Our Medical Billing process takes the next step for the physician’s office. We focus on providing detailed oriented services that allow the physicians to get back to what they do best; provide excellent patient care.
Credentialing Services
- Completion of credentialing applications for insurance carriers and hospitals, including all necessary follow up while monitoring the application(s) through to approval.
Eligibility Verification
- We utilize tools from our Practice Management system and from our robust Clearinghouse Module to ensure patients are eligible for services to be rendered dramatically reducing processing time for claims.
Verification of Benefits
- Determine that services rendered are a covered expense under the patient’s plan.
- Ensure revenue is gained not lost by obtaining information that isn’t given on the eligibility verification report from the carrier.
- Authorizations, in-network/out-of-network information, policy limitations and allowed amounts are just a few of the items that can be obtained at this stage in the process.
Demographic Entry
- Information obtained via a secure portal or other form of secure transmission from the practice and/or provider will be entered in our database.
- Where applicable Sertus will utilize an automated demographic entry (via interface-integration) into the Practice Management (PM) system for accuracy. Sertus will review all items prior to submissions.
Patient Services
- Efficient patient billing process customized to the needs of the practice
- Receive patient phone inquiries
- Manage collection agency relationship
- Secured Patient Portal available for the office staff, billing staff and patients
Coding Services/Audits
- We provide full coding services for office visits, surgeries, hospital rounds and other specialty services.
- A 10 chart audit will be performed annually to assist the physician with feedback regarding documentation pertaining to CPT codes chosen and Diagnosis codes used.
- Concurrent QA at a set ratio –for example take 5-10% of charges per month and provide feedback-provide feedback that can be applied back to the practice plan
Accounts Receivable
- Sertus strategically performs follow up on unpaid claims within 30-45 business days.
- Insurance guidelines are followed to ensure claims are paid in a timely manner.
Address Verification
- Prior to a patient statement being sent the patient’s address in the statement file is compared against two national change-of-address databases to help ensure prompt and accurate delivery.
Automated Payment Posting
- Payments are posted within 24-48 hours.
- Payments are posted by using automated functions within the Practice Management system.
- Automated posting reduces/eliminates errors
Customize your Medical Billing Package with Premium Services
A summary of premium services and how they benefit your practice:
- Robust Denial Management Tools for quicker resolution of denied claims
- EOB to ERA Tools allow us to convert your outdated Explanation of Benefits forms to Electronic Remittance Advices to improve cash flow
- Lockbox Services to better track patient and insurance payments
- Patient Portal facilitates real-time transactions
- Analytics Platform to help manage cash flow