Transform Denials Into Revenue Turn Claims Into Cash Flow.

We obtain payer approvals efficiently to prevent delays and denials.

• Authorization Request Submission: Initiate and track pre-certifications for procedures, imaging, and labs.
• Clinical Documentation Support: Compile and attach required medical records for approval.
• Proactive Follow-ups: Regularly follow up with payers until approval is secured.
• Expedited Turnaround: Use electronic and direct-payer channels for faster processing.
• Compliance Assurance: Maintain complete audit trails to meet payer and regulatory standards.

We ensure clean and accurate data entry to improve claim acceptance rates.

• Patient Demographics Entry: Capture and validate key details (DOB, insurance ID, contact info, etc.).
• Charge Entry & Review: Enter provider charges accurately based on fee schedules and encounter forms.
• CPT/ICD Cross-Verification: Match diagnosis and procedure codes for coding accuracy.
• Batch Audit & QC: Run quality checks before claim generation.
• Productivity & Accuracy Tracking: Maintain performance metrics to ensure 99%+ accuracy.

Certified coders ensure accuracy and compliance for maximum legitimate reimbursement.

• Certified Coding Experts: AHIMA/AAPC-certified coders specializing in multi- specialty practices.
• Code Accuracy: Assign precise CPT, ICD-10, and HCPCS codes per documentation.
• Payer-specific Guidelines: Ensure compliance with federal, state, and payer- specific coding rules.
• Internal Auditing: Regular coding audits to maintain accuracy and reduce compliance risk.
• Education & Updates: Continuous training on payer policy and coding guideline changes.

We submit clean claims promptly to accelerate revenue collection.

• Electronic & Manual Submission: File claims via clearinghouses or directly with payers.
• Claim Scrubbing: Use automated tools to detect and correct errors pre- submission.
• Timely Filing Compliance: Track deadlines to avoid claim rejections.
• Duplicate Prevention: Validate against previously submitted claims.
• Submission Confirmation & Tracking: Monitor claim acceptance and payer acknowledgment.

We reduce aging AR and denial rates through focused follow-up and root-cause analysis.

• AR Follow-up: Categorize and prioritize unpaid claims for systematic resolution.
• Denial Analysis: Identify trends and root causes behind recurring denials.
• Rejection Correction: Correct and resubmit rejected claims swiftly.
• Payer Communication: Engage directly with payers for quicker turnaround.
• Performance Reporting: Provide regular AR aging, denial, and recovery reports.

We pursue every denied claim through structured, evidence-based appeal processes.

• Denial Review: Assess denial reason and gather supporting documentation.
• Appeal Drafting: Prepare comprehensive appeal letters citing medical necessity and payer guidelines.
• Timely Filing of Appeals: Ensure submission within payer-specific appeal windows.
• Escalation Handling: Move to higher-level reviews or external appeals when necessary.
• Outcome Tracking: Monitor appeal decisions and integrate learnings into future prevention.

We ensure accurate financial records and transparency through systematic payment posting.

• ERA/EOB Posting: Apply payments and adjustments accurately against claims.
• Reconciliation: Match deposits with posted payments to ensure balance accuracy.
• Underpayment Identification: Detect and escalate discrepancies for correction.
• Denial & Adjustment Tracking: Flag and route denials for follow-up or appeals.
• Reporting & Transparency: Provide daily/monthly payment summaries and reconciliation reports.