We provide revenue cycle management solutions to a wide variety of USA healthcare specialties and organizations to cut through the complexity with our expertise, operational excellence, and a sophisticated approach. With experience since 2013, our RCM billing experts are well versed in all medicare billing rules, medicaid state plans, managed care plans, commercial and third-party insurance, and more.
RCM Services We Provide
- Insurance Verification and Pre-authorization
- Medical Coding
- Demo Entry and Charge Entry
- Electronic Claim Submission and EDI / Front End Rejection
- ERA and Manual Payment Posting
- Denial Management and Appeal Process
- A/R Insurance Follow-up
- Patient Credit Balance review and Secondary Billing
- Patient Statement Electronically
- Monthly Reports
Medical Coding Services
- Medical Coding services that ensure compliance, accuracy and results
- Certified American Academy of Professional Coders (AAPC)
- Diligent coding compliance at all levels
- Coders receive comprehensive training in specialty-specific areas, and have a minimum of a Bachelor's degree in a healthcare-related field.
- Experienced Coders can help you improve patient care by using appropriate code and better documentation practices.
- Coders will work on coding related denials and reduce AR backlogs.
- Our Team can deliver quality coding work within the turnaround time.
Front-End Fixes, Transaction Processing & Payment Posting
- Prevent missed revenue opportunities
- Insurance and benefit verification
- Pre-authorizations to prevent claim denials
- Enable the claims to be processed at first pass and receive payment in a timely manner.
- EDI / Front End Rejection and Resubmit the claims on time
- Patient Demographic and Charge Entry
- Submit claims electronically
- Payment posting with Manual EOB and Electronically
- Capturing all denials in the software
Denial Management and Insurance Follow-up
- Denial Management specialist review the EOB / ERA denial based on payer guidelines to take action.
- They work on web portal, software and take appropriate action.
- Team has experience to send out appeal & determination letter to payer.
- Timely Turnaround to recover and close out accounts receivable.
- Analysts adept at trending denials and looking for patterns of deficiency
- Insurance Follow-up team work on all pending accounts
- Increase cash flow and reduce aging A/R
- Print Patient Statement
- Monthly Reports
We deliver a comprehensive suite of RCM services customized for each client - to serve as an extension of your in-house team. We follow industry-standard and key performance metrics to measure success and integrate best practices, so that you get the value of our proven experience and skill, including
❖ Strategic coding partner who can deliver 95% plus accuracy in coding
❖ Accurate, timely and regular reporting
❖ Pragmatic recommendations for front-end fixes
❖ Improved coding accuracy and resolution while delivering bottom line results
❖ Constant communication with respect to documentation, providing actionable recommendations to eliminate claim denials
❖ Instant ramp up or ramp down to deal with workload spikes
❖ 24/7 continuous operation on demand
❖ Access to latest technology and highly secured IT infrastructure
❖ Understands Your Needs
Having a partner who truly understands the best way to address the financial burdens you face is imperative. That's why we at Integra deliver RCM coding solutions specific to your needs and work with your existing system using its in-built tools.
❖ Save Money
Healthcare practices and providers and DME companies are constantly evaluating their business models to address their shrinking profit margins. By using our revenue cycle management services, you get instant access to qualified billing and coding specialists. Our service is tailored to help you save costs.
❖ Better Management of Staff
You can reduce the burden on your staff and manage them better when you outsource your revenue cycle management to a reliable RCM company like Integra to handle day to day RCM activities.
❖ Access to a Highly Skilled Team
As your trusted revenue cycle management company, we help you with a highly skilled and expert team of medical billing and coding specialists to handle your projects. Our coders receive comprehensive training in specialty-specific areas, and have a minimum of Bachelor's degree in healthcare-related fields.
❖ Greater Customer Satisfaction
We take our responsibilities seriously especially when it comes to our clients. We've been given a 97% positive service rating by our clients. Our RCM coding specialists are here to take care of your projects and we work hard to find new ways to ensure your experience with us is nothing but exceptional.
❖ Greater Accuracy and Increased Efficiency
The efficiency and accuracy of your billing processes are crucial for the success of your medical practice. Outsourcing your revenue cycle management to a reputable company like EdithPro can help achieve this and increase the cash flow of your business.
Book a free consultation today to explore the possibilities.
Get in touch with us to find out how we can help your business achieve its goals. We have helped 100’s of companies small to large, since our inception in 2013.