Academic medical centers are under pressure to improve the quality of care while simultaneously facing declining reimbursement, increased risk and margin pressure. Improving efficiency in the areas of medical billing, coding and accounts receivable management are critical to improve the cash flows, revenues and profitability.
Medical Billing and Coding is a complex process and has a direct effect on the bottom line and financial performance. For most Healthcare providers RCM includes everything from Pre-registering a patient all way through the final zero balance invoicing for a visit. There are three broad level of activity within Revenue Cycle Management:
The first level includes patient access, pre-registration, entitlement, and eligibility verification as well as self-pay, which includes co-pays.
The second level represents an intersection between information technology and administrative RCM. More specifically, this includes coding, manipulation of electronic medical and health records (EMR / EHR) and electronic submission of the claim
The third level consists of account collections, receivables management, account postings and reporting.
At New England Revenue Cycle Solutions (NERC), our Certified coders and billers will Code for the services right at the first instance and submit the claims on time to the Payers, follow-up to greatly improve your cash flow and total income.
Medical Coding: Our certified coders have extensive experience and knowledge of intricacies of proper procedure codes and modifiers. Identifying incremental reimbursement opportunities can deliver an immediate return without a significant amount of time or cost. We will work closely with you and your office staff to ensure all your services are captured and coded right the first time.
Medical Billing: Our experienced Billers goal is to submit the bills to the payers within 48 hours from the date of service. They will verify insurance eligibility, confirm the correct insurance company, and ensure that all the necessary documentations are submitted along with the charts right at the first time to the Payers so that the bills get paid on time.
Electronic Claim submission: Most of the Payers including CMS require electronic submission of claims. We will submit all your claims electronically and we have wide range of experience with most of the practice management software. We will work with your existing practice management to minimize the data entry errors
Payment Postings: Our experienced accounting professionals will receive all the EOB’s and payments electronically through our secure FTP site and make necessary charge entries. In addition, our Accounting professionals will analyze all the denials and work with your office staff for re-submission of all the claims.
Account Receivable Management: We will follow-up with all your Payers for any delay in processing your claims. In addition, we will research and appeal all denied claims, send you a list for unpaid Co-pays to your office to follow-up with your patients for collection of the Co-pays. We will also provide customized periodic reports on accounts receivables, collections, and overdue payments.
If your practice or your organization is struggling to maintain its revenue cycle operations, our end-to-end revenue cycle management and medical billing services can provide as much – or as little – help as you need.
Audit Services:
For hospitals, physician practices and other providers, three objectives matter most when it comes to billing for clinical services: improving cash flows, maximizing revenues and reducing regulatory risk. Faced with an increasingly complex regulatory environment and aggressive federal and state audit initiatives, medical billing and coding operations at hospitals and physician practices must comply with all applicable healthcare laws and regulations. Additionally, lost revenue from poor medical coding practices can significantly impact financial performance.
Audit services is a process to determine whether data in a provider’s health record, and/or appropriately referenced medical policies, documents or support services listed on a provider’s bill. Our certified coders will conduct such audits and present our customers with a detail report of our findings and any training recommendations to improve the coding efficiency and regulatory complinace. These audits will be conducted on a retrospective or concurrent basis and are referred to as revenue recovery audit
Concurrent Audit: a billing audit conducted before the issuance of an interim or final bill.
Retrospective Audit: a billing audit conducted after the issuance of an interim or final bill.
We provide both Concurrent Audit and Retrospective audit service.
Qualifications of Our Auditors and Audit Coordinators
All our personals performing billing audits are certified with appropriate knowledge, experience, and/or expertise in several areas of health care including, but not limited to the following areas:
- Format and content of the health record as well as other forms of medical/clinical documentation.
- Accepted auditing principles and practices as they may apply to billing audits.
- Coding, including ICD-10, CPT, HCPCS, and medical terminology
- Billing claims forms, including the UB-82, UB-92, the HCFA 1500 and charging and billing procedures
- All state and federal regulations concerning the use, disclosure, and confidentiality of all patient records
- Specific critical care units, specialty areas, and/or ancillary unity involved in an audit
Please contact usfor all your Auditing requirements.
Medical Billing and Coding Staffing services
We understand a client’s need for highly qualified, expertly trained and certified professional. Our mission is to solve customer staffing challenges by providing qualified and experienced human capital. We have access to certified medical coders and HIM professionals across the country and we are able to quickly fill your temporary and full time staffing requests with qualified personnel. Our cost-effective staffing solutions exceed industry standards and we offer the complete staffing solutions. Our dedicated recruiters will listen to your needs and help you fill both temporary and fulltime positions. We assist Physician Practice groups, Clinics, Academic and Community Hospitals with both remote and on-site personals in the following areas:
Auditing
- Inpatient
- Outpatient
- ER
- Ancillary
- Charge Capture
Coding
- Inpatient
- Outpatient
- ER
- Ancillary
- Charge Capture
Health Information Management
- Operations
- Revenue Cycle
- Coding
- Charge Capture
Please contact us with your staffing needs and our friendly recruiter will help you find the suitable resources
Ambulance Billing Services
New England Revenue Cycle Solutions (NERC), has extensive experience giving Coding, Billing, Eligibility verification, Electronic claim submission, Cash Posting, Account Receivable management, Documentation audits and Customized reporting to Ambulance companies. Our Certified Ambulance Coders, will work closely with you and will review every claim to ensure all codes captured, and claims sent correct first time with all necessary documentation.
Our Certified Billers have hands on experience in various ePCR software such as Zoll, Jefbar, Tritech, AmbuPro EMS, Medapoint and we take time to verify eligibility from Local and State Fire and Police departments, Patient demographics from Hospital ED interfaces and CMS before submitting the claims.
Our AR team will work to ensure all the claims are paid on time, and provides our customers with easy to understand customized financials reports.
Please contact us for all your Ambulance billing needs.
