I have been in US Healthcare called Medical Billing (RCM) from last 5 years and from last 2 years i am working as an Account receivable. I have extensive Experience in Medical Billing.
a) Medical Billing Services includes the following:-
- To check Eligibility and verification of patientís health benefits from insurance carrierís website and Via Phone.
- Create appointments on scheduler while receiving patient calls
- Full patient demographics and charge entry
- Insurance claims submission (primary, secondary or tertiary)
- Accounts receivable analysis and decision making for Collections
- Strong claims follow up on denials from insurances like Workers Comp, Government payers, Managed care and Commercial Insurances (Aetna, BCBS, Cigna etc...)
- Patient billing inquiries as per received information from your office
- To check claim status from insurance auto response unit and via live calls.
- To make on call appeals for reprocessing of incorrectly processed claims based on billing knowledge
- ICD9, CPT and HCPCS Coding and/or review
- Monthly and annual reports preparation
- Custom reports where required
- Patient billing as per instructions
- Credentialing guidelines
- Super bill review
(b). Medical Coding
- To research the right DX and CPT code according to medical records
- Provide right DX pointers for the first time to avoid payment delays
- Suggest appropriate modifier for maximizing the revenue
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