• Intake: Intake refers to the process of gathering and recording essential information from patients or healthcare providers at the beginning of their interaction with your medical billing service. This may include patient demographics, insurance details, medical history, and other relevant information necessary for accurate billing and reimbursement.
• Authorization: Authorization involves obtaining approval from insurance companies or third-party payers for medical services or procedures before they are performed. This process ensures that services rendered are covered by the patient’s insurance plan, reducing the risk of claim denials and reimbursement delays.
• Charge Entry: Charge Entry is the process of entering billed charges for medical services rendered to patients into the billing system. This includes assigning appropriate billing codes, such as Current Procedural Terminology (CPT) codes and International Classification of Diseases (ICD) codes, to accurately represent the services provided.
• Electronic Rejection: Electronic Rejection occurs when claims submitted electronically to insurance companies are rejected due to errors or discrepancies in the claim. This may include issues such as missing information, invalid codes, or billing errors. Addressing electronic rejections promptly is essential to ensure timely reimbursement and minimize revenue loss.
• AR Follow-up: Accounts Receivable (AR) Follow-up involves monitoring and tracking outstanding claims and payments from insurance companies or patients. This includes following up on unpaid or denied claims, identifying reasons for non-payment, and taking appropriate action to resolve outstanding balances and expedite reimbursement.
• Denials Management: Denials Management involves identifying, analyzing, and resolving denied or rejected claims from insurance companies. This process includes investigating the reasons for denials, appealing denied claims when necessary, and implementing strategies to prevent future denials, ultimately optimizing revenue collection for healthcare providers.
• Appeals: Appeals refer to the process of challenging denied claims with insurance companies or third-party payers to request reconsideration and overturn the denial decision. This may involve providing additional documentation, clarifying coding or billing issues, or addressing discrepancies in the claim to support the appeal.
• Posting: Posting in medical billing involves recording payments, adjustments, and denials received from insurance companies or patients into the practice management system. This step ensures accurate accounting of financial transactions and helps track the status of outstanding balances, allowing for effective revenue reconciliation and reporting.
• Medical Scribe: A medical scribe assists healthcare providers by documenting patient encounters in real-time, either through direct observation or remotely. Scribes accurately capture patient information, including medical history, examination findings, and treatment plans, allowing providers to focus on patient care without the burden of documentation. This enhances efficiency, improves clinical workflows, and ensures comprehensive and accurate medical records.
• Virtual Medical Assistant: A Virtual Medical Assistant (VMA) provides administrative and clerical support to healthcare providers remotely. VMAs perform various tasks, such as scheduling appointments, managing electronic health records (EHR), handling phone calls and emails, processing insurance claims, and assisting with billing and coding. By outsourcing administrative functions to VMAs, healthcare practices can improve efficiency, reduce costs, and focus on delivering quality patient care.

These services play crucial roles in the revenue cycle management process, helping healthcare providers streamline operations, improve financial performance, and enhance the overall patient experience. Have questions or ready to get started? Contact us today to learn more about our comprehensive medical billing solutions tailored to your practice’s needs.”