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Comprehensive Medical Billing Solutions
At Ask Medical Billing, we understand the complexities of the modern healthcare landscape. From ever-changing regulations and intricate coding guidelines to the constant pressure to maximize revenue and improve efficiency, healthcare providers face numerous challenges. Our mission is to alleviate these burdens and empower you to focus on what truly matters: providing exceptional patient care.
We offer a comprehensive suite of medical billing and revenue cycle management services designed to streamline your operations, maximize reimbursements, and improve your practice’s financial health. Our experienced team leverages cutting-edge technology and industry best practices to ensure accurate and timely claim processing, minimize denials, and optimize cash flow.
Core Services
Medical Billing and Coding
Our highly skilled and certified coders ensure accurate and timely claim submissions across all major payers. We specialize in:
- CPT Coding: Accurate and precise coding of medical procedures and services, including but not limited to:
- Evaluation and Management (E/M) services
- Surgical procedures
- Diagnostic tests
- Radiology procedures
- Anesthesia services
- Preventive medicine services
- Mental health services
- ICD-10 Coding: Accurate diagnosis coding to ensure appropriate reimbursement, encompassing a wide range of medical conditions and diagnoses, including:
- Diseases
- Injuries
- Symptoms
- External causes of injury
- HCPCS Coding: Coding for medical supplies, equipment, and procedures not covered by CPT or ICD-10, including:
- Durable medical equipment (DME)
- Prosthetics and orthotics
- Laboratory tests
- Outpatient hospital services
- Ambulance services
- Modifiers: Appropriate application of modifiers to accurately reflect the circumstances of a service, such as:
- Place of service modifiers
- Multiple procedure modifiers
- Anesthesia modifiers
- Modifier -59 for distinct procedural services
- E/M Coding: Accurate coding of Evaluation and Management services based on patient complexity and physician work, including:
- New patient visits
- Established patient visits
- Consultations
- Emergency department visits
- Preventive medicine services
We stay abreast of the latest coding guidelines and regulatory updates, including those from the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA), to ensure your practice receives the maximum reimbursement for every service rendered.
Insurance Verification and Eligibility
We proactively verify patient insurance coverage and eligibility prior to service delivery, minimizing the risk of denied claims due to incorrect or missing information. Our streamlined process includes:
- Real-time eligibility checks with insurance carriers using electronic data interchange (EDI) and other advanced technologies.
- Verification of patient demographics and insurance information, including:
- Name
- Date of birth
- Social Security Number
- Insurance card information
- Group number
- Policy number
- Effective and termination dates of coverage
- Deductibles and copayments
- Identification and resolution of any potential coverage issues, such as:
- Prior authorizations
- Pre-certification requirements
- Out-of-network benefits
- Benefit exclusions
- Limitations and restrictions
- Obtaining prior authorizations for necessary procedures and services from insurance carriers, including:
- Completing and submitting prior authorization forms
- Following up with payers to track the status of requests
- Obtaining necessary supporting documentation
- Maintaining accurate and up-to-date patient insurance information in your practice management system.
By ensuring accurate and up-to-date patient insurance information, we minimize the risk of denied claims and ensure timely reimbursement.
Accounts Receivable Management
We manage the entire accounts receivable cycle, from claim submission to payment posting and follow-up on denials. Our comprehensive services include:
- Clean claim submission to ensure timely processing by payers, including:
- Accurate and complete claim forms
- Correctly coded diagnoses and procedures
- Supporting documentation, such as operative reports, pathology reports, and medical records
- Diligent follow-up on denied claims, including:
- Appealing denied claims with supporting documentation
- Resubmitting corrected claims
- Following up with payers on the status of claims
- Identifying and resolving payer-specific issues
- Prompt and accurate payment posting to your practice’s accounts, including:
- Reconciling payments from payers
- Identifying and resolving any payment discrepancies
- Posting payments to patient accounts
- Generating daily, weekly, and monthly reports on accounts receivable
- Regular reporting and analysis of key performance indicators (KPIs), including:
- Days in accounts receivable
- Claim denial rates
- Reimbursement rates
- Cash flow analysis
- Aging of accounts receivable
- Proactive identification and resolution of any outstanding issues, such as:
- Unpaid claims
- Patient billing issues
- System errors
- Contractual issues with payers
Our goal is to maximize your practice’s cash flow by ensuring timely and accurate reimbursement for all services rendered.
Denial Management
Denials are a common occurrence in the healthcare industry. Our dedicated team specializes in:
- Root Cause Analysis: Identifying why claims are denied, uncovering issues in workflows, documentation, or coding practices.
- Proactive Strategies to Prevent Denials:
- Conducting comprehensive audits of medical records and coding practices to ensure compliance and accuracy.
- Streamlining workflows to eliminate inefficiencies that lead to claim rejections.
- Educating staff on payer guidelines and best practices to reduce avoidable errors.
- Let us handle denials while you focus on delivering exceptional patient care.