Medical billing is the backbone of healthcare revenue cycle management. At TALL RCM INCORPORATION, we provide end-to-end billing solutions that ensure accurate claims submission, rapid payment processing, and compliance with all major insurance providers.

We use FTP upload or PC anywhere Access we search/scan the appropriate documents or superbills that would be received from provider office everyday..

  • All patient demographics, insurance information, superbills, and charges are entered and submitted electronically through the Billing Software. The claims posting/submission process takes about 36-48 hours..
  • The daily paper source such as EOB (Explanation of Benefits) will be updated into billing applications, and payment details will be updated to individual claims.
  • AR aging files will be meticulously compiled and returned to the provider for evaluation. The Account Receivable (AR) team would review, and respond to any unpaid, denied, or rejected claims. Based on the requirement Team would call the Insurance companies and bring the issues to a resolution.
  • For lawsuits based on the AR survey, insurance calls will be made. We will submit-secondary and tertiary claims with attachments, patient accounts, and other paperwork to the Insurance Companies via our Office / Client.
  • Work progress reports will be submitted on a regular, weekly, and monthly basis.

3-Steps of A/R Follow Up

Outsourcing medical billing services to TALL RCM INCORPORATION is a smart choice. Our team of trained A/R professionals works diligently to reduce A/R days, while our Certified Professional Billers are committed to maximizing collections and improving your cash flow. We prioritize transparency and efficiency throughout the entire process to ensure a seamless experience for our clients.

STEP 1: EVALUATION

In this phase, we conduct a comprehensive review and analysis of all cases listed in the A/R report. Our team carefully examines insurance plans and identifies the root causes behind claim rejections and denials.

STEP 2: ANALYSIS AND PRIORITISATION

Once the issues have been identified, our A/R specialists work to resolve them and implement preventive measures to avoid recurrence. Claims are prioritized based on their age and the likelihood of payment from insurance companies.

STEP 3: COLLECTION OPTIMISING THE COLLECTIONS

Our structured approach to claim resolution focuses on improving key performance indicators such as First Pass Rate (FPR) and Clean Claim Rate (CCR). This leads to increased revenue and a reduction in outstanding accounts receivable.

Why Outsourcing medical billing services to TALL RCM INCORPORATION would be beneficial?

  • Patient Collection (Keeping Your Front Office Updated Through Diligent Eligibility, Benefits and Preauthorization)
  • Specialty Centric Billing Rules (Maximizing Revenue)
  • Skilled, Trained, and Certified Resources (Increasing First Pass Ratio)
  • Intuitive Business Intelligence Tools (Better cashflow)
  • Dedicated Billing Team and Supervisors (Zero Hold Time)
  • Quality Measures at Each Stage of Billing (Maximizing Revenue)
  • Real-Time Performance Data Dashboard (Complete Visibility in Our Performance)
  • 100% Confidential and HIPAA Compliant
  • You’ll save 60% of the existing running expenses.
  • Services are available 24/7, with a short turnaround time (Turn Around Time).

FAQ

The medical billing cycle is a key component of the Revenue Cycle Management (RCM) process in healthcare. It refers to the entire sequence of steps involved in the submission, processing, and collection of payments for medical services rendered to patients. The goal of medical billing cycle is to ensure that healthcare providers are reimbursed efficiently and accurately for the services they provide.

Accounts Receivable (A/R) in medical billing refers to the outstanding payments owed to healthcare providers for services rendered to patients. It represents the amount of money that has been billed but not yet collected from insurance companies, government programs (such as Medicare or Medicaid), or patients. In essence, A/R is the unpaid claims that are due to the provider. In the context of medical billing, A/R is managed as part of the Revenue Cycle Management (RCM) process. Efficient management of A/R is critical to maintaining a healthy cash flow for healthcare organizations.

  • Patient Registration
  • Eligibility check
  • Patient encounter
  • Medical claims preparation
  • Compliance with the Medical coding rules
  • Claim scrubbing
  • Submission of claims
  • Payer Adjudication
  • Patient Statements
  • Follow-ups
  • Payment posting
  • Reporting

There are pre-set billing rules in the Billing Software which captures the missing/invalid information in a claim – The Billing company would provide the required information to fix those errors and would provide a heads-up to Provider to prevent such errors or include valid information in future.