Helping Healthcare Providers Get Paid Properly
100%
HIPPA Compliant
96%
Accuracy Rate
2073 Park Trail Rd, Baltimore, MD 21244, United States
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We start by looking at why your claims are being denied. We figure out the common reasons why your claims are not being accepted. This helps us fix the issues from the start. By knowing why claims are denied, we can make plans to stop it from happening again. This means you will get paid faster and have more money coming in.
We understand that effective Accounts Receivable (A/R) and Denial Management are more than just financial processes – they’re the lifeblood of your healthcare practice’s financial health. That’s why we’ve crafted an approach that combines empathy, expertise, and efficiency, turning financial challenges into opportunities for growth and stability.
Claim tracking and status updates involve monitoring the progress and current status of insurance claims submitted by healthcare providers. This process includes keeping track of the claim’s journey from submission to payment, and providing regular updates to healthcare providers regarding any developments, such as claim acceptance, denial, or payment processing. Pro Medical Billing Solutions diligently track each claim, regularly updating payment statuses after comprehensive verification through calls and online checks. This ensures you’re always in the loop with the latest claim developments.
Strategic claim adjustments and adjudication refer to the deliberate and planned process of reviewing, modifying, and making decisions on insurance claims with a specific goal in mind. This could involve analyzing claims data to identify patterns, trends, or opportunities for improvement, as well as making informed decisions to optimize claim reimbursement, minimize denials, and ensure compliance with payer policies and regulations.Our team conducts in-depth investigations, adjusting denied or partially paid claims for a balanced financial ledger.
Efficient claim reprocessing involves the swift and effective handling of insurance claims that require reevaluation or resubmission. This process aims to rectify any errors or issues that led to claim denials or underpayments, ensuring that the claims are processed accurately and promptly to expedite reimbursement for healthcare services provided. Pro Medical Billing Solutions tackle resubmissions and appeals head-on, providing additional documentation when needed to secure full payments.
Regular follow-ups on claims entail consistent monitoring and communication regarding the status and progress of insurance claims. This involves reaching out to insurance companies or payers at predetermined intervals to inquire about the status of pending claims, identify any delays or issues, and ensure timely resolution to expedite claim processing and reimbursement.Every 30 days, we conduct follow-ups, providing insights into the status of each claim – whether paid, pending, or denied.
Handling rejections and denials involves managing instances where insurance claims are not accepted or approved by the payer. This process includes investigating the reasons for rejection or denial, correcting any errors or deficiencies in the claim, and resubmitting the claim with necessary adjustments or additional documentation to appeal the decision and secure reimbursement for the healthcare services provided. We quickly address issues like incorrect information or invalid codes, identifying non-payment causes, and reprocessing claims with supplementary details to overturn denials.
Addressing partial payments involves managing situations where insurance companies or payers only partially reimburse healthcare providers for the services rendered. This process includes identifying the reasons for the partial payment, such as coding errors or coverage limitations, and taking appropriate steps to rectify the situation. This may involve appealing the payment decision, providing additional documentation or clarification, or negotiating with the payer to ensure full reimbursement for the services provided. Pro Medical Billing Solutions delves into reasons behind incomplete payments, pursuing reprocessing or appeals with added information to secure the remaining balance.
