Medical Billing

Helicom Systems is specializes in providing medical billing services to help healthcare providers maximize profits. With over 6 years of experience in providing medical billing, coding and associated services, we know what it takes to achieve operational excellence and so can determine what type of medical billing services you need and what is important for you to get reimbursed faster and better.

Regulatory changes are here to stay, and the easy way to tackle them is to get on top of them. That's precisely what you get with our medical billing outsourcing services. Being an expert medical billing company, we constantly update our medical billing process to match evolving regulations; hence almost all our claims get accepted on first submission. In the rare case of a denial, we delegate it to a team specializing in denial management to put it on a fast track mode. As a result, quick resolution stands guaranteed.

Comprehensive Range of Medical Billing Outsourcing Services that We Provide Our clients - including nursing homes, sole physician practices, hospitals and medical centers, home healthcare companies, medical billing companies and physical therapy companies - bank on us to provide following medical billing outsourcing services:

Insurance Eligibility Verification

Insurance information of every new patient sent to us is verified and updated as follows:

  • Receive patient schedules from the hospital via fax, email or EDI
  • patients insurance coverage
  • Contact patients for additional information
  • Update the billing system with eligibility and verification details including member ID, group ID, co-pay information, coverage start and end dates, and so on.

Medical Coding

Helicom Systems has put in place an expert team of highly credentialed and experienced coders. All our coders are AAPC certified, have a minimum of five years of experience and are continually working to stay on top of latest changes in the industry. Leveraging this vast repository of expertise, we can provide medical coding services in almost all the specialties.

Medical Claims Audit

The claims are then put through a series of rigorous auditing sessions, which involves extensive testing at various levels. The completed claims then go through the second round of examination for validation of information, including correctness of procedures and diagnoses codes. Only those claims that are error-free go to the next step.

Claim Transmission and Working on Clearing House Rejections

Once the charges are created and their correctness is established, they are filed with the payer electronically. At the clearing houses, the accuracy of information contained in the claims is validated and a report is sent back within 24 hours in case of any inconsistencies. Once we get the report, the inaccuracies in the claims will be rectified and within next 24 hours error-free claims will be resubmitted to the insurance company.

Payment Posting

Our experienced team of medical billing and coding experts can carry out all payment posting processes including:

  • Payment Posting from Explanation of Benefits (EOBs) to Patient Account
  • Indexing of EOBs to patient account
  • Analysis of EOBs for under-payment or over-payment
  • Reconciliation to Match Payment Posting to Actual Deposits
  • Denial Management

We track every claim that is denied and present it in a manner that allows fast identification of trends. With this kind of powerful intelligence in hand, we can dramatically drive up the first-time claim acceptance rate and stop the torrent of claim denials.

Some of the key functions of our denial management process are as follows:

  • Identifying the root cause of denials - We identify and interpret patterns to quantify the causes of each denials
  • Supporting accurate workflow priorities - We collect every piece of information related to denied claims, including status, escalation and correspondence
  • Providing timely and accurate statistics - We provide accurate analytics and reports that can go a long way in preventing future denials
  • Tracking, prioritizing and appealing denials - We generate appeal letters that adhere to state/ federal rules and provide case citations in favor of the clients appeal
  • Avoiding out-of-timely filing

Analyzing the effectiveness of the resolutions Identifying business process improvements to avoid future denials

Account Receivable Recovery

Here our team of AR management experts rigorously tracks all unpaid insurance claims that pass the 30 days bucket and ensure that they are collected, thereby greatly reducing accounts receivable (AR) days. They also ensure that all underpaid claims are processed and paid correctly by the insurance payer, while making sure that all the denied claims are appealed in time.

Patient Follow-Up/Patient Statements

We approach patients regarding pending balances that are due after the claim is processed. Those that receive no responses are moved to collections and the client is notified to take further action.

Collections

This is the final and most important step in the medical billing cycle, wherein we persistently follow-up with insurance agencies for final settlement of payments and get the job done within the shortest possible time.