Facility Services

 

Medical Billing

Our focus and success with various types of facilities is exceptional. Coding and billing go hand-in-hand for facilities and our team is extremely experienced with all aspects of UB04 billing. We are able to implement efficiencies further streamlining the entire process leading not only to increased revenue but with much quicker reimbursements. 

Our facility billing team is extremely experienced with billing for all specialties given the unique requirements for each. We also understand how to bill for and collect on out-of-network claims and maximize reimbursements, and have  solid relationship with the third-party pricing companies to maximize negotiations. 

 

Coding

Facility coding services are an integral component of the billing process to ensure all revenue is captured and the documentation supports the codes being billed. We have certified coders by specialty to help code for all the various types of complex procedures offered by facilities. We also have the ability to help facilities become current on charts to code so that the current billing team can bill out claims. 

 

Audits

Our team of auditors lead by staff from Big 4 accounting firms and former SIU from the payers will help you understand where revenue leakage is occurring. The audit will also identify gaps in coding processes, which can expose a facility not only to revenue shortfall but also to over billing due to insufficient documentation. 


The audit can be focused on chart documentation or claims. We have the ability to scale up very quickly regardless of volume. 

 

A/R Recovery

We have dedicated resources not only focus on this function, but more importantly they have the right skill set to work with these types of claims. Given our relationship with he payers we are able to generate significant revenue from old unpaid balances. We are also very cognizant about what claims to correct and appeal and not to "mass-submit" all claims, leading to further issues with the payers. We are very skilled at determining claim-level issues and then determining which set of claims can be resubmitted. 

We also offer services whereby we can provide very specific reasons for claim-level denials and provide corrective actions to your team to process.

 
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