Our Services
*
Our Services *
Insurance Billing & Claims Management
Prepare and submit insurance claims accurately and in a timely manner.
Verify patient insurance eligibility and benefits prior to services.
Review claims for completeness, coding accuracy, and compliance with payer requirements.
Monitor claim status through insurance portals and clearinghouses.
Follow up on unpaid, denied, rejected, or partially paid claims.
Investigate claim discrepancies and resolve billing issues with insurance carriers.
Submit corrected claims and appeals when necessary.
Post insurance payments, adjustments, and denials into the billing system.
Reconcile accounts receivable and track outstanding balances.
Maintain compliance with HIPAA and payer-specific billing regulations.
Conduct routine follow-up with insurance companies regarding outstanding claims.
Document all payer communications, reference numbers, and claim updates.
Identify trends in denials and recommend corrective actions.
Escalate unresolved claims according to payer timelines and policies.
Maintain aging reports and prioritize high-balance or time-sensitive accounts.
Coordinate with providers and staff to obtain additional documentation required for payment
Complete initial provider credentialing and enrollment applications.
Manage provider recredentialing/re-attestation processes with insurance carriers.
Maintain accurate provider demographic, licensure, and certification records.
Track credentialing expiration dates and renewal deadlines.
Submit required supporting documentation for payer enrollment and revalidation.
Communicate with insurance networks regarding credentialing status updates.
Ensure providers remain in-network and compliant with payer participation requirements.