BENEFITS & ELIGIBILITY VERIFICATION
We make sure your patients benefit and eligibility is verified which will eliminate all eligibility related denials and increases revenue by at least 7-10%
CODING & SUBMISSION
Claims are scrutinized ensuring maximized reimbursements without over-coding which is one of the ways we typically increase clients’ revenue by 10% – 20%. We maintain a nearly 100% success rate on first attempt HCFA and UB clearinghouse claims with WC (workers compensation) and NF (No Fault) available as well. We stay on top of all latest coding updates.
AR FOLLOW UP
We all know that Insurances will deny claims. Thus AR follow-up is the most critical part of any billing work flow. Account receivables follow-up ensures timely turn around of rejections and denials. Here at Root RCM, we make sure that maximum resources are allocated to the AR.
DENIAL MANAGEMENT
We make sure your AR experiences will minimize the denials. Our experts have extensive experience in overturning all types of denials, right from medical necessity, maximum benefits exhausted, additional documents required, coding related, patient benefit related, prior authorization issues, EDI issues, our team is adept at resolving and getting denials resolved on time.
APPEALS / MEDICAL NECESSITY
We have a separate appeals and reconsiderations team that works closely with the AR team. The team has both pre-set and customizable appeal formats for each and every type of denial. Extensive appeals including the right information, submitted timely can have a huge impact on overturning the most complicated denials effectively.
EOB / ERA POSTING
We make sure all your EOB’s ( Explanation of benefits ) and ERA’s ( Electronic remittance advice ) are posted and reconciled daily to ensure an accurate end of day statement for your staff to review and access average growth in revenue. We have a two tier quality system in place, ensuring all postings go through a level 1 and level 2 check before.