Grow High - We develop the new heights to your Growth

Complete Revenue Cycle Management

Eligibility Verification

We Extracts Appointment Scheduled 4 days in prior to Service Date from Client’s System.
Verify Patient’s insurance coverage & Demographics Info with insurance
Patient A/c’s with issues are mapped with appropriate status code
Eligibility reports forwarded to corresponding site location
Front Desk at site location rectifies the invalid or missing patient. A/c information.

Medical Coding

Client scans super bills and upload the scanned files on to a secured server located at client’s office.
We downloads the scanned Super-bills and distribute the files for coding.
Our certified coders analyze each super-bill and code as per the guidelines set by CMS and AMA
The coded Super-bills are then examined for any possible errors by a well experienced certified coder.
Audited Super-bills are sent to the Charge Entry team to create claims in Client’s EMR.

Patient Registration and Charge Entry

Scanned patient’s demographics and the coded Super-bills are sent to Entry team to create claims in Client’s EMR system.
Each patient’s scanned record is analyzed and determined if it is a New patient or an Established patient.
If it is a new patient, then create an account in Client’s EMR system. And update the patient ‘s A/c if it is an Established patient.
Create claims in Client’s EMR system based on coded Super-bills.
Thorough audit of claims data to ensure optimal quality levels prior to claim submission.

Payment Posting and Reconciliation

Scanned EOB’s are downloaded from Client’s office and distributed among the Payment posting team to further process those batches
Payment team will create a batch and set the target value to be posted in Client’s PMS system
Analyze each EOB and post payments, adjustments or flag denials in Client’s PMS system as per the scanned EOB files.
Batch log is printed from Client’s PMS system to reconcile the batch posted and audit transactions by the posting team
Thorough audit by experienced payment team to ensure optimal quality levels in transaction posting

Accounts Receivable Management

The AR Analyst receives the work order from the Cash posting department on all the Unpaid/Part paid claims
After analyzing the Unpaid/Part paid claims report, the Analyst identifies the claims that need to be further researched allocate the work order to our AR team
A weekly Insurance receivables summary and detailed report are generated from the Client’s PMS system by our Analyst team for claims that are 20 days past billed date
Work orders are then distributed by the Analyst team based on the Age of the Ins. AR and Filing /Appeal limits of outstanding claims.
The A/R Analyst takes final action on the claims worked by our AR team and forward reports to client if additional information is needed to resolve those balances.

Grow-High Reporting

Grow-High Delivery Model

Daily charges are posted in to client’s Billing system within 18 hrs of receipt
Claims are submitted on the same day the charges are posted in PMS system.
Prompt resolution of EDI claim rejections with 24 hrs from claims transmission date and resubmit corrected claims.
Report to client on any unresolved EDI claim rejections pertaining provider and patient registration issues.
Same day payment posting & reconciliation in to client’s Billing system within 18-24 hrs.
Increase the probability of payment through timely follow-up on accounts having possibilities for delay in payments and take corrective actions to resolve these claims.
Delivery Model that not only accelerates your cash flow, but also reduce Days in A/R and also improve Collection Ration.

Advantages - Grow-High

Value Adds