Providing a Rapid and Highly Efficient Payment Posting Process

Centre State Practice Management possesses unmatched experience in providing consistent and cost-effective payment posting services to various different healthcare organizations and providers. We use this experience to precisely post insurance payment data from ERAs, post insurance checks from EOBs, post patient payments, and print receipts.

Our Payment Posting Services Distinctly Include:

  • Reviewing payments intermittently
  • Tracking patterns of payments
  • Keeping a check on any inconsistencies arising in payments.
  • Assisting with comprehending payments routinely
  • Making payment the patients' responsibility if any difference arises in the allowed amount for payment and actual amount paid.
  • Identifying and reporting differences between the submitted claims and received claims.
  • Identifying denied claims, services that are no covered or authorized, etc. and prevent these occurrences.
  • Re-submitting to insurance company.

Scope of Our Payment Posting Services

Explanation of Benefits (EOBs) Analysis

Not only does our team of highly trained and experienced individuals accurately gather patient details such has their names, account numbers, control numbers, dates or acquired services, procedures etc, but they also scrupulously analyze all the data to reveal and record all the critical payment patterns such as percentage of insurance receivable, rate of inflows, denials, amount outstanding percentage, and so on.

Scrutiny Based Action

Once the payment receivable patterns are recognized and recorded, the necessary action plan is forwarded to instruct the billing department of a specific client to take obligatory actions that are required to be taken for a positive impact on revenue inflows. If we identify any difference between the allowed amount and the paid amount, we instantly take it up with the patient and make him/her responsible for reimbursing the unpaid amount and lastly the billing department of our client is instructed to take necessary action to collect remaining amount from the patient.

Follow-up with Cash Inflows

We ensure the rigorous monitoring and tracking of every unpaid or remaining amount as well as the status of cash inflow on a regular basis. This allows us to flawlessly keep a check on the rate of the cash inflows and take essential actions whenever there is an interruption in revenue generation under unexpected circumstances.

Following a Definite and Rationalized Process for Payment Posting in Medical Billing

  • Thorough verification of patient details mentioned in EOB (Explanation of Benefits) such as payable amounts, accustomed amounts, permitted amounts, denial information, co-pays, etc.
  • Tracking and scrutinizing the appropriate processing of claims and recording these trends on a regular basis for supplementary analysis.
  • Forwarding information regarding payments to the clients billing department and instructing them to take the necessary measure for increasing incoming revenues.
  • Keeping a check on all the due amounts that need to be received and cash inflow status on a regular basis.

The following benefits sets apart Centre State Practice management's Payment Posting services including:

1

Enhanced personnel efficiency

Enhanced personnel efficiency

Boosting the efficiency of your workforce up to 70%

2

Precision

Precision

Our meticulous ability to deliver the most proficient and consistent payment posting outsourcing services has enables us to deliver 99.99% accuracy in our services

3

Improved denial management

Improved denial management

Our detailed tracking and denial reporting services assists you in keeping the denial rate as low as possible.

4

No log jam

No log jam

We take the charge of eliminating all your worries related to unposted cash as we will be posting backlogs within no time.

5

Lower cost

Lower cost

Here to make you witness saving ranging from 30% to 40% with our payment posting services.Outsourcing your payment posting services for medical billing from us gives you the opportunity of partnering with a company that offers exceptional performance across many parameters such as increased precision, productivity and significant reduction in denials.

HEALTHCARE CLAIMS ADJUDICATION (Advanced Services for Settling Medical Claims)

Increasing payments with the correct claims processing services

Improve Your Claims Settlement Process with Our Superior Offshore Medical Claim Adjudication Services

The acquisition of rapid and correct settlement of medical claims is not an easy task. It requires a watchful concern over various variables, and the process can profoundly affect your resources. In order to run a smooth practice, the claims adjudication process must be efficiently handled by experts. Instead of burdening yourself with all this hassle, we urge you to outsource our medical claim adjudication services for all your medical claims adjudication requirements. As we take care of your claims you can continue to work on providing accessible healthcare to your patients in a carefree environment.

We at Centre State Practice management, provide our users digitized healthcare claims adjudication services to increase their productivity and cash inflows. We have a team of expert and highly skilled adjudicators, who are to assist you in optimizing your current procedures, automate your analysis, and assume a safe and digitized workflow. Our client-centric processes handled by a hard-working workforce have established the most reliable medical claims adjudication services that are customized as per the requirement of our clients' business.

Here's Why Our Claims Adjudication Services Prove to Generate Healthy Returns

  • Precisely analyzing the validity of claims to identify any fraud or repeated claims which prevents the loss of revenues.
  • Data validation against adjudicating systems and calculation of the amount of validated claims for profit generation.
  • Carrying out a digitized claims settlement process with result producing project plans customized according to your requirements.
  • Providing complete transparency of our processes to better collaborate with our clients and attain operational distinction.
  • Providing maximum security and safety of private and confidential information by assuring consistent compliance with HIPAA regulations and guidelines.

