Medical Billing

Pre-certification & Insurance Verification

The patient list, a copy of the insurance card and demographic details are sent to us via email/fax or secure FTP. Iovite medical billing specialists call up the insurance company prior to the appointment. Pre-certification is done for specific lab tests, diagnostic tests and surgeries. The details are sent to the hospital/clinic in the prescribed format.

Patient Demographic Entry

Iovite medical billing specialists enter patient demographic details such as name, date of birth, address, insurance details, medical history, guarantor etc as provided by the patients at the time of the visit. For established patients, we validate these details and necessary changes, if any, are done to the patient records on the practice management system.

CPT and ICD-9 Coding

Iovite coding team consists of AAPC certified coders with over 2 years of multi-specialty coding experience. You may send us superbills with diagnostic notes with or without ICD and CPT codes. If codes are already provided on the superbill, they are validated by our coding team compulsorily to prevent any 'up-coding' or 'down-coding' and therefore, any denials.

Charge Entry

The fee schedules are pre- loaded into the practice management system. CPT and ICD-9 codes are entered into the system. The billing specialists ensure that all details have been provided in the claim and ready to be filed.

Claims Submission

Claims are submitted electronically via the practice management system. However, we can process paper claims also. At this stage, a thorough quality check is done by a senior billing specialist and then submitted. The rejection report received from the clearing house, if any, is analyzed and the necessary changes are done. These claims are then resubmitted.

Payment Posting

Scanned EOBs and checks are sent to our team. All payments are entered into the system. The amounts from EOBs/checks and amounts posted in the system are reconciled on a daily basis. A daily log is updated with these data.

Account Receivables Follow-up

All claims in the system are examined and priorities are set. First the claims close to their filing limits, and then work down from the age of the claim. Periodic follow-ups over phone, email and/or online is done to get the status of each claim submitted to the insurance company.

Denial Management

Analysis of denials and partial payments is done by our senior medical billing specialists. Payors, patients, providers, facilities and any other participants are called to follow-up on denied, underpaid, pending and any other improperly processed claims and the action is documented in the system. We will call patients, if authorized by the provider, to obtain information from the patient needed for billing such as ID# and to update the COB (Coordination of benefits) with their insurance companies. Secondary paper claims are processed and sent to the client office for submission.

HOSPITAL BILLING

Hospitals and health care service providers, like any other organization, need to maintain an effective billing mechanism to receive payments and also track expenses. Conducting hospital billing services in-house is not only tedious but also expensive. Staff costs, administrative expenses and overheads towards infrastructure will be some of the costs that you will have to consider if you conduct hospital billing in-house.

If you'd much rather focus on providing better care for your patients and have some one else take care of maintaining your reimbursements, outsourcing your hospital billing services might be the solution you are looking for. Outsourcing brings direct cost savings on running a billing operation whilst saving costs on staff salaries and other overheads.

Iovite has been in the forefront in providing hospital billing services coming with an acute knowledge of the US healthcare industry. We have been working with various hospitals and medical practitioners for over 2 years and can help you increase your reimbursements by more than 20%. Features of hospital billing services by Iovite

One of the prime reasons why some hospital billing collection services have a low success rate with outsourcing providers is a defective quality process. Hospitals require an error free operation; errors should be restricted to a maximum of 2% to achieve better rates of return. Our experience in working with hospitals in the US with a strict quality control process has consistently ensured low rates of errors for our customers. The features of Iovite's hospital billing and collection services include:

• Accounts receivables management such as follow up on bills, collections reporting, insurance follow-up, denials analysis and re-billing
• Data entry of patient information such as the Patient's Name, Present Address, City, State, Zip Code, Social Security Number, Employer Details, Insurance Details like Primary, Secondary and Tertiary, and guarantor information
• Entry of CPT / ICD codes and other charge entry details like Date of Service, Referring Physician, Ordering Physician, Place of Service, Type of Service, Modifiers, Authorization or Referral Details and Co-pay Details
• EOB entry such as Patient Account Number / Patient Control Number, Patient Name, Date of Service, Procedure Code, Billed Amount , Allowed Amount, Adjusted Amount, Paid Amount, Deductibles and Denial Details

Medical standards followed at Iovite

• We can work with all major medical billing software such as Medisoft, Medical Manager, eClinicalWorks, AdvancedMD, Kareo, Elligence etc
• We are HIPAA compliant
• We have extensive experience in CPT, HCPCS, ICD-9 coding Level I, II, III
• We're proficient in regulations related to Medicare, Medicaid, managed care, third party liability, workers compensation, Preferred Provider organizations and indemnity insurers.