Medical Billing & Collections

Process & Delivery

At Austin, we work as an extension of the practice. We consider medical billing and collections as a process in itself. We follow the conventional conveyor belt model of processes where every process has a cyclic effect on the subsequent process that is best suited to captive business units.

The reporting system at Austin provides the facility and the physicians the following services:

  • Verification of Benefits
  • Document Management
  • Patient Demographics Verification
  • Coding and Charge Entry
  • Claims Transmission and Frontend Rejections
  • Payment Posting
  • Denial Management and AR Follow Up

Verification of Benefits

Our dedicated team of eligibility specialists ensures all the services performed are eligible for reimbursement. Our tailor made VOB form provides detailed information on patient coverage, services eligible and patient responsibilities helping the clinic to collect better. We utilize Insurance web portals, customized online resources and if required call the payers to determine the eligibility of the patient, thus avoiding rejections and denials forefront.

Even a small percentage of eligibility misses or errors that slip through the cracks can cost organizations big, so we quickly find these missed opportunities by using our proactive and retroactive scrubbing tools.

Document Management

At Austin, we believe that the basic of billing is accurate documentation. Our seasoned team has expertise in organizing and uploading all type of Patient, Insurance and Provider documents to the EMR system for easy accessibility. The medical documents are uploaded with Document Name; Type and Date helping us easily identify the required document.

Patient Demographics Verification

Patient demographics verification is the key to timely reimbursement from the Insurance. Critical error due to clerical lapses is given utmost priority in order to tackle issues at the onset using six sigma methodologies. Single incorrect information on the claim form will get the claim rejected or denied. Our dedicated demographics team ensures all the information received from patient is updated correctly into the patient chart.

Coding and Charge Entry

Our team of AAPC certified medical coding specialists strictly adhere to Insurance and Government Regulations. Our medical coding team is well versed in ICD-10, CPT coding, and HCPCS codes across various specialties.

The Coding team at Austin is proficient in the following specialties:

  • Ambulatory Surgical Center
  • Anesthesiology
  • Audiology
  • Cardiology
  • Chiropractic
  • Diagnostic Radiology
  • Endocrinology
  • Evaluation and Management
  • Gastroenterology
  • General Surgery
  • Gynecologic Oncology
  • Internal Medicine & Family Practice
  • Interventional Pain Management
  • Medical Oncology
  • Neurology & Sleep Medicine
  • Obstetrics & Gynecology
  • Orthopedic Surgery
  • Radiology
  • Rheumatology
  • Spine Surgery
  • Sports Medicