Menu
As administrative burdens and financial pressures continue to rise, physician groups need a trusted revenue cycle partner to guide them through the rapidly changing healthcare landscape.
Managing the healthcare revenue cycle can be a complex and daunting task. At Prime RCM solutions, we provide comprehensive medical billing, coding, and accounts receivable management services to help you navigate this complex maze of administrative and clinical processes.
Medical Billing is the process of submitting and following upon on all the claims with the health insurances in order to receive payments for services rendered by the healthcare provider.
Patient Scheduling and Appointment Management: Our front end team helps you manage patient appointments, ensuring timely scheduling and reducing no-shows.
Eligibility Verification: We verify patient insurance coverage, eligibility, and benefits, ensuring accurate billing and reducing claim denials.
Prior Authorization: Our team manages the prior authorization process, ensuring approvals are obtained for required services.
Patient Registration/Patient Demographics: We manage patient registration and demographic data, ensuring accurate billing and timely claims submission.
Charge Entry & Charge Audit: We manage charge entry and audit processes, ensuring accurate billing and timely claims submission.
Medical Coding Services: Our certified medical coders assign accurate codes to medical procedures, ensuring timely reimbursements and reducing claim denials.
Claim submission: We help ensure revenue integrity by conducting regular audits and reviews of billing processes and claims submissions.
Medical Coding Audit: Our team performs medical coding audits to identify and rectify coding errors, ensuring timely reimbursements and reducing claim denials.
Provider Education: Team of certified coders also provide coding education to the provider if they notice Missing/Incorrect codes, Missing/Incorrect Modifiers.
Compliance audit: We help improve clinical documentation to support accurate coding, reduce claim denials, and ensure compliance with regulations.
Certified coders: Coders are well-versed in all the specialties like Ortho, Spine, Podiatry, cardio -respiratory, OB/GYN, inpatient and outpatient coding, Anesthesia, ASC(Ambulatory surgery coding), Radiology, Interventional Radiology, pathology, Gastroenterology, Neurology, Integumentary, Urology, Vaccine/injections/Infusion, Hydration and Push, HCPCS coding.
Payer specific coding – Team of coders are very familiar with telehealth guidelines based on state and payers. Research on payer policies there by decreasing rejections and denials. Well versed in Medicare and commercial payer coding guidelines
Clearing house – Familiar with clearing houses like Trizetto, Encoda, Waystar, Emdeon
Remittance Processing: We process remittance advice and EOBs, ensuring timely and accurate payment posting.
Accounts Receivable: Our team manages accounts receivable, ensuring timely follow-up and collections.
Denial Management: We manage claim denials and appeals, ensuring maximum reimbursement and reducing revenue loss.
Credit Balance: We manage credit balance accounts, ensuring timely and accurate refunds.