ABC submits insurance claims to payers within 8 hours of claim creation to ensure timely reimbursements and maintain consistent cash flow for healthcare providers.

Accurate and timely posting ensures proper revenue tracking, minimizes billing errors, and streamlines claim reconciliation under our Premium medical billing pricing tier.

ABC reviews, corrects, and resubmits denied insurance claims within 48 hours of denial to ensure timely and accurate reimbursement. Additionally, we conduct root cause analysis to prevent future denials and enhance first-pass claim approval rates.

ABC will check the status of claims starting from the 10th day after submission, through various channels, including web portals, IVR systems, inquiries, or direct calls. Once the claim status is obtained, we take the necessary steps to address the denial and proceed with further processing to resolve the issue. - Refer (AR webpage)

ABC will contact insurance companies directly to resolve claim denials within 48 hours, address root causes, and ensure appropriate claim payments. Our goal is to reduce future denial rates and optimize the overall claims acceptance process for all medical billing pricing tiers.

ABC coordinates directly with each payer and submits applications electronically to ensure faster processing. We also handle any required paperwork for specific payers. We manage end-to-end communication with payers for seamless processing. The cost of medical billing services also ensures our team handles all follow-ups, keeping the credentialing process on track. We streamline provider enrollment by managing the full credentialing workflow.

ABC will send a payment report that includes detailed information on payments collected from insurance, including check numbers and check dates, as well as patient payments received. This report ensures transparency and accuracy in tracking all payments processed. This reporting also helps practices understand the cost of medical billing services.

ABC will provide a yearly report to assess the practice's performance and check into how well our medical billing pricing is working. The payment comparison report will show collections from insurance, grouped by the top five insurances and patients. ABC help practices maximize reimbursements and reduce insurance denials.

ABC will answer all patient inquiries regarding balances, receipts, and bills.

ABC will generate and send patient statements every 30 days, as per client requirements, to ensure consistent communication regarding outstanding balances. This regular process helps keep patients informed of their financial responsibility.

ABC will promptly send statements to patients immediately after insurance processing to accelerate the practice’s payment flow. This ensures that patients are notified promptly of their financial responsibility and reduces delays.

ABC will generate the insurance-wise Account Receivable (AR) report weekly. This will create transparency between the practice's revenue and outstanding receivables, allowing the client to monitor financial performance. It helps to identify payment trends, aging claims, and any potential bottlenecks in the reimbursement cycle.

ABC will fetch batches from the system and transfer them securely to the ACOs.

ABC will submit medical records to payers upon request for claim verification. For workers’ compensation cases, ABC will include the necessary medical records when submitting the claim to ensure faster processing and reduce delays through our medical billing pricing services.

If the payer ID and fax number are unavailable for a specific payer, ABC will submit paper claims to reduce the overall cost of medical billing services.

Insurance companies may pay claims with virtual credit cards. Providers can process the card, but a transaction fee of 2% to 5% may apply. To avoid this fee, ABC has implemented a process to convert virtual card payments into paper checks or Electronic Funds Transfers (EFT). This ensures that providers receive their full reimbursement without incurring unexpected fees under our medical billing pricing structure.

ABC will perform a thorough reconciliation of all claims to verify that reimbursements are accurate and aligned with the payer’s contracted rates and terms.

ABC will provide a quarterly report highlighting patient overpayments or credits to keep the practice informed of any discrepancies. This can help reduce unnecessary adjustments to the cost of medical billing services.

ABC will promptly post all patient payments to ensure account balances are accurately updated.

ABC keeps billing accurate across multiple facilities by reviewing doctors’ notes, nursing records, and procedure reports. We also verify that all services are properly documented while confirming service dates and types. Additionally, ABC assigns the correct CPT/HCPCS codes, posts charges to the patient’s account, and enters appropriate diagnosis (ICD-10) and procedure codes in accordance with our medical billing pricing scales.

ABC will conduct regular high-level account review meetings with clients to address concerns, share key performance metrics, and align on future goals and needs. We also review trends across billing packages.

ABC will provide the client with a detailed bi-weekly report identifying all claim denials related to missing precertification, prior authorization, or referral.

ABC converts paper EOBs to electronic format and assists with direct deposit setup, saving time and ensuring faster payments.

ABC’s medical billing pricing services securely access hospital and facility systems to download patient face sheets directly, reducing manual hours for the practice.

ABC verifies active insurance coverage through facility portals and Medicare and Medicaid for uninsured patients before sending any statements.

ABC delivers all types of provider reports, customizing solutions when needed to ensure practices always have the insights they need. These reports can also be adjusted based on billing packages and reporting needs.

ABC will submit patient accounts to a third-party collection agency and follow up on the payments/disputes.

ABC releases medical records to third parties promptly upon receipt of the invoice payment.

ABC securely accesses hospital and facility systems to download the Medical records directly, reducing manual hours for the practice.

ABC contacts facilities directly to obtain prior authorizations or precertification numbers for denied claims, ensuring timely resubmission and secure payment while balancing the cost of medical billing services.

Choosing ABC for medical billing pricing allows us to securely access hospital and facility systems to obtain valid authorization numbers, reducing manual effort for the practice.

ABC raises invoices to third parties for the record request for any post-paid claims.

ABC manages all claim appeals directly, ensuring denials are addressed without adjusting the original claim, so practices can recover maximum reimbursement efficiently while protecting their medical billing pricing status.

ABC handles the mailing of all appeals with tracking, ensuring every submission is securely sent and easily monitored for timely follow-up.

ABC empowers your team by setting up insurance portals that simplify workflows, reduce errors, and accelerate reimbursements.

ABC raises invoices to attorneys for itemized bills or record requests for any post-paid claims.

ABC directly contacts dialysis centers to resolve any lock-in issues promptly and efficiently.

ABC will provide comprehensive training for front office staff, covering key areas such as eligibility verification, obtaining authorizations, and reviewing patient balances, to support accurate and efficient patient and billing workflows. Proper workflows can reduce the cost of medical billing services.

ABC will perform a complimentary coding audit by a certified coder for the first three months from the signing date.

We provide a complimentary consultation to help practices evaluate their current billing performance and address any questions beyond RCM services and medical billing pricing. We help providers compare available billing packages.

ABC coordinates directly with leading Practice Management Systems (PMS) such as eCW, Tebra, AdvancedMD, DrChrono, eMedicalPractice, and Greenway. We work closely with each vendor to ensure all essential settings are properly configured for a smooth setup. We schedule and attend setup meetings with PMS vendors on your behalf. ABC ensures system settings are customized to meet your practice’s specific workflow. We assist in integrating billing, scheduling, and reporting functionalities. Our team verifies that all modules are correctly activated and functioning. Ongoing support is provided during and after the implementation process under this medical billing pricing service. This support is available across all billing packages.

ABC identifies the correct mailing address for any payer-returned claims through calls and inquiries, then promptly resends the claim to the updated address.

Patient accounts submitted to collections will be reconciled every 6 months to ensure balances are accurate and up to date. This process can help practices control the cost of medical billing services.

Payments received after accounts are submitted to collections will be reviewed and posted monthly.

ABC will integrate e-payment services into the Practice Management System (PMS), enabling the practice to collect patient payments online securely.

ABC ensures each provider’s Council for Affordable Quality Healthcare(CAQH) profile remains up to date by regularly updating licenses, credentials, and other key information.

ABC ensures the timely re-attestation of individual providers' Council for Affordable Quality Healthcare (CAQH) profiles. We manage the re-attestation process to prevent delays in credentialing or reimbursement.

ABC coordinates directly with leading clearinghouses such as TriZetto, Waystar, Office Ally, Optum, and eProvider Solution. We work closely with each vendor to ensure all essential settings are properly configured for a smooth setup when you choose our medical billing pricing options. Proper setup can also minimize delays that increase the cost of medical billing services.

ABC manages Medicaid Care Management Organization (CMO) revalidation by ensuring that an individual provider’s information is up to date and compliant with payer timelines. We handle the revalidation process to prevent delays in credentialing or reimbursement.

ABC handles Medicare revalidation for both individual providers and group practices, ensuring timely submission of accurate information to maintain active enrollment. We handle the revalidation process to prevent delays in credentialing or reimbursement.

ABC uses its medical billing pricing service to help providers and practices connect with the right entities for payer contract negotiations. We ensure you're referred to experienced legal professionals to help secure favorable contract terms. We help you understand when legal support is needed during payer negotiations. ABC refers attorneys with expertise in healthcare contracts. Our team supports you through the process, from review to execution. We aim to protect your financial interests and ensure compliance.

ABC handles the complete Provider Enrollment, Chain, and Ownership System (PECOS) enrollment process for Individual providers (855I application), Group practices (855B application), and Reassigning of benefits (855R). We ensure smooth, timely submissions for efficient Medicare participation. We manage all necessary forms to ensure proper enrollment and revalidation.

The allowed rates for CPT codes are carefully verified against payer contracts before posting insurance payments. This review supports accurate reimbursement while helping to manage the costs of medical billing services.