Are you finding it difficult to achieve a smoother administrative experience and generate better revenues? Is your organization falling short of trained resources to handle your revenue cycle management requirements? Then, the best option for your organization would be to opt for revenue cycle management outsourcing to experienced revenue cycle management companies. The service provider will not only help you generate better revenues by reducing operational costs but also provide your clients with a smooth administrative experience.
Aqkode Healthcare Solutions provides high-quality and cost-effective revenue cycle management solutions to global customers. We can help you collect payments on submitted claims, increase the revenue from underpaid claims, and follow up with insurance companies for quick settlements. Read below for a breakdown on how it all works, and how we can help.
Medical Billing, Coding, and Auditing Services to help your practice focus on what matters the most.
Aqkode Healthcare Solutions has fine-tuned the entire Revenue Cycle Management process.
Step 1 – Credentialing is not DYI project. The consequences of incorrect provider enrollment and credentialing are costly. The provider can be terminated from payer networks, lose hospital admitting privileges, and see dramatic reductions in new patients and revenue.
Step 2 – Collect information before patient arrival. The term authorization refers to the process of getting a medical service(s) authorized (pre-authorization or prior authorization) from the insurance payers. Without authorization, the insurance payer is free to refuse the payment.
Step 3 – Once the patient arrives at your facility, the receptionist or front desk staff will collect and enter patients information into your CRM or billing system.
Step 4 – For a specialist or internal medicine, verification of insurance eligibility is necessary as it is directly linked to claim denials or payment delays of any healthcare services.
Step 5 – Properly code diagnoses and procedures, IICD, CPT & HCPCS Coding. When a claim is coded accurately, it lets the insurance payer know the illness or injury and the method of treatment that is necessary.
Step 6 – Level of coding can be based on total time spend or medical decision making. Total time must be documented to code the level of service for new or established patients. Total time includes non-face to face reviewing data prior to face to face with patient on the same day.
Step 7 – We follow a well-structured charge entry process ensuring that relevant checks are made at each processing stage. This enables us to manage a zero-error process and provide our services to you with speed and efficiency.
Step 8 – Submit claims of billable fees to insurance companies, this includes: Plan Benefit Administration, Providers and Contracts, Members Enrollment Processing, Claims Entry and Processing, Re-Pricing of UB Claims, Agent Verifications, Referral Authorizations and Credentialing.
Step 9 – We will assist whenever a patient may be referred by one professional to another, who may be a specialist or more knowledgeable in the diagnosing and treatment of the patient.
Step 10 – After the adjudication of the claim from the payer, the claim will be either paid or denied. If the claim is processed towards payment from payer, then a payment will be issued to the provider (medical office) from the payer (insurance company).
Step 11 – A claim is REJECTED if patient’s demographic info is incorrect by the clearinghouse. If the claim contains correct demographic information, it is accepted by the insurance company and a claim ID is assign. If the claim is challenged by the insurance company it is called DENIED claim.
Step 12 – After a decision has been made from the insurance company, one of several actions will occur: insurance payment denial explanation, additional documentation request, authorization approval or rejection, medical necessity determinations, bill under review or legal correspondence.
Step 13 – Our team analyzes, tracks, and reports denials, identifying unpublished rules and recommending fixes for individual denied claims while helping you identify and implement process improvements to eliminate recurring denials and optimize revenue.
Step 14 – Managing Accounts receivables and working to reduce the number of days to collect for services rendered is yet another crucial piece of medical billing. Understanding payer processing times, payment policies and documentation requirements are a few of the ways in which we decrease AR, increase revenue and reduce stress.
Step 15 – Auditing is key to ensure the properly levels are coded. If you are under coding, you are losing out on the additional reimbursement. If you are upcoding you’re at risk for audits by Insurances, they can take back the difference on future payments.
Why Choose Aqkode Healthcare Solutions?
Increased transparency with financial reports
Better Revenue Cycle Management
Reduce operational costs
Process claims faster and more effectively
Eliminate financial and billing errors
Pre-billing review and coding analysis
Generate more revenue with better financial models
Managing inquiries: patients, insurers, and regulatory authorities
AAPC Certified professional billers, coders and M.R.A., E/M chart auditors
Most practices can't match payer technology, sophistication and man-power. We can help.
Taking care of your patients is what you do best.
Taking care of your billing is what we do the best.
