Medical Billing Services

Right Revenue’s Medical Billing Services enable our clients to optimize their revenue and receive maximum reimbursements for all the rendered services keeping in mind the latest regulations and requirements the current healthcare delivery system demands. Our end to end Billing services consists of the following:

Patient Appointments - Auditing daily patient schedule against claims received and promptly intimate the doctor's office of any missing claims arising out of lost-in-transit and thus avoiding revenue loss.

Medical Eligibility Verification - Verifying patients’ insurance coverage by phone call to the primary and secondary payors or confirming the eligibility from authorized healthcare insurance portals. We also contact patients for missing information.

Demographics and Charge Entry - Considered as one of the most critical aspect of billing, our experienced specialist billing experts take care of the demographics & charge entry with 100% accuracy and consistency. We record a turn-around-time of 12-24 hours before transmission of claims.

Quality Review - Our dedicated quality team performs 100% quality check of every process of the Billing cycle. The QC report will be transparently shared with our clients on a daily basis to share and track compliance with the quality standards and performance in accordance with standard operating procedures.

Electronic Claims Submission/Rejections Resolutions - Our billing specialist maintain a 100% clean claim submission standard. Any denial with respect to insurance claim submissions electronically is resolved promptly by contacting the healthcare insurance payor, doctor’s office and/or patient for additional information; for eg, incorrect payor ID.

Payment Posting – ERAs are posted electronically and paper EOBs are manually by our payment posting experts who have a detailed knowledge to co-pay/coinsurance, deductible and billing the secondary insurance wherever applicable. Before closing the day by totaling the payments received and balancing with bank slips/accounting, every payment line posted is reviewed for accuracy and error-free statements.

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Denial analysis & Resolutions –Our expert denial resolution team detect the trend and track the percentage of denials daily and also segregates the denials into 3 pools:

Medical coding pool – Takes care of coding issues such as insurance specific coding reporting requirements; eg, -bilateral (50) billing or quantity billing and attends to request for medical records.

Demo/payment posting pool – Takes care of change in insurance policy, change of patient’s address, out-of-network claim status and deductibles, incorrect reporting of DOB etc.

Account Receivable pool - Authorization issues, referral issues, non-participation with insurance network, terminated insurance, coordination of benefits, no status and no claim on file etc.

Accounts Receivable follow-up- Our expert A/R specialists keep a hawk-eye on the A/R. Electronic claims follow-up begins 8 business days post submission and paper claims is followed within 21 days of submission. The aging report is further broken down into 0-30 days, 30-60 days, 60-90 days and 90-120 buckets. All our A/R specialists aggressively follow-up on claims via online, interactive voice response system and calling the insurance company representatives. A/R reports are generated on a weekly basis to target and resolve high dollar value claims and aging claims on priority.