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Medical Billing

We are a technology enabled Revenue Cycle Management Company providing complete practice management support for Medical and Dental Providers right from Appointment Scheduling, till the collection of Payments.

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Medical Billing

What we do for you?

Credentialing :
Until providers are properly credentialed with appropriate insurance carriers and for specific locations, claims cannot be submitted and cash flow is severely impacted, TCT’s professional credentialing experts assure you that all relevant information required for credentialing is obtained from the health practitioner. Each and every insurance carrier has a specific protocol to be followed and we customize the information to meet it. We make sure to follow up with the insurance company in order for the providers to get enrolled. TCT will also maintain a data base of all such information and monitor it on a regular basis to meet re-credentialing requirements.

 

Coding :
Our expert team of certified coders complies with CCI coding edits to ensure accurate application of procedure and diagnosis codes to the patient’s medical records. We adhere to the guidelines of Local Coverage Determination (LCD) and national coverage determination (NCD) and match the right Current Procedural Terminology with the ICD-10 CM codes, to prevent coding denials and prove medical necessity to the payer making sure clients don’t suffer a revenue loss. All coding work is audited by quality assurance experts to ensure the highest accuracy.

 

Eligibility verification:
Eligibility / Benefits verification is a very important process in Quality Revenue Cycle Management. It is the first step to eliminate Coverage information Denials. Through Eligibility and Verifications Services, TCT provides accurate insurance information including patient benefits information such as Copay, Deductibles, Maximums benefits used, type of Plan (PPO, HMO, Medicaid), Out of pocket expenses, Referrals & Authorizations. Our Insurance Verification team access Payer’s portals, Voice Response Systems and also speaks with the Insurance Company’s representatives to get the required information.

 

Patient Demographics & Charge Entry:
We at TCT accentuate on quality than quantity and that is why we focus on entering 100% error free Charges to ensure quick payments. The claims that are entered in Practice Management Software undergo multiple quality checks before it reaches the insurance.

 

Claim Submission/Transmission:
Electronic transmission of all claims is the route for easy payments, as paper transfers are more risky. We follow claims until they reach the payer and continue our follow-up until the payer acknowledges the receipt of claims. If the insurance company doesn’t accept electronic claims, Paper claims will be printed and sent through Certified mail.

 

Payment Posting:
Let it be ERA or EFT or EOB, our team of professionals will post the payment into the appropriate accounts by verifying whether the allowed amount given in the EOB is Carrier’s Original allowable amount.

 

Denial Management & AR Analysis:
Our perfect billing and coding system make Denials and A/R calling non-existent. In few cases when an insurance carrier does not pay the entire claim or the insurance allowable rate is less that is where our Denial Management and AR F/U team will come in. Our team will work on the denied claims or contact the insurance carrier to determine reason for non-payment and take the appropriate action. In any event, this service will take away the labour, time and cost associated with your staff handling this function.

We believe in being prepared for any situation and extend our support to A/R, ensuring that our clients get paid promptly at allowable rate.

Our AR team works effectively that all the 20+ accounts are worked within 5-10 biz days depending on the insurance carrier and the volume of AR. In other words, our AR experts will not allow any claim to go over 60+ buckets based upon the insurance company.(In some cases the Paper claims insurance, WC and MVA might take 60+ days to issue the payment)

 

AR Follow-Up/Patient Follow-Up:
TCT has a dedicated team that offers extensive support to patients, healthcare providers and payers. Our inbound calling services address queries from health care providers for verification, denials, re-processing, authorization, queries from patients etc…

If claims are not paid during a specified period of time, we follow up with the carrier regarding the unpaid claims and also if information needed from patient a follow-up is done with the patient to retrieve the required information.

 

Correspondence:
TCT has a dedicated team for working on the insurance disputes. In those cases we resubmit the claim that needs to be corrected and resubmitted. All submissions are confirmed with the insurance company to prevent any denials for untimely filing.

Based upon the information gathered by the calling support team, our team will take necessary action on the unpaid claim to correct and resubmit it. This may include re-billing, re-coding, or sending appeals to the insurance.

 

Secondary Claims and Patient Statements:
At TCT we send the Secondary claims at the end of each week after posting the payment in appropriate accounts. It includes electronic and paper claims.

Three Statements are sent to the Patients in a period of 90 days. A report of Patient Ageing will be sent to your office for your assistance