Remittance & Payment Management

  • Assignments of diagnosis codes by the physicians and other clinical staff reviewed for the highest level of specificity
  • Procedure codes reviewed to ensure appropriateness and documentation support in the medical record
  • All documented services, diagnostic tests and treatments coded and billed
  • A designated contact at the practice notified of missing and incomplete documentation
  • Confirmation of data elements prior to claims submission decreases denial rate and reduces account receivable turnover
  • All required information included on the claim with the first submission
  • Known requirements of payers that require special attention to their claims requested from the practice
  • Payer responses tracked to determine and identify new and unique payer requirements that should be implemented
  • Payers not paying for more than one service or test on the same date of service communicated to the practice
  • Equal attention in the claims processing work flow devoted to high dollar and low dollar claims
  • Matrices of timely filing limits and reimbursement contracts for third party payers