A right code will reimburse you right remuneration”, Medical coding is a crucial process involved in the RCM process. As per sources there are 18% less certified coders available in US. ProMaestro professional coders with several years of medical coding experience and certified as CPC, CPC-H, CPC-A from AAPC, provide highly accurate and compliant coding services by adhering to the LMRP, CCI Edits and other coding guidelines. This ensures cost saving for coding at all level of practices.
As per the super bill our Coders verifies all the CPTs, ICDs and Modifiers before the charges are transmitted.
Our Coders are:
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AAPC certified Professionals
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Proficient in ICD-9 CM, CPT, DRG coding and HCPCS codes across various specialties
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Getting ready for ICD-10 implementation in 2013
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Familiar with Insurance and Government regulatory requirements
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Comprehensively trained and pursue continual education
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Stringent quality audit & HIPAA compliance
Our coders review denied claims regularly and update the doctors on usage of the correct CPT and Diagnosis which ensures smoother cash flow.
Our billing solutions are designed to help increase your revenues and decrease the reimbursement days of claims.
With qualified, experienced billing professionals and by adhering to the client’s billing guidelines clean claims are sent to the payers faster. Our highly trained team with effective training and feedback mechanism are dedicated to maximize the reimbursements through accurate claims entry with minimum denials and A/R follow up.
ProMaestro extends to all its clients:
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Increased operational efficiency
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Increased cash flow with faster payments
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Higher customer satisfaction
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HIPAA compliant process
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High quality with quick turnaround
We specialize in every one of the below mentioned functions as well as the end to end cycle of Revenue Cycle Management.
We specialize in every one of the below mentioned functions as well as the end to end cycle of Revenue Cycle Management.
Eligibility Verification:
The moment appointment is fixed in the EMR system; our team processes the verification of insurance details within 24 Hours via web or calling. This makes easier for the front desk to collect the copays and deductible shares as the next day appointment details are already verified. Our EMR has the automated insurance verification feature through which even front desk at provider’s office can do the eligibility checking for non-scheduled patient. Generally, Providers lose 1% of their annual income if the patient's eligibility is not verified. Our billing system reduces this risk in real time.
Charge Entry:
After entering the CPT and ICD codes from the medical transcripts or super bills (as the case may be), our charge entry team checks for the compatibility of the diagnosis and procedures codes and LMRP match, to ensure submission of a clean claim to insurance carriers.
We have implemented three layers of quality process before submission of claims that ensures 100% clean claims submission first time.
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Manual re-check by Charge entry team
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Random Quality Audit using statistical data
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Claim Scrubber by billing software
Payment Posting:
A team of highly skilled and analytical staff enables the timely and accurate posting of all payments from Explanation of benefits (EOB), correspondence and contractual adjustments, allowing for the efficient use of AR and follow-up staff. We also balance the amount deposited by the Doctor using deposit slips with the ERA and check posted in the PMS, so there will be no confusion on the balancing of the accounts.
Denial Management:
Our highly skilled analysis team works on all the denials received from various payors within 24 hours and resubmits the claims back to insurances companies. ProMaestro team is specially trained to recover the collectibles from
At ProMaestro, we aim to improve the client's cash flow by reducing Accounts Receivable days and improving profitability, by increasing collection ratio.
Our A/R Follow up team is trained to identify patient accounts that require follow-up and take the necessary action to collect unpaid and partially paid claims. It is essential to follow-up and document unpaid claims prior to the 60 or 90 days timely filing limits assigned by many managed care contracts. ProMaestro team run reports on accounts 30 to 60 days past due and call insurance companies to check claim status, re-file, or gather additional information. Our goal is to keep the average days of Accounts Receivable at 25 days or less.
At ProMaestro, it is all about prompt reimbursement. We are extremely familiar with the current State and Federal Insurance regulations and strive to obtain high rates of return from their Follow-up efforts.
Effective Accounts receivable begins with proper coding. The claims are checked for proper order and placement of CPT codes and modifiers. Consistent, thorough detailed follow-up is performed by our domain experts. Their involvement with the insurance carriers has enabled our specialists to develop contacts and rapport that help speed the payment process. All the claims are tracked until they are paid.
