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Claims Processing-CMS 1500

Claims submission: Medesun team assign the codes as per documentation and guidelines and submit medical claims electronically to insurance companies or payers on behalf of healthcare providers and ensuring that they are complete, accurate, and meet the requirements of the payer.

Claims follow-up: Follow up on denied or rejected claims, working with insurance companies or payers to resolve any issues and resubmit claims if necessary.

Payment posting: Services will post payments received from insurance companies or payers to the healthcare provider’s account and reconcile them against the original claims.

Patient billing: Generate patient bills for any co-pays, deductibles, or other patient responsibility amounts, and send them to the patient.

Denial management: Track denials, analyze trends, and identify areas for improvement to reduce future denials.

Revenue cycle management: Medical billing claims processing services will entire revenue cycle, from patient registration to claim submission to payment posting and patient billing.

Reporting and analytics: Regular reports to healthcare providers on key metrics such as claim denial rates, payment turnaround times, and revenue cycle performance.

Credentialing: Credentialing, including provider enrolment, re-credentialing, and ongoing maintenance.

Compliance: Ensure compliance with regulatory requirements, such as HIPAA and other privacy and security regulations.

Email : info@medesun.com for more details