Here's How We Help You Optimize Your Accounts Receivable Cycle:

  • Inspecting your accounts receivable balances and separating your collectible and non-collectible sums to help you bill deductible sums to compensators.
  • We ensure to provide you with an accurate analysis of your billing processes which assists in identifying the issues causing claim denials or payment faults and resolving them.
  • We review your accounts to spring up an appropriate action plan which includes the recognition and scrutiny of patterns in codes, dealings or any operational faults.
  • By evaluating the regulation policy of your provider and categorizing claims that require instant amendments, we carry out a complete health check-up of your suppliers AR aging report.
  • We assist you in resubmitting claims along with the essential documents that are either under the filing restrictions of the carrier or the ones that you failed to acquire payments for as per your contract.

Our Client-Centric Healthcare Claims Adjudication Process

1

Eligibility verification

Eligibility verification

verification of the patients eligibility based on their insurance coverage to guarantee reimbursements

2

Verification of Incorrect/Repeated claims

Verification of Incorrect/Repeated claims

reviewing claims to identify the root cause of the existence of fraud or duplicated claims

3

Thorough analysis of provider

Thorough analysis of provider

Thoroughly analyzing the insurance policy and the payment responsibilities of the insurance provider

4

Determining Benefits

Determining Benefits

Evaluating claims to determine all the benefits that would be covered under the umbrella of the insurance policy

5

Processing Appeals

Processing Appeals

Denial management and processing claim reimbursement appeals for better analytical solutions

An Overview of Our Medical Claims Adjudication Services

Reviewing Initial Processing

We start our medical claims adjudication outsourcing services by initially reviewing the entire processing procedure to look for any errors or omissions that can cause significant revenue losses if they remained unchecked. During this review we ensure to take into consideration the importance of verifying patient identity and eligibility so that any misplaced data is instantly obtained for the generation of a complete claim. During the review, our team ensures that the data provided in the claim documents can be verified and backed by original source documents.

Scrutinizing Claims Validity

Our experts look into more complicated matters regarding claims such as the payment policies pen downed by the insurance payer. This involves inspecting if the insurance coverage is active. Our automated review system also identifies the issues of repetitive claims, delayed filing of claims, and other types of fraud.

Pre-Certification Verification Review

Our automated review process evaluates pre-certified or authorized records to identify cases with an issue of missing or invalid pre-certifications. Such cases arise when the diagnosis, procedure, or the date of service cannot be associated to the information provided in the pre-certification or authorization. Also, our automated review process precisely identifies when the authorization number required for a particular service is not acquired or added to the claim prior to its submission.

Manual Review

Our claim examining experts carry out a cross-verification of the claims to validate their authenticity and rule out any possibility of cases where the non-listed services were benefited by patients who did not posses any medical necessity. To achieve this, we follow a detailed review process that verifies if every necessary document is in the required order for the claim to be processed successfully. This prevents the occurrence of delayed or denied claims by reducing claims management process.

Determining Payments and Adjustments

While our services are intended to ensure a reduction in denied claims, we also continually provide support in processing claims that are considered paid, as well as reduced claims. We also provide an accurate analysis for determining the root cause for the arousal of denied claims and identify errors that can be prevented in future claims.

Processing Appeals

Our medical claim adjudication team supports the appeal process for cases where there are inconsistencies between the claim and the policy. We are completely prepared to handle any complexities associated with the appeals process and adjust our procedures accordingly. Our proficient appeals processing services make certain that healthcare providers receive accurate and ample reimbursements for their services and for this, we strive to assist our clients in filing clean claims from the start.

Why We Claim to be Better Than Our Competitors

1

Reliable Quality Services

Reliable Quality Services

We provide the most reliable and highest quality medical claim adjudication services in the market

2

Rapid Turnaround Time

Rapid Turnaround Time

We produce the most optimum outcomes in reduced turn around times through our automated systems for efficient process handling

3

Cost Effective Processes

Cost Effective Processes

Our proficient and automated procedures reduces your operational costs and increases your claim reimbursements while minimizing denials

4

Reduction of Administrative Tasks

Reduction of Administrative Tasks

We assist you to decrease the tiresome administrative tasks and let you focus on your central activities of providing healthcare services

5

Strict Data Encryption

Strict Data Encryption

We believe in the complete privacy of our user’s information and for this purpose we use all types of encryption techniques such as VPNs, firewalls etc during to protect your data.

6

Complete Compliance

Complete Compliance

We conform to the unyielding documented protocols to ensure our compliance with HIPPA.

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