Healthcare providers are losing significant revenue annually due to several reasons such as inaccurate coding, insufficient documentation, billing and collections mistakes, failure to monitor the medical claims process from beginning to end and not staying updated with industry changes. The optimization of the medical billing process is thus essential to ensure long-term, sustained operations for healthcare providers to maximize reimbursement, increase accuracy, and avoid audits. From streamlining the collections process to eliminating reimbursement denials, all while satisfying HIPAA requirements, adds a lot of complexity to medical billing.
We are here to keep up with your needs! 3Gen is a leading medical billing services company delivering a comprehensive range of medical billing solutions to healthcare organizations. When you outsource to us, we aim to deliver the best-in-class revenue cycle management (RCM) services, which enables providers to accelerate its pace of revenue generation, increase overall efficiency, and reduce operational costs.
We check eligibility with the patient’s insurance provider to ensure they qualify for a service. Verifying eligibility and obtaining prior authorization is vital as it provides a clear understanding regarding insurance coverage and patient’s responsibility to pay. This in turn helps providers submit clean claims, minimize denials, reduce write-offs and increase collections.
Our eligibility verification & prior authorization services include:
Patient demographics entry is a critical step in generating an insurance claim. Incorrect demographic information is one of the leading causes for claim denials. Similarly, accurate charge capture will reduce instances of revenue loss.
Our patient demographics & charge entry services include:
Coding is a crucial component of the revenue cycle process. It is imperative that rendered services are coded correctly. This includes the appropriate use of CPT, HCPCS, ICD codes and modifiers. With the vast expertise that our medical coders bring, we are able to efficiently and accurately code services in compliance with guidelines. We pride ourselves to have a separate audit team who specialize in comprehensive review of the services coded.
Our medical coding services include:
We carefully scrutinize each EOB/ERA from insurance companies and make adjustments accordingly. Our team posts payments, co-insurance and deductibles and makes insurance adjustments. Additionally, we do secondary claims submission and patient statements. Denials are assigned to the denial management team for further pursuit.
Our payment posting services include:
A/R follow-up is vital after claim submission. It identifies the adjudication status of the submitted claim and helps in understanding the claim outcome. Early notification of a denial helps correct the claim at the initial stage and saves it from becoming ‘untimely’ for appeals or corrections.
Our accounts receivable management services include:
This is one of the most critical verticals of the revenue cycle process. A major portion of revenue is stuck here in the form of denied claims and requires additional attention. We have a dedicated team for denial management who are experienced in identifying different types of denials and providing corrective action for them. We send out periodic reports to providers by identifying common denial types and ways to avoid it for future submission.
Our denial management services include:
Credit balances can be a significant compliance risk if not managed well. Credit balances result from overpayment from insurance companies or excess payment by patients. Thus, credit balance resolution is essential to remain in compliance, clean A/R and also improve patient satisfaction.