PROCESS
Our Charge Entry Process
Collecting documents - Encounter forms, superbills, charge sheets, scanned documents, etc. through fax or other document management systems.
Gathering patient information - Gather patient demographic information, insurance details, and the information regarding services rendered.
Verifying insurance coverage - Verify insurance coverage to ensure the patient is eligible for the services provided.

Reviewing medical records - Review medical / health records to ensure that the services provided are accurately captured and billed.

Assigning codes - Ensure procedural and diagnosis codes, with specialty-appropriate modifiers are applied to the services rendered.

Entering charges - Once the codes have been assigned, charges are entered into the medical billing system. This includes the charges for the services provided, any co-payments, and deductibles.

Double-checking entries - Before submitting the charges to the insurance company, entries are double-checked to ensure that all information is accurate.

Submitting claims - The final step in the charge entry process involves submitting the claims to the insurance company for payment.

Reporting - Providing daily reports to the customer and resolving pending issues for improved process turn-around time.

PROCESS
Our Charge Audit Process
Reviewing charges - The charges are reviewed to ensure they are accurate and compliant with the coding guidelines and policies of the payer.
Identifying coding errors - Coding errors, such as incorrect modifiers, upcoding, and undercoding, are identified to prevent denials or audits from payers.

Checking documentation - The documentation is checked to ensure that it supports the medical necessity of the services provided and meets the requirements of the payer.

Verifying reimbursement - The reimbursement is verified to ensure that it is consistent with the contracted rates and the fee schedules of the payer.

Reporting findings - The audit findings are documented and communicated to the billing staff or the providers, along with recommendations for improvement.
Implementing corrective action - The corrective action is taken to address the issues identified during the audit and to prevent similar errors in the future.

Monitoring results - The audit results are monitored to ensure that the corrective action is effective and that the billing processes are optimized for maximum revenue generation.