Charge Entry & Claims Processing Services
Accurate charge capture, validated coding, and scrubbed claims submitted the same cycle.
Accurate Charge Entry. Clean Claims. Faster Reimbursements.
All claims start with proper chargers. Please note that claim denials, delayed payments, and loss of revenue can result even from minor coding mistakes, lack of modifiers and/or incomplete documentation.
ZechionMed offers Healthcare Charge Entry & Claims Processing Services for all healthcare providers in the United States. Specialists with industry knowledge and payer-specific expertise, coupled with sophisticated AI-driven validation processes, guarantee that each claim is submitted correctly, in compliance with complex regulations and on schedule.
From independent physicians to multi-specialty practices, ambulatory surgery centers, hospitals, telehealth providers, to large healthcare organizations, we help streamline your revenue cycle and cut down on claim denials and claim cycle delays.
What We Cover
Claim Status Monitoring · Monitoring Services
Charge Capture Review
- The first step to successful reimbursement is accurate charge capture.
- All charges are captured and documented correctly by our specialists before entering charges into your billing system (billable services).
Charge Capture Review · Services Include
- Clinical documentation review
- Missing charge identification
- Duplicate charge prevention
- Encounter reconciliation
- Provider documentation verification
- Charge completeness review
- Revenue leakage prevention
- Use EHR to reconcile charges
- Benefits
- Prevent missed revenue
- Improve billing accuracy
- Reduce lost charges
- Increase clean claim rates
CPT, ICD-10-CM & HCPCS Code Validation
- Coding is checked by our certified coding experts before claims are submitted.
CPT, ICD-10-CM & HCPCS Code Validation
Validation Includes
- Electronic claim generation
- CPT coding verification
- ICD-10-CM diagnosis validation
- A review of HCPCS Level II
- Medical necessity validation
- Diagnosis-to-procedure matching
- National Correct Coding Initiative (NCCI) edits
- LCD/NCD guideline validation
- This is a review of the coding compliance of payers
- Benefits
- Reduce coding errors
- Improve payer acceptance
- Lower denial rates
- Maintain coding compliance
Modifier Accuracy Review
- Use of the wrong modifier is one of the most common claims denied reasons.
- Our billing experts ensure modifiers are assigned correctly as per the billing rules of the payers.
Modifier Accuracy Review · Modifier Review Includes
- Modifier 25 validation
- Modifier 59 review
- This will review Modifier XE, XP, XS, XU.
- Surgical modifier validation
- Telehealth modifier verification
- Bilateral procedure modifiers
- Multiple procedure modifiers
- The review of the Global surgery modifier
- Benefits
- Prevent modifier-related denials
- Improve reimbursement accuracy
- Reduce unnecessary audits
Medical Charge Entry · Charge Entry Services
Our highly trained charge entry professionals enter charges into your Practice Management (PM) or Revenue Cycle Management (RCM) system properly.
- Charge Entry Services
- Patient encounter entry
- Procedure entry
- Diagnosis entry
- Provider assignment
- Facility assignment
- Units verification
- The date of the service being validated.
- Fee schedule application
- Works on most EHR/PM systems, such as Epic, athenahealth, eClinicalWorks, NextGen Healthcare, Kareo, AdvancedMD, Greenway Health, and other healthcare systems.
- Benefits
- Accurate billing records
- Faster claim generation
- Minimized manual data entry mistakes
Creation of Professional & Facility Claims
Claim Types We create comprehensive claims for bills and claims to work and facility providers.
- CMS-1500 claims
- UB-04 claims
- Professional claims
- Facility claims
- Hospital outpatient claims
- Ambulatory Surgery Center (ASC) claims
- Telehealth claims
- Specialty-specific claims
- Benefits
- Accurate claim formatting
- Faster payer acceptance
- Reduced claim corrections
Electronic Claims Submission
- Submitting claims on time is critical for good cash flow.
- Claims are electronically submitted to commercial insurance carriers, Medicare, Medicaid and other government programs.
Electronic Claims Submission · Submission Services
- Electronic Data Interchange (EDI)
- Clearinghouse submission
- Real-time acknowledgment monitoring
- Batch claim processing
- Submission of claims on the same day as the accident (when available)
- Submission tracking
- Rejected claim management
- Claim acceptance verification
- Benefits
- Faster payment cycles
- Reduced mailing costs
- Real-time claim visibility
Advanced Claim Scrubbing · Claim Scrubbing Includes
Each claim is reviewed for a number of validations before it is submitted to ensure potential claim issues are identified that could result in a claim denial.
