Healthcare Billing Services
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Claim Submission:
Medical insurance claim Submission is one of the key steps in the medical billing process. It determines the amount of reimbursement that the healthcare provider will receive after the insurance company clears the dues.
Denial & Rejection Management:
Our experienced and proactive denial management team carefully analyze your remittance advice to identify the root causes of denials, zero pays, claim reversals and meticulously work on them until the claim is closed out.
Payment Posting:
Payment posting is a critical step of the revenue cycle management of any solo practitioner or healthcare organization. It involves posting and deposit functions and reconciling posting activities with deposits. The payment posting process affects many other functions of the medical office and can have a major impact on patient satisfaction, efficiency, and overall financial performance.
Payment posting also provides insight into a practice’s daily revenue stream and helps practice’s promptly catch potential issues and make corrections. It your practice to be able to see daily insurance payments from EOBs, insurance checks from ERAs, patient payments and more. And having an efficient payment posting system provides an efficient view of your day to day financial picture.
A/R Collection:
Increasingly physicians, clinics, hospitals and healthcare providers are accepting patients who have heath insurance instead of collecting payment directly from the patient using their services. However, some of the health insurance claims of these organizations and professionals are being denied by the insurance companies or only partly paid. Since the costs of providing healthcare is increasing, the profit margins of medical providers is adversely affected when insurance claims are denied. Accounts receivables (A/R) recovery is one of the most effective ways an organization can use to recover the amount due for healthcare services provided. We resolve old insurance claims which remain unpaid, which adversely affect the profit of a practice.
Medical Credentialing
Credentialing can be a tedious and confusing task for medical providers and their staff. Done haphazardly, the process can become a nightmare. Our experienced team can streamline these processes for you and give you peace of mind that all paperwork has been completed accurately and timely. The sooner your providers are credentialed; the faster you can start seeing those patients and making money.
Eligibility Verification
Eligibility & Benefits verification is one of the top most integral part in the Medical Billing process. As per the industry research, most of the insurance denials occur due to improper coverage information.Insurance companies frequently make policy changes and updates in their health plans. If the provider or the billing office is not aware of these changes, this may directly impact the practice revenue. Therefore, insurance eligibility verification of patients becomes inevitable part in the Medical billing process. We at Spectra Solutions have built a template for verifying and updating the member’s benefits and Eligibility.