Mission Health issued a press release announcing their plans to remain in-network for Blue Cross and Blue Shield of North Carolina (Blue Cross NC) customers enrolled on an ACA plan in 2018. …
Physically review order documentation, applying Payor Policy and Guidelines, to catch potential denials, audit issues and fraud. Recommended changes and corrections are communicated back to client staff.
Our Document Review Team is dedicated to the accuracy and compliance of DME Provider paperwork. When claims are submitted they review each claim for accuracy, compliance with Payor Policy and even fraud. Any issues found are promptly brought to the attention of the appropriate client contact and an effort to expedite the resolution of the issues is begun. This proven process resolves denials before they happen while educating client staff.
Ensure proper claims submission, price table configuration and cash posting. Stay in front of Payor Communication issues to streamline the Revenue Cycle Process..
Our Team can assist with software conversions, price table configuration, EFT and EDI enrollment and more.
Tackle outstanding billed claims utilizing a proprietary algorithm and tasking system turning Accounts Receivables to Cash.
Our AR Team continually works any Denials or AR Issues that arise consistently striving to stay in front of changes in Payor Policy that affect cash flow. Our Proprietary Dashboards utilize intelligent algorithms to guide our Collection Team in tackling Client AR effectively while organizing work efforts.