Medical Billing and Coding

Medical Billing & ACR

We have a highly qualified, dedicated and professional team to cater to the Medical billing and ACR needs of our US clients wherein we followup with the Insurance companies to enable consistent and timely disbursal of the claims by the US Healthcare professionals.  As a competent, experienced billing service we can provide a well-managed computer system as well as motivated, efficient billing personnel that can produce your desired results. Physicians and other health care professionals who utilize our billing service can expect our billing agents to perform initial data entry of patient demographic and charge data, prepare insurance claims, diligently follow up unpaid claims, post payments and adjustments and bill patients for deductibles and co-insurance.

Working closely with doctors and other health care professionals, we quickly file claims with a patient’s insurance company first, then followup with patient billing. You determine what components are billed by us. We maintain all patient data, send all statements, quickly file claims and obtain maximum reimbursement on all accounts.

Payment Deposits & Posting Services

Alfa e-Solutions Pvt. Ltd’s professional Cash posting Service delivers account creation and payment posting service for each individual patient record and effectively lowers the overall cost of Healthcare providers. Recording and managing of cash posting service requires expert and dedicated human skills and innovative technology. Our highly skilled and experienced executives do Insurance payment posting, Self-pay posting and Denial posting, maintaining high levels of accuracy and confidentiality.

Our success in cash posting service has been driven through successful assimilation of technology and customer focus. We have constantly invested in technology and experienced manpower. Our solutions have increased productivity and reduced equipment, manpower and infrastructure costs.

Insurance Payment Posting

Payment posting service consists of posting primary insurance payments, adjustments and transfer co-insurance to secondary insurance (if available) or patient. Posting of secondary insurance payment is also done by us.

Self Pay Posting

Self-pay posting service consists of posting payments made by patients to the healthcare provider.

Denial Posting

Claims needing resubmission that is claims denied by insurance are checked for all necessary documents like Medical records, Referral, Authorization etc. and resubmitted.

Quality Process

Our quality assurance team does complete checkup of entire process of cash posting. Checks are done to validate the fields such as check number, co-insurance transfer and adjustment. Denial and re-submission of claims posting service is very important as it involves a specific time period within which claim has to be re-submitted. Our quality team assures that all denial and re-submission of claims posting is done within time and without missing any record including all supporting documents and information.

Reports

The reports regarding transaction volume (Number of line items received and submitted by us) are provided to clients as part of the service. These reports are generated Daily, Weekly/Fortnight, Monthly based on the customers preference.

Accounts Receivable Services

Alfa’s Accounts Receivable Service saves Healthcare service providers valuable practice time and resources and focus on building core competencies.

Many healthcare providers have tried managing accounts receivables, in the process ended up mismanaging the whole thing, resulting in reduced cash flow and increased collection cost and negligence. Our account receivable service improves cash flow, reduces account receivables, increases collection ratios, and enhances customer relationships with timely Accounts Receivable Follow-Up Service.. Our professional approach and timely follow-up has increased the revenue to many healthcare providers. Call center executives meticulously follow patient records, analyze them, take up with the insurance companies, address and rectify the problem.

Assessment Process

Receivable Analysis, Payer Follow-up, Denials Management, Reporting, Practice Analysis
Daily Insurance aging report is run and claims are analyzed. The analysis is done to identify:

  • Unpaid Claims
  • Low Paid Claims
  • Denied Claims
  • Rejected Claims
  • Claims not on file

Analysis Process

Our competent and knowledgeable professionals review each claim in each payer type to ensure proper reimbursement to the healthcare provider. After the Claims are analyzed, steps are initiated to streamline cash-flow based on the following:

  • Claims needing resubmission are checked for all necessary documents like Medical records, Referral, Authorization etc. and resubmitted.
  • Claims that need to be appealed for low payment, timely filing etc.
  • Separation of Denials.
  • Issue of instructions to the callers for follow-up to get the status.