Medical Billing
We have been billing on behalf of physician groups across different
(a) Regions
(b) Specialties
(c) Payor Sources
Services
Entry of Patient Demographics
Capturing information like Patient's Name, Residence Address, City, State, Zip Code, Social Security Number, Employer Details and Insurance Details (like Primary, Secondary Tertiary, and guarantor information etc.)
Charge Entry
Super bill / Encounter Forms are used to capture details like Date of Service, Referring Physician, Rendering Physician, Place of Service, Type of Service, CPT Codes, ICD Codes, Modifiers, Authorization or Referral Details and Co-pay Details.
Payment Posting
EOB / Private Checks or scanned credit card statements are used to capture details like Patient Account Number / Patient Control Number, Patient Name, Date of Service, Procedure Code, Billed Amount, Allowed Amount, Adjusted Amount, Paid Amount, Deductibles and Denial Details, Refunds, Offsets and Reconciliation.
Transmission
Charge entered claims are transmitted to different payor sources electronically. Where required, paper claims are printed remotely or shipped to our partners' offices. Claims that encounter transmission problems are fixed with a high priority.
Accounts Receivable and Claims Follow-up
- Denials / Rejections Analysis - Re-billing.
- Systemic A/R projects - Re-billing.
- Insurance / Patient Follow Up - Collection Agency Reporting.
- Tracking and Management Reports.
Quality Control
- All entered demos, changes and payment entered are verified by a quality resource.
- A sample of all demos, charges and payment entered that have undergone a check by quality resources are verified again by senior quality resources.
- Freshers and new recruits training in regulations related to Medicare, Medicaid, Managed care, third party liability, workers compensation, Preferred Provider organizations, and Indemnity Insurers.
- Knowledge on payments systems (KNOX KEENE Act, COBRA, OBRA, & PPS).
Strengths
- Faster turnaround time.
- Consistent delivery of accurate coding across specialties.
- HIPAA compliance (Complete Data and Document Security).
- Secure Information & Data Flow between Promantra and our partners enabled with reliable networking software & hardware (includes secured Virtual Private Networks and FTP sites).
- Business Continuity.
- A workforce geared to handle surges in volumes.
