Our Services

Claim Submission

We handle the entire claim submission and processing workflow with precision, ensuring providers receive timely and accurate reimbursements. Our process begins with reviewing and analyzing the diagnosis and procedure codes provided by the healthcare provider to ensure accuracy, compliance, and proper claim formatting. We check for potential coding errors, required modifiers, and payer-specific guidelines to minimize the risk of denials or underpayments.Once coding accuracy is verified, we submit claims electronically through a secure clearinghouse or via paper submission when required. Electronic claim submission allows for faster processing and real-time tracking, reducing delays associated with manual submissions. Our team actively monitors all submitted claims, ensuring they move through the insurance processing system without issues. If a claim is rejected or delayed, we quickly identify the problem, make necessary corrections, and resubmit to avoid revenue loss. Payment posting is another essential step in our process, where we review Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) to ensure payments are correctly applied to patient accounts. Any discrepancies, underpayments, or missed reimbursements are flagged for immediate follow-up.Denial management is a key part of our services, as even properly submitted claims can be denied due to technicalities, missing information, or payer-specific policies. When this happens, we analyze the reason for denial, correct any errors, and submit appeals within payer deadlines to recover revenue. Our proactive approach ensures that denials are not left unaddressed, preventing financial loss for our clients. Beyond individual claims, we provide in-depth reporting and analytics to help providers understand their revenue cycle performance. By tracking claim approval rates, identifying denial trends, and analyzing aging reports, we offer actionable insights to optimize financial operations.