· Check eligibility and benefit verification by calls and web portals.
· Work on authorizations and referrals where required
· Call patients for PR and explain their portion to pay before they come for visit
· Coordinate with Primary care offices to obtain referrals/auth
· Review patient bills for accuracy and completeness and obtain any missing information.
· Check each insurance payment for accuracy and compliance with contract discount.
· Post charges and payments EOB/ERA’s
· Call insurance companies regarding any discrepancy in payments if necessary.
· Follow up on unpaid claims through insurance calls & web/portals.
· Research and appeal denied claims.
· Create custom reports & verify analytical data
· Coordinate with Attorney offices for LIEN cases
· Maintain a strong follow up with each insurance adjusters/patient/attorney offices
Setup and Services is an expert provider of outsourced HIPAA compliant Medical Billing Services. We provide end-to-end medical billing bpo services.