Medical Billing
The aim of our billing services is to provide our clients with maximum reimbursement on the backend by utilizing efficacious billing processes. Medical billing is the process of submitting and following up on claims. This requires the bulk of day-to-day activity as amendments must be made and correspondence back-and-forth with the insurance company and patient will be required. Medical billing is the last step on the end of the healthcare provider. From this point on the facility should expect to receive a payout or an explanation. Medical billing is the collection portion of the business and is necessary for any healthcare facility to survive.
Medical billers are expected to be knowledgeable about the appeals process, timely filing, as well as coding guidelines and insurance policies. The medical biller works off all the information provided on the CMS-1500, CMS-1450 or the UB04 form. Medical billers also follow up with insurance companies via insurance portals or phone to follow up on denials and to ensure they are being reimbursed to all the compensation the facility is entitled to.
At EHS we are able to work with the EHR system your facility already has in place or we can use our own software system, in compliance with HIPAA, to minimize your expenses.
Medical billers are expected to be knowledgeable about the appeals process, timely filing, as well as coding guidelines and insurance policies. The medical biller works off all the information provided on the CMS-1500, CMS-1450 or the UB04 form. Medical billers also follow up with insurance companies via insurance portals or phone to follow up on denials and to ensure they are being reimbursed to all the compensation the facility is entitled to.
At EHS we are able to work with the EHR system your facility already has in place or we can use our own software system, in compliance with HIPAA, to minimize your expenses.
Payment process
1) Patient is seen by a physician who evaluates the patient and provides treatment. Evaluation and remarks are observed then recorded. The information the physician provides is then given a designated ICD-10 code that accurately describes the primary diagnosis (or chief complaint) as well as any clinical findings. The treatment that was provided is then logged using CPT code language and any necessary modifiers.
2) Diagnosis and treatment codes are then checked for accuracy on the super bill.
3) Medical billing specialist then take over from this point and input the information listed above as well as insurance information and additional documents into the medical billing software. When all this information is properly compiled, ordered, and sent out to the parties involved, a claim has successfully been created. Claim is also double checked here to ensure accuracy and fulfillment of all necessary information for insurance companies.
4) Follow up is necessary for the back-and-forth correspondence between the insurance company, clearinghouse, and your facility.
About:
Eliza’s Healthcare Services, LLC was founded with the mission to provide affordable, quality medical coding, billing and auditing services to healthcare facilities, private clinics, and other agencies. This includes hospitals, ancillary services, emergency department, outpatient surgical facilities and physician groups. Coding and billing work together, hand in hand, in order to maintain compliance with governmental policies. We specialize in minimizing your clinic’s denials guaranteed, which will increase your overall revenue.
With the adoption of HCC’s, MS-DRG and APR DRG in addition to the implementation of the CMS Recovery Audit Program, comprehensive and accurate coding is critical to your organization’s financial health and compliance. We integrate our expertise and knowledge of the HIM Revenue Cycle, Coding and Auditing skill set to benefit our clients.
Billing Services
- Charge entry
- Claim scrubbing
- Modifiers (if applicable)
- Claim edits
- Insurance & Denial
- Payment Posting
- Patient Statements> ABN's> Services not covered.
- Maximize productivity.
- Timely claim submission- within 48 hours or sooner of receipt of patient encounter/ superbill (either paper or electronically). We process and submit claims to the insurance company.
- Reporting of financial snapshot available within EHS medical billing software.
