Private Medical Billing Services


CompuClaim’s medical billing division brings over 20 years of experience and expertise to private medical practices. We keep pace with industry trends, so we can anticipate and plan for changes that affect you.

Let us work with you. You will have the advantage of an expert, full-time billing staff without the full-time salaries. We will manage the business of your practice, so you can get on with the practice of health care. Our medical billing services include the following services:

Revenue Cycle Management
Accounts Receivable Follow-up
Denial Management
Remittance Management
Claims Edits
Interface Coding/Charge Capture
Collections

REVENUE CYCLE MANAGEMENT

We Know Revenue Cycle Management. Our information systems and skilled staff are powerful resources that you can utilize to improve revenues and manage your revenue cycles efficiently and effectively.

  • Our reimbursement specialists have the expertise and tools to deal with multiple payors, complex reimbursement methodologies, regulatory issues, and patient demands.
  • Our state-of-the-art Billing and Information System ensures faster, more efficient claims processing for all major insurance carriers.
  • CompuClaim staff helps our clients understand compliance rules and regulations

Create an alliance with CompuClaim as your partner in revenue cycle management. We offer added value at every stage in the process.

ACCOUNTS RECEIVABLE FOLLOW-UP

We use systems designed to achieve maximum net revenue in the shortest amount of time. By using a combination of subsequent insurance claims, statements, pre-collection letters, and telephone calls to patients based on your payor mix, our staff stays in contact with your patients.

  • CompuClaim’s accounts receivable recovery strategies are implemented in a manner that gets results, while preserving your image and reputation.
  • The accounts receivable and recovery services that CompuClaim provides are ideal for large hospitals or a single practitioner.
  • CompuClaim’s collection efforts are pursued with the highest level of integrity and the strictest adherence to all state and federal laws, all with a zero tolerance for complaints.

Whether you seek the lowest possible cost, or the maximum recovery ratio, our service satisfies the need for profit improvements.

DENIAL MANAGEMENT

Improper denials are the leading cause of practitioner’s revenue loss. It is important to employ proven strategies to prevent claims rejections from occurring.

  • We work hard to prevent denials from occurring and, when they do, we work quickly to resolve them. We have procedures on the front end to help minimize the quantity of denials received.
  • We watch denial trends by specialty and provide updates to our clients at periodic meetings.
  • In addition, because of our claims volume, we are able to arrange meetings with payors, when necessary. A dedicated team is assigned to follow up on insurance carrier rejections.

Our staff monitors rejection trends and provides you with information you can use to prevent future denials.

REMITTANCE MANAGEMENT

Many insurance carriers pay claims incorrectly by taking incorrect or completely invalid discounts not agreed to contractually by the provider.

  • We verified and posted payments to the correct individual line item of the patient’s account.
  • If any payor makes invalid payments, our remittance specialists follow up with the payor consistently, until the payor corrects the issue.

The importance of accurate and timely payment posting cannot be overemphasized.

ELECTRONIC CLAIMS MANAGEMENT

Electronic claims management makes tracking claims status – and receiving and resolving denials, where necessary – faster and more efficient.

  • We are able to track your claims to ensure that they reach payors on a timely basis.
  • Claims errors, when they occur, are usually received within 24 hours of submission and many can be corrected online and re-sent to the payor immediately.
  • We can also see and sort denials by payor in order to identify problems or opportunities to improve the process.

Our process facilitates every step of the management of electronic claims.

CLAIMS EDITS

Failures caused by inadequate or inaccurate data in the charge capture process can jeopardize revenues, customer satisfaction, and regulatory compliance. When clean claims are delivered to payors, you realize revenues more quickly.

  • CompuClaim has experienced coders who are experts in translating medical terminology variations into accurate codes.
  • Our coders work diligently to ensure that clean claims are delivered to payors on a timely basis.

Before any charges are captured, we lay the groundwork. We provide you with interface specifications that include specific data elements and other requirements for completing the billing process.

COLLECTIONS

CompuClaim’s support systems monitor, assist, and improve the efficiency and effectiveness, of each collection effort while providing management information for daily, hands-on decision making.

  • If patient accounts reach the collection stage, CompuClaim, follows the Fair Debt Collection Act (FDCPA) guidelines.
  • Our staff is trained to minimize the negativity associated with the collection process.

Collections are a part of the revenue management cycle. It is important to have a follow-up process in place to help you maximize your collections.

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