Our Team & Professional Expertise

Our billing professionals understand the operational processes that follow once healthcare services are documented and coded. We provide expertise across:

• Charge entry
• Claim preparation
• Electronic claim submission
• Claim status monitoring
• Payment posting
• Electronic remittance processing
• Accounts receivable management
• Payer follow-up
• Patient balance workflows
• Claim reconciliation
• Billing review
• Denial-related billing analysis
• Revenue cycle reporting

The focus is on keeping workflows accurate and finding the problems that hold up claims and payments.

Our coding professionals assign accurate codes based on the clinical documentation available and the coding requirements that apply to the case. Areas of expertise may include:

• ICD-10-CM coding
• CPT coding
• HCPCS coding
• Evaluation and Management coding
• Specialty-specific coding
• Diagnosis coding
• Procedure coding
• Documentation review
• Coding validation
• Coding quality review
• Coding audits
• Pre-bill coding review
• Denial-related coding analysis

Coding work is tied to what happens downstream — the billing and claims processes it feeds.

Medical billing and coding is one component of the revenue cycle. Our specialists understand how the functions along the claim path depend on each other. Broader expertise may include:

• Claims management
• Denial management
• Appeals support
• Accounts receivable
• Revenue integrity
• Payment posting
• Claims audits
• Underpayment analysis
• Billing quality review
• Revenue cycle reporting
• Workflow analysis

A connected approach lets clients address problems across the revenue cycle rather than treating one billing issue on its own.

We support organizations that need an additional review of their coding, billing and claims processes. Audit and quality work can include:

• Coding accuracy reviews
• Documentation-to-code validation
• Claims quality reviews
• Billing workflow reviews
• Denial trend analysis
• Reimbursement issue identification
• Coding variance analysis
• Pre-bill audits
• Post-bill audits
• Revenue cycle process walkthroughs

The purpose is to identify gaps in the process, issues that recur, and opportunities to improve.

We also handle provider credentialing and enrollment. Depending on the engagement, support may include:

• Provider enrollment
• Credentialing documentation
• Recredentialing support
• Payer enrollment workflows
• Provider information management
• Enrollment status tracking
• Credentialing-related follow-up
• Documentation organization

Credentialing matters to the revenue cycle because provider enrollment and payer participation affect reimbursement for services.