- Missing data validation
- Invalid diagnosis review
- CPT compatibility checks
- Modifier validation
- Eligibility verification
- Duplicate claim detection
- Frequency edits
- Medical necessity edits
- NCCI edit review
- Payer-specific edits
- Benefits
- Higher first-pass acceptance
- Fewer rejected claims
- Faster reimbursement
Payer-Specific Billing Compliance
- Each payor has their own billing needs.
- Our billing experts keep abreast of the evolving policies of payers throughout the U.S. healthcare landscape to boost claim acceptance.
Payer-Specific Billing Compliance · Supported Payers
- Medicare
- Medicaid
- Medicare Advantage Plans
- Blue Cross Blue Shield Plans
- Aetna
- Cigna
- UnitedHealthcare
- Humana
- TRICARE
- Workers' Compensation
- Commercial Insurance Plans
- Managed Care Organizations
Payer-Specific Billing Compliance
Compliance Services
- Payer-specific edits
- Billing rule validation
- Filing deadline monitoring
- Authorization verification
- Referral validation
- Coverage policy review
- Documentation requirements
- Electronic submission standards
- Benefits
- Fewer payer rejections
- Increased reimbursement success
- Improved compliance
AI-Assisted Claims Validation (2026 Ready)
AI-Supported Capabilities ZechionMed utilizes intelligent automation to reinforce quality assurance prior to claims being submitted to payers.
- Predictive denial analysis
- Coding anomaly detection
- Duplicate charge identification
- Missing documentation alerts
- Claim prioritization
- Revenue leakage detection
- Real-time quality scoring
- Billing trend analytics
- Benefits
- Improved time efficiency – less manual review time.
- Better clean claim performance
- Improved operational efficiency
- Better revenue visibility
Claim Status Monitoring
- When you submit our work, it's not done.
- Continuous monitoring of claims to ensure that claims flow through reimbursement process efficiently.
Claim Status Monitoring · Monitoring Services
- Claim acceptance verification
- Rejected claim identification
- Clearinghouse monitoring
- Payer acknowledgment review
- Submission confirmation
- Timely follow-up
- Resubmission support
- Benefits
- Faster issue resolution
- Reduced payment delays
- Improved reimbursement timelines
What We Cover
Industries We Support
Increased profitability has led to a growing trend of outsourcing billing to allow health care providers more time to devote to patient care.
Why Healthcare Providers Choose ZechionMed
- The medical billing professionals in the United States are seasoned professionals.
- Certified coding and billing professionals
- Claim Quality Review using AI
- HIPAA-compliant workflows
- Multi-specialty billing expertise
- Understanding Medicare, Medicaid and commercial payer knowledge
- EHR and Practice Management system experience
- Support for practices of all sizes, scalable!
- Clear reporting and monitoring of the outcomes
- Flexible engagement models
Business Benefits
- Improved clean claim rates
- Faster reimbursement cycles
- Reduce denial and rejection rates
- Better initial claim acceptance
- Reduced administrative costs
- Improved cash flow management.
- Increased revenue capture
- Fewer billing errors
- Enhanced coding compliance
- Improved payer relationships
- Greater operational efficiency
- Scalable support in growth
- Proper access to protected health information (PHI).
- In-depth reporting and revenue details
- Additional time to spend with patients while providers are free to focus on patient care.
Industries We Support
- Independent Physician Practices
- Multi-Specialty Medical Groups
- Hospitals & Health Systems
- Ambulatory Surgery Centers (ASCs)
- This is part of the Rural Health Clinics (RHCs)
- Federally Qualified Health Centers (FQHCs)
- Urgent Care Centers
- Behavioral Health Providers
- Telehealth Organizations
- Surgery of the teeth and mouth
- Physical & Occupational Therapy Clinics
- Home Health Agencies
- Diagnostic Imaging Centers
- Laboratories
- Durable Medical Equipment (DME) Suppliers
Frequently Asked Questions
Charge entry is the process of correctly entering patient services, diagnosis codes, procedure codes, modifiers, provider information, fees, etc., into the billing system prior to creating insurance claims.
Contact ZechionMed
Capture, review, and dispute every claim to ensure it's optimized, from entry to payment.
Healthcare organizations benefit from ZechionMed's full Charge Entry & Claims Processing services, which provide accurate charge capture, compliant coding validation, intelligent claim review and timely electronic submission – increasing reimbursement, limiting denials and improving performance throughout the U.S. healthcare market.