Medical billing and coding plays a critical role in your entire revenue cycle management (RCM) and you can surely benefit from the services provided by a reliable healthcare outsourcing company. Outsource Strategies International (OSI) offers you medical coding and billing services that will help reduce claim rejection and denial rates while ensuring smooth practice cash flow.
Call us at 1-800-670-2809 for HIPAA-compliant medical billing services. Ask us for a Free Billing Analysis.
Revenue Cycle Management
From patient enrollment and verification to claims submission and denials management, we work closely with you to ensure efficient RCM.
- Patient Enrollment: Once you provide us with the relevant documents, we enter the demographic details of the patients and their insurance information into the medical billing system.
- Verification: Our staffs contact the insurers and verify whether the patient has an active medical coverage with the insurance company and its details. We also confirm whether the policy has been terminated or modified and perform thorough checking of:
- Primary and secondary payers
- Out-of-pocket costs
- Plan exclusions
- Effective date
- Policy status
Prior authorization requests are processed quickly and efficiently.
- Coding: Our AAPC-certified medical coders assign the most appropriate diagnosis and procedural codes to report your diagnoses and services provided. They are also trained in assigning the new ICD-10 codes. Our medical coding specialists keep abreast of the latest coding changes in almost all specialties.
- Billing and Reconciliation of Accounts: We carry out charge entry and cash posting according to the services provided. The charge team enters the patient details from the demographic sheets and check for the relationship of the diagnosis code and CPT code to create a charge as per the rules pertaining to specific carriers and locations. All charges are accomplished within the agreed turnaround time, generally 24 hours. We check for account balance and provide documentation that proves the balance is correct.
- Audit: The daily charge entry is audited to double check the accuracy of the entry and confirm that the rules are being followed accurately. The audit department also verifies the accuracy of the claims based on carrier requirements to ensure we have clean claims.
- Claims Submission and Processing: Once the claims are transmitted electronically, confirmation reports are obtained that are filed after all verification processes. After the review, the claims are adjudicated and processed for payment. Then the check and Explanation of Benefits (EOB) is sent to the provider and the payments are entered into the billing software against the appropriate patient account. Claim rejections, overpayments and underpayments are analyzed and appropriate corrective action including the appeal process is taken.
- Accounts Receivable (A/R) Collections: This includes patient collection, insurance and A/R follow up to ensure high reimbursements.
Let OSI help you experience streamlined medical billing and coding, improved cash flow, efficiency, security and seamless functioning with our service.