BillingEdge is a leading provider of RCM Services empowering healthcare organizations to achieve business transformation and growth through our innovative healthcare services. An experienced Medical billing & coding company knows that a strategic approach to insurance and patient billing generates greater results. This makes us a premier on/offshore billing company, supporting our clients to achieve cash flow success. We understand that every client is different. We don’t stand on ceremony around our company standards. We strive to help you achieve your objectives by doing whatever is necessary to get the job done & consistently work towards achieving operational excellence to earn more business.
Credentialing
Encounter / Super-Bill Designing or Redesigning
Eligibility Verification / Pre-Authorization
Patient Registration / Demographics Entry
Charges Entry
Electronic Claims Submission
Denials Management
Cash / Payment Posting
Account Receivables Management
Old AR Clean Up / Recovery Services
Patient Billing & Statements
Reporting & Statements
At BillingEdge we help you by creating a new encounter form or
assist you in updating your existing form with latest diagnosis
and procedure codes. We clearly understand that every step of
the medical billing process is important and thus ensure to
start it with clean encounter forms. Incorrect or invalid codes
in the encounter form causes rejections and denials, this in
turn affects the cash flow.
An Encounter form or Superbill or Charge Sheet is a very
important document in the medical billing process. A healthcare
provider indicates all the diagnosis and procedures of a patient
in the encounter form. An encounter form is filled in by the
provider for each patient’s visit. Medical billers use this form
to enter charges in the practice management software.
We take the time and carefully draft a clean specialty specific
encounter form. Our forms are easy to read with all the commonly
used codes by our clients. It also covers patient information
like Name, Date of Birth, Date of Service, Insurance Name,
Patient Payments, Location and more.
BillingEdge Healthcare Services is a leading revenue cycle
management company, delivering provider enrollment,
credentialing and managed care contract negotiation services.
We work with all providers including hospitals, physicians,
Ambulatory Surgery Centers, sleep labs, rehabilitation (PT, OT,
SLP, DC) providers,diagnostic testing facilities and providers,
podiatrists, optometrists, and more.
Our team is focused on reliability, commitment, confidentiality
and industry knowledge. In a nut-shell, we provide high quality,
flexible healthcare consultancy.
We offer the following services:just
Let our specialists take away the headache of filling out all
the paperwork and cutting through all the red tape for you. We
get you credentialed and enrolled with all of the federal and
commercial insurance companies and we get it done right! We take
your information and get to work immediately and donot stop
until it is completed and you are 100% satisfied.
Provider Enrollment Services / Physician Credentialing
Services
Free yourself of all the headaches, hills of paperwork, and
confusion with the insurance companies!
Trust the experts at BillingEdge Healthcare Services to help you
navigate the difficult process of provider enrollment and
medical credentialing all at a low cost!
Simply put, we handle the entire enrollment and credentialing process from start to finish for one low flat fee!
Enrolling with Medicare is one of the most difficult challenges
that healthcare providers face today! We do it all for you from
start to finish. We complete 855A, 855B, 855I, 855R, 855O, 855S,
588, and 460 CMS forms. We assist with Medicare Revalidation as
well!
BillingEdge Healthcare Services specializes in all areas of
Medicare enrollment, working rapidly so that you can be
correctly enrolled with your Medicare administrator. We service
nationwide providers, physicians, non-physician practitioners,
and more
Let Us Fill Out Your Medicare CMS Applications
Opening a new practice can be hectic. We will provide you with
the help that you need to complete your Medicare enrollment and
revalidation applications even when your submission has been
returned because of errors (or) of a delay. Keep in mind that if
your application is not correctly filled out, then you could end
up losing thousands of dollars in revenue. That is why we are
here to help you. We have an understanding of all of the
Medicare enrollment rules. For more information, call us at
800-253-7320 or fill out our contact form.
Eligibility Verification Service makes sure that the insurance claims of your patients are checked thoroughly so that they are eligible for the reimbursement. Hence, the smooth flow of the Revenue Cycle Managementof a healthcare system is directly proportional to the efficiency of the eligibility Verification service that you have employed. Most of the claims are denied just because they are billed to a wrong insurance carrier or someone not standing tall on the eligibility status. Thus a quick and detail minute check of patients credibility goes high just before their admission to the hospital. We understand this well and hence offer a strong eligibility verification service to make your claims immune against insurance denials.
We aim to boost your Revenue Cycle Management through providing an Eligibility Verification service that will guaranty towards achieving 100% acceptance of claims and for that we do the followings;
Having us at your side will
We will
Apart from that, we can keep a tap on the recent health
insurance policies to make sure that your patients can avail
maximum medical reimbursement. The experts have their knowledge
up to date with current health terminology to offer your
quick-processing service thereby aiding towards a healthy
Revenue Cycle Management.
So what are you waiting for? Get in touch with us today!
Data capturing is the first step in the entire claims
reimbursement cycle. We understand its importance and ensure
patient demographic and insurance information are captured
accurately. We thoroughly review patient intake forms and our
experienced billers enter them into Electronic Health Records
Software or Practice Management Software. Our systematic entry
process eliminates rejections and reduces denials. We ensure all
the information received is entered into the software within
12-24 hours from the time of receipt.
Paper Forms and Scanned Images :
You can send us paper intake forms or scanned images of the
forms.
Electronic Medical Records Entries :
We can make new entries or completely review patient
demographics information entered at your office for accuracy
before claim submission.
New Patients Vs Existing Patients :
New Patients : For new patients we capture patient
information, guarantor information, Insurance information,
Provider information and employer information.
On existing Patients : We verify and update any new
information received.
Charge entry process plays a crucial role in overall billing
management. Charge entry is a process where actual claim is
created for a particular date of service. A claim is the most
important aspect for getting reimbursements. We give high
importance for accurate charge entry in order to submit clean
claims.
We can capture data from charge sheets, scanned
documents and can review charges entered in EMR / EHR for
accuracy. Our team has the experience to analyze and ensure to
enter all the required information to submit a clean claim. We
link appropriate diagnosis codes to the procedures in order to
eliminate denials. We help you to streamline all your data entry
process.
Our high quality data entry ensures we capture all the
procedures performed along with required modifiers. Our
experienced billers are well aware of each payer requirements
and process the entries based on their specifications. We
consistently keep track of industry changes and requirements,
which enables us to submit clean claims.
BillingEdge submits all your claims electronically within 24 hours
from the time we receive the encounters. Electronic claim speeds
up overall claim processing times. It also provides a
confirmation that your claims have reached the payer on time.
Electronic claims reduce your claims submission expenses by 40%
to 50%. Electronic claims reduce rejections and denials
drastically. We can submit the claims directly to many payers
and also use many different clearing houses.
Electronic claim submission allows you to reduce your
administrative expenses and improves cash flow substantially.
Many payers have very strict claim filing time limits.
Electronic claim filing helps us to stay on time and enhance
cash flow. As soon as claims are filed electronically a
confirmation and rejection report is generated. These reports
help us to improve operational efficiency. Confirmation reports
provide us the list of claims that have gone through to the
payers. Rejection reports provide us the list of incomplete
claims. Electronic claims submitted are commonly scrubbed for
payer, specialty and coding rules. We work on rejected claims
immediately and resubmit them with required corrections.
BillingEdge’s denials management decreases your AR days and
increases your collections. Our specialty specific guidelines
help our AR experts to resolve denials efficiently. We look at
no-pays and low-pays and get to the root of the problem. Our
experts not only fix a denied claim but proactively make changes
to our procedures to avoid future denials. Our AR team works
very closely with our coders to fix and eliminate coding related
denials.
BillingEdge’s denials management follows principles of
tracking, categorizing and analyzing.
Tracking : We review explanation of benefits received
from all payers. We track all partial payments and
Non-payments.
Categorizing : We categorize denials by type and assign a
denial code to it. Our categorization determines and clearly
list down common denials.
Analyze : We analyze the types of denial and list them on
bases of numbers and claim value. Our experts conduct root cause
analysis for each denial category and fix them immediately. Our
standard operating procedures are modified / updated in order to
avoid and eliminate these denials in future.
We provide high quality, accurate and efficient payment posting
services. We post all your payments to respective patient
accounts on the same day. We post, balance and reconcile all
payments received within 12-24 hours. Our daily reconciliation
process assures smooth month-end closing. All payments received
for the month are accurately accounted and matched to actual
deposits.
Standing high on outstanding account receivables is what every
healthcare company tries to avoid. If it grows more, the healthy
cash flow of the organization gets affected. The revenue takes a
bad hit and reversing the situation gets equally difficult. So,
it is vital to have Certified Medical Coders and the support of
an expert to tackle Account receivable is essential. If you are
a healthcare provider and your economy is going through similar
situation, then you too need experienced service provider, and
that's where we come into the picture.
Our approach:
We can ensureyou get paid on all your claims in a most efficient
and timely manner under our Account Receivables Management
service. We adhere to an efficient denial management process
based on your payer mix and outstanding account receivables.
BillingEdge Byte our in-house software tracks and monitors every
step of the entire medical billing process. Our accuracy and
turn around time has been higher than the industry standards
always.
We process all demos/charges/payments within 12-24 hours
of its receipt. We send clean claims immediately to the
insurance companies. Our follow-up calls are automatically
triggered by our BillingEdge Byte software which has been set with
high standard AR metrics. We have efficiently increased a
minimum of 5-8% of all our client’s revenues.
Our old AR clean up / recovery services help you to collect on all your unpaid claims. We do appeals and follow up on unpaid balances aggressively. We can perform these services on your billing software without disturbing your regular work-flow. Get access to additional revenue, which you thought can never be collected.
"Get your money now. Let us handle the
process"
We understand how insurance companies adjudicate their claims
and strategize our follow up accordingly. Our experienced
follow-up staffs analyze and ensure your old claims are paid
quickly. Our staffs categorize the outstanding claims based on
AR days and type of insurances. We start our follow up and based
on the outcome of the calls we appeal, re-bill and send
additional documents. We look at payer's claims filing and
appeal limits and prioritize our follow-up accordingly. Overall
we aggressively follow up with insurance companies and resolve
unpaid claims.
BillingEdge provides comprehensive patient billing solutions. We understand the importance of collecting every dollar and bill patients on time. Unpaid balance, co-pays, non-covered services, deductibles, out of pocket expenses are billed to the patients. We generate patient statements every 15 days to ensure quick payments.
“Bill on Time, Get Paid on Time”
If patients have any questions regarding their bill, they can
reach our customer services department during normal business
hours. Our on time patient billing and statement generation
services help you to optimize your collections. Our services
help you to accelerate cash flow and also ensure good customer
services. All patient payments received are immediately posted
into the accounts.
Medical billing reports help to provide a complete picture of our
performances. Our reports help you to understand the overall
financial situation and performance. Our reports empower our
clients to make necessary changes required to receive optimal
reimbursements. We provide various reports helping you to
analyze performances overall. Our reports help you to make good
business decisions.
Our medical billing reports help you to understand
various trends. We provide reports based on insurance and
pending AR days. All changing trends are clearly reported and it
helps to identify delinquent accounts. Monitoring our reports
for few months will help to precisely focus on the areas for
improvement resulting in higher collections.
“Our reports help you to determine if your claims
are getting paid on time”
Our Medical billing reports provide key performance indicators
helping you to assess and reassess strategies every month. We
understand each client is different and provide client specific
customized reports. Our reports indicate and provide detailed
visibility into your standard operating procedures. We provide
monthly reports and specific reports whenever required.