Medical Claims Processing
At Flatworld, we understand that the key reason for denials is incorrect medical billing and coding. Flatworld turns your receivables into cash.
As a healthcare provider, you know that insurance companies reject most of the claims they receive. Also, federal regulations in the US have become increasingly more stringent. Chasing insurance companies for money that is rightfully yours can be painstaking.
Our Medical Claims Processing services will shorten the number of days in your accounts receivables cycle. We improve your cash flow and reduce claims denials.
The federal centers for Medicare and Medicaid services recently announced their decision to reduce time physicians are given to file an appeal against a claim denial (from six months to 120 days). This increases the pressure on your staff to follow up on denied or appealed claims.
The most common causes of rejection are errors in medical billing and coding. The key to filing an accurate medical claim lies in the ability to distinguish between intricate medical procedures.
Flatworld's AAPC-certified medical coders have knowledge of both diagnostic coding and procedural coding.
We have experience in handling CPT and HCPCS coding. Based on the guidelines of AMA and CMS, we code for surgery, lab and other tests.
Contact us for accurate medical claims processing.
How we handle your medical claims processing
Our high-end medical claims processing software helps us to carefully handle your claim in the following steps:
- Check for errors of coding and billing
- Send you an EOB (explanation of benefits)
- Pre-adjudicate the claim to make it accurate
- File the processed claim with the insurance company
- Provide you electronic eligibility details and claim status
- Receive denied claims and re-adjudicate them as recommended to get them approved
Our effective medical billing and Medical Claims Processing software translates to fewer denials and lesser effort from you.
We can file the Medical Claim for you
The submission of a claim is one of the most cumbersome processes in the healthcare sector. Accuracy in compiling information from your database is critical to have a valid claim.
We will save you the time, labor and effort required to file a claim by doing so ourselves with the insurance company.
We follow up to ensure your claims are being attended to. We receive denied claims and reprocess them to facilitate approval.
When you outsource your medical claims processing to Flatworld, you also get:
- Compliance with HIPAA regulations
- Regular productivity reports
- A Clear Contract agreement - with service levels and consequences
- Clean claims, fewer denials
Flatworld helps you focus on your core business and we eliminate recruiting and training, reduce labor costs and improve accuracy through our healthcare management software and high quality medical claims processing services.
We, at Flatworld will increase your revenue by up to 20%. We will ease the outsourcing process by promptly answering your queries, assisting smooth flow of information and catering to all your medical claims processing requirements.
Flatworld has the manpower, the experience, the technology and strong domain knowledge to address your specific needs in medical claims processing.
How to avoid payment delays for medical claims
Flatworld steers you into avoiding payment delays from Medicare as well as from other third party insurance payers by following these steps:
Review of all claims before submission
This pulls down the error rate significantly. More time is spent on reviews at the front end, rather than a longer time later to deal with each denial.
We maintain a billing and coding claims review log
We track the trends for each healthcare BPO provider, based on the remittance advice from Medicare as well as the EOBs (Explanation of Benefits) from all third party payers. These trends are then monitored and evaluated to find ways to set right the problems causing the denials and rejections for your practice.
Our monthly billing review
The staff who perform tasks like data entry, coding and documentation, billing and payment posting, analyzing denials and down coding, meet once a month to review the following:
- All recent insurance carrier newsletters and notices of any billing or coding changes
- Practice issues that are current and relevant to the billing function
- An analysis of how trends noted from the claims review log are being handled and the effect on the accounts receivable, measured in terms of percentage of error and as "dollars and cents".
Cost Reduction in medical claims processing
We can deliver approximately 30-45% fixed cost reductions with our medical claims processing services. We assure you an increase in your bottom line by as much as 24% on an average.
We are HIPAA compliant
We are fully HIPAA complaint. We will provide you with our comprehensive and user-friendly medical billing software package if you do not have a billing software suite.
How we can enhance your business
Our medical claims processing service tracks updates and maintains a comprehensive knowledge base specific to the health industry. These are the value-adds you will receive:
- Increase your ongoing practice revenues by 15-25%
- Reduce your administration costs by decreasing billing and collection expenses
- By automating processing and collection, increase time spent in actual medical care
- Recover lost revenue resulting from inefficient filing
- Reduce rejected claims by pre-adjudicating your claims to assure approval
Expand Your Business Possibilities! Contact us now
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