OUR CORE SERVICES
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Medical Billing & Coding
Appointment Setting
24/7 Medical Call Center
Account Receivable Services
Medical Billing & Coding
Medical Coding Services is a specialized function in the Revenue Cycle Management which involves healthcare providers, patients, payers and Physician administrative staff. Medical Coders work in tandem with billers to process accurate revenue codes on the basis of the clinical documentation maintained by the healthcare provider. The expertise of a certified and experienced Medical Coder is to ensure quick and denial-free reimbursement to the providers.
Our coders’ expertise includes the ICD-9-CM, Evaluation and Management codes and CPT coding systems with specific training in each specialties we cater .
- Updates on all coding changes and Fee Schedule analysis
- They follow all CCI edits and LMRP standards for coded charts
- Code Audits for unbundling, up-coding and down-coding
Medical Billers
- Medical coders review clinical documentation and assign standardized codes to each service, diagnosis, medication, and procedure that a patient receives. These codes are used to communicate with insurance companies and other payers about what was done and why.
- Medical billers use the codes provided by the medical coders to create claims, which are bills that are sent to insurance companies or patients for payment. Medical billers are responsible for verifying the accuracy and completeness of the claims, as well as following up on any denials, rejections, or errors.
- Medical billers and coders sometimes collaborate to create a superbill, which is an itemized form that lists all the codes and charges for a patient visit. A superbill is used to create claims and to keep track of patient accounts.
- Medical billers and coders also work closely with other healthcare professionals, such as physicians, nurses, and administrators, to ensure that the coding and billing processes are done correctly and efficiently. They may also provide feedback, education, and support to improve the quality and consistency of the clinical documentation and coding practices.
Medical Call Center Representatives
Key Features:
Customer Support
- Interacting with patients and customers to handle complaints, process orders, and provide information about medical products and services.
- Successfully managing large volumes of inbound and outbound calls, sometimes on multiple phone lines.
- Following communication scripts and acting as a contact point between customers and the organization.
Intake and Information
- Managing all aspects of patient intake, including data entry, answering phones, outbound calling, and receiving faxes.
- Maintaining referral source information and logs.
- Communicating with insurance offices for authorization requests and conducting insurance verification and eligibility checks.
Healthcare Provider Support
- Assist physicians, nurses, and other healthcare professionals with after-hours calls.
- Relay messages, handle prescription refills, and coordinate care.
Emergency Call Handling
- Handle emergency calls promptly, assess the situation, and guide patients to appropriate care.
- Dispatch emergency services when necessary.
Appointment Scheduler
Key Features:
Appointment Scheduling
- Coordinate Appointments: The appointment scheduler manages the scheduling of patient appointments.
- Phone and Email Communication: They answer phone calls and respond to email inquiries from patients regarding appointment availability.
- Appointment Length Determination: Determine the appropriate length of time needed for each appointment based on the type of visit (e.g., routine check-up, consultation, procedure).
Patient Interaction
- Professional Communication: Courteously interact with patients, providing information about available appointment slots.
- Confirmation and Reminders: Confirm patient appointments and send reminders via phone calls or other communication channels.
Insurance and Billing
- Insurance Verification: Verify patient insurance coverage and eligibility.
- Billing Inquiries: Address billing-related questions and provide information on payment options.
Conflict Resolution
- Resolve Scheduling Conflicts: Handle situations where multiple patients request the same time slot or when rescheduling is necessary.
- Prioritization: Determine the urgency of patients’ needs to allocate immediate slots or find suitable alternatives.
Accounts Receivable Services
Staff4me account managers provide accounts receivable and billing services.
Key Features:
Census Management
Manage resident eligibility verification, including benefit days left, and review authorizations on file.
Billing
Handle Medicaid, Medicare, Managed Care, and Private/Income billing.
Comprehensive Reporting
Monthly accounts receivable reporting, census and revenue trends, and percentage collection.
Short-Term / Long-Term Resident Tracking
Ensure proper payer sources for all residents and plan for future payer sources for long-term stays.
Medicaid Pending Oversight and Tracking
Real-time oversight to ensure timely Medicaid approvals.
Benefits of Outsourcing
Key Features:
Appointment Scheduling
- Precise and Compliant: Staff4me expertise ensures compliance and precision in revenue cycle management.
- Custom-Built Software: Proprietary tracking and aging software streamline patient intake and reduce billing delays.
- Peace of Mind: Depend on specialists with a sole focus on accounts receivable and billing.
- Scalability: Scale staff resources while Staff4me handles claims efficiently.
Billing and Regulations
- Evaluating all documents to ensure appropriate information has been obtained for billing purposes.
- Developing and maintaining a working knowledge of current Medicare, Medicaid, insurance regulations, and applicable governmental guidelines.