Comprehensive Billing Services
Our back office expertise is in providing services on claims follow-up, eligibility verification, appointment scheduling, filing of scanned medical records, claims entry, Payment posting, Denial & EDI rejections.
Due to rising costs for billing companies, healthcare providers and reduced insurance reimbursement rates offices should not burden their staff with task that can be performed by our team for a lesser fee along with better results. We hire the experts for auditing to insure optimal outcomes for our clients and always guarantee confidentiality.
MeDocto's Best RCM Services
Eligibility Verification with Payers
We specialize in insurance verification services, ensuring accurate patient information and eligibility checks to streamline the billing process and reduce claim denials for healthcare providers by three ways.
Online-Using various Insurance company websites internet payer portal we check patient coverage.
Automated Voice System (IVR) - By calling insurance company directly an interactive voice response system will give the eligibility status.
Insurance Company Calling Process - If necessary calling an insurance company representative will give us more details of patient’s benefits.
For coding our certified coders received medical reports through scanning and revert back after coding to physician’s billing office or Claims entry team to feed the codes in medical software and submit the claims.
Medical Coding
Demographics & Claims Entry
For claim creation the process starts with Demographics entry and insurance verification. Either through scanning documents to our team to generate encounter: Patient’s profile, insurance information and ICD/CPT codes.
Payment Posting
Explanation of Benefits {EOB} payment posting is done as service using two methods described below.
Manual Posting- EOBs are sent to the posting team by scanning them in at the doctor office level or having them picked up directly at the provider location. Once they are retrieved posting is done only after creating batches of payments. This batch system allows for proper accounting making sure that the money deposited into the doctor’s checking accounts matches our posting.
Auto Posting- EOBs payments come in form of ERA (Electronic Remittance Advice) files which are downloaded directly into the provider’s Medical Practice Software. All posting is done directly in the system so the provider can audit any time.
Our follow-up service is designed to increase Revenue Collection for physician offices. The process begins after the doctor’s office biller crates and sends Health Insurance Claims (Electronic/Paper claims form) to various insurance companies. Depending on the transmission type and length of time since submission we begin our follow-up:
Electronic Claims- Follow-Up begins 10+ days after submission claims.
Paper/HCFA Claims- Follow-Up begins 20-45 days after submission claims.
Insurance Follow-up
Denials & Appeals Management
Our Denials and Appeal Management service is designed to increase Revenue Collection for Physicians office.
Our expertise managing denials for various reasons:
Authorization Issues Referral Issues, Medical Necessity, Medical Records Request, Non-Participation with insurance Network, Terminated Insurance, Coordination of Benefits, Wrong Diagnosis & Procedures, Partial Payments, Out of Network claim status & Deductibles, Letter of protection from Attorney cases, No status No claim on file, EDI Rejections Etc.
EDI Rejections
Electronic Data Interchange (EDI) rejections in
medical billing occur when a claim file stops
processing before reaching Medicare. Some
common reasons for EDI rejections include:
Invalid diagnosis code
Invalid or missing payer ID
Mismatched claim data with codes
Incomplete insurance provider
informationClaims for newborn patients
EDI file syntax errors
Client Feedback
Our clients trust us for reliable revenue cycle management services.
Medocto's services streamlined our billing process, improving cash flow significantly.
John Doe
New York
The team at Medocto provided exceptional support, ensuring our claims were processed efficiently and accurately, which greatly reduced our administrative burden.
Jane Smith
Los Angeles