Our coding experts (with analytical solutions) will help you in reducing the overall denials related to Coding at the beginning itself by identifying the problems that are eating out into the revenue of a provider
Cash posting plays a major role when payment or denial is received from the insurance company. Our domain expertise in the revenue cycle management monitors both cash flow and denials from the insurances to improve the overall efficiency of the entire system.
Patient Registration & Charge Entry
Data provided by the Doctor’s office is captured based on the ICD & CPT codes into practice management software once coding is completed. Once entry is completed, claims are transmitted to the clearinghouse. At World PAG, we have a very less TAT between the service and charge entry dates
At World PAG, we are committed to increase your collections by reducing the outstanding receivables, with regular follow up with the insurance companies / patients by our experts’ who has got more than a decade of experience in the overall revenue cycle management will ensure smooth cash flow to your business in a cost effective manner.
Patient Scheduling & Management
- Scheduling of patient appointments with the providers over the phone / web based chat / app based applications
- Collection of patient’s data including demographics, insurance and reason for visit / chief complaint information over the phone and updating the same in practise management software at the time of appointment which reduces considerable amount of time spent by a patient at the clinic / hospital
- Verification of Benefits (VOB) – After collecting patient’s insurance information, patient’s benefits will be verified thru the respective insurance websites or calling the representatives to collect Out of Pocket Expenses (including Copay, Deductible and coinsurance information), which in-turn saves huge amount of time for both patients and the providers.
- Sending reminders to patients on their schedule date for confirmation / cancellation of appointments
Billing and Collections
- Once patient visits the clinic / hospital and gets the treatment from the doctor, data will be captured into Practise Management Software system within 4-5 days based on the codes provided by the Doctor’s office
- Claims Audit process will take place before the electronic claims are transmitted thru the clearing house to the respective insurance companies
- Based on the scrub reports from the clearing house, action will be taken on the rejected claims within 24 / 48hours
- After receiving the payments and Explanation of Benefits (EOB) from the insurances, action will be taken accordingly; payments will be posted into software and the denials will be taken care of separately by following up with the insurance companies to find out the exact reasons, will inform the insurance representative to reprocess the claims if all the submitted information is appropriate from the provider side, else, will collect the appropriate data from the Provider’s office and resubmit the claim within the stipulated time.
- Follow up on the unpaid / aged claims if no payment received within 30-45 days for electronic claims.
- Taking care of mailing patient statements thru third party applications if it is electronic (cost effective method) or mailing the paper statements to the patients (from the local office which is expensive compared to electronic method)
- Follow up on Aging accounts which are more than 120+ days and sending final notices to the patients based on Doctor’s approval if they have received more than 4 statements during this period.
- If patient is willing to opt for a payment / budget plans, and making regular payments, then they will be eliminated from sending their accounts to an external collections agency.
- If there is no response from the patient then the accounts will be moved to the collections agency based on Doctor’s confirmation.
- Data Entry
- Account Receivable
- Revenue Cycle Management
- Insurance Verification
- Patient Records
- Medical Billing & Reimbursement Records
- Patient Demographic entry
- Claim submission
- Claims Records
- Texts or Lab Records
- Collecting Co-pay
- Payment Posting
- Medicare & Medicaid
- Cash flow increase
- Reduce staff size and employees expenses
- Eliminate training costs
- Reduce call volume
- Customized Client Services
- Secured data facility
- Assured productivity and service levels
- Increase Revenues and decrease expense
- Improve your cash flow
- Eliminate medical billing headaches
- Collect more money faster
- Reduce staffing liabilities
- Reduce payer denials
- Reduce errors
- Focus on patient care not billing
- Efficient, accurate and complete data exchange
- Monthly practice analysis & collections reporting meetings
- All Claims submitted within 24-48 hours
- 100% Claims Follow-up for faster receivable
- Reduce payer Denials
- HIPAA Compliant
- Free 30 day trials
- Patient Statements and balance collection