Fee schedule means fixed amount approved by Federal government as a reimburse for the service provider. Here service provider are doctors, other non providers or supplier. The providers reimbursement rates can determine the difference between profit and loss of business. Still many insurance payers still process the claim with low reimbursement contract amount, without knowing the trick of insurance payer. Provider in an urge fall in to trap of Insurance payer quickly, by accepting the contract so that they may get new patients swiftly.
In usual occurrence most of the provider either Individual physician or Small provider group are no aware of the negotiation or renegotiation rates. In Medigenix we do Research on the Insurance payer policies, Analyse break even point with payer rate, we do under the Medicare RBRVS for each service is assigned RVUs based on the physician effort, practice expenses/malpractice risk involved and also evaluate specifically on demographic specific patient plans too. So it provides better networks of physician, employee groups and patients of that particular healthcare. We assure positive payer rewards as we have better coding and charge accuracy.
Mindgenix offer special service on Re-credential followup. Credential are normally done to New provider to get affiliate to payers. So credential are done to validate Insurance payer on Provider qualification and to show providers Practice history. By doing Re-credentials we can avoid Insurance payment delays, also avoid denials and reworks. Re-credential are reprocess/reviewing the provider credential and upgrading the physician work practice history once again. And an advantage in Mindgenix we have normal mandatory TAT for Re-credential process for every 3 to 5 year as per Payer.
EDI or ERA(Electronic Remittance advice) is a process which eliminates the paper EOB.ERA setup goes hand in hand with EFT(Electronic fund transfer). EFT are required to get electronic fund movement instead of Paper check. Paper checks takes time to deposition and clearance, but in EFT automatic payments are carried on. So to get this automatic payment deposition we need to setup path way to transmit the claim via Clearing house. This setup require special ACH followup as per HIPAA Protocol.
Benefits on EDI/ERA & EFT setup are “Fast payment settlement, Avoid unwanted fees, Reduces risk of fraud and also enables easy reconciliation?
Front office before pre visit collects insurance information. And this is fed in EMR and it is cross checked with insurance to confirm Active or inactive Insurance status. So front desk can inform Patient for collecting copay and patient responsibility. Initiating a solid insurance verification process in place can reduce the denials and makes medical billing process more efficient. Physicians need to verify each patient’s eligibility and benefits to ensure they will receive payment for services rendered.
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