Real-time benefit checks before appointments. Accurate CPT/ICD-10 entry from encounter notes.
KPI: <1% eligibility-related denials
Payer-specific scrubbing, modifier validation, and timely filing compliance for primary care and specialists.
KPI: 99%+ data accuracy rate
Daily EOB review, root-cause analysis, corrected claim resubmission, and live insurance follow-up calls.
KPI: 30-day denial rebill turnaround
Inbound call handling, statement inquiries, payment plan setup, and dedicated account manager support.
SLA: 48-hr escalation resolution
Medicare, Medicaid, and commercial payer enrollment. CAQH management and re-credentialing tracking.
Timeline: 45–90 days, end-to-end
CPC/CCS certified coders. ICD-10, CPT, HCPCS, E&M optimization, and specialty coding for cardiology, ortho, and behavioral health.
Continuous payer policy updates
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