Medical Billing Services
Medical Billing has become the crucial part of revenue management for the healthcare service provider and hospitals. Millions of dollars are lost annually due to underpricing, coding errors, missed charges and un-reimbursed claims. Pacific's medical billing service enables to eliminate these losses and accurately process the medical billing. Our professional approach and expertise always help our client by freeing with the tedious tasks of billing and follow-up function. Pacific's medical billing service incorporates the latest technological and software developments and is very user-friendly. Medical Billing service is customized to meet individual clients specific requirements.
SERVICES PORTFOLIO
- Data entry - we obtain information from the provider and/or practice and enter this information into our database.
- File claims - most claims are filed electronically and only a few go on paper. This is dependent upon the insurance carrier the claims are going to.
- Statements - are mailed out from our office on behalf of the facility. The protocols of statements and collections are done specifically to client's specifications.
- Payments - as we receive payments and explanations of benefits from the client, we post these into our database. Each EOB will be audited for correct payment and/or benefits.
- Reports - are done on a monthly basis. Because each provider and/or practice is different, we are always open to customizing reports on client's requirements.
Medical billing is a serious business in this day and age of medical practices. Without the proper knowledge of medical billing and reimbursement methodologies, providers and practices will not receive the proper reimbursements, if any reimbursement at all. Pacific can help to manage the billing process professionally and enhance your revenue generation.
DEMOGRAPHIC AND CHARGE ENTRY SERVICES
We have expertise in Demographic and Charge entry service for many Specialties ranging from General Practice to more complicated specialties. We provide demographic identification and verification as patients register for healthcare services.
- Patient Demographic Entry Services. Individual patient details are cataloged in billing software. The entries consist of Patient Demographics, Insurance, Employment and sponsor details.
- Patient Demographic Update Services. This service consists of verifying patient information, registered in the billing software with the current information and update if necessary.
- Charge Entry Services. Our charge entry service consists of entering CPT codes, ICD codes, modifiers and other related information into the Billing Software
CLAIM SUBMISSION
The claims submission to insurance company proceeds electronically after demographics and charges are entered into the billing software. Speeding up the reimbursement and reducing the claim rejection.
QUALITY PROCESS
Pacific has two levels of checks for claim processing. This reduces underpayments and denials of claims substantially and provides prompt and accurate settlement of claims.
- Stage I: Our quality assurance team reviews each and every entry of demographic and charges fields in Billing software. This process itself reduces 99% of the errors. The audit is conducted ascertaining maximum accuracy. We audit each and every field in demographic and charges.
- Stage II: In this stage of quality audit entries are randomly checked for errors. The fields and the entries such as patient name, DOB, insurance ID and others are verified for Demographic accuracy. Charges Entry checkup includes fields such as CPT codes, ICD codes, modifiers, service provider and referring physician. Claims are then submitted electronically to the insurance company.
PAYMENT POSTING SERVICES
Cash Posting. Pacific's professional Cash posting Service delivers account creation and payment posting service for each individual patient record and effectively lowers the overall cost of Healthcare Providers. Recording and managing of cash posting service require expert and dedicated human skills and innovative technology. Our highly skilled and experienced executives do Insurance payment posting, Self-pay posting and Denial posting, maintaining high levels of accuracy and confidentiality.
Our success in cash posting service has been driven through the successful assimilation of technology and customer focus. We have constantly invested in technology and experienced manpower. Our solutions have increased productivity and reduced equipment, manpower and infrastructure costs.
- Insurance payment posting. Payment posting service consists of posting primary insurance payments, adjustments and transfer co-insurance to secondary insurance (if available) or patient. Posting of secondary insurance payment is also done by us.
- Self-pay posting. Self-pay posting service consists of posting payments made by patients to the healthcare provider.
- Denial posting. Claims needing resubmission that is claims denied by insurance are checked for all necessary documents like Medical records, Referral, Authorization etc. and resubmitted.
- Quality process. Our quality assurance team reviews cash posting transactions. Checks are done to validate the fields such as check number, co-insurance transfer, and adjustment. Denial and re-submission of claims posting service are very important as it involves a specific time period within which claim has to be re-submitted. Our quality team assures that all denial and re-submission of claims posting is done within time and without missing any record including all supporting documents and information.
- Reports. The reports regarding transaction volume (Number of line items received and submitted by us) are provided to clients as part of the service. These reports are generated in Daily, Weekly/Fortnightly, Monthly based on the customer's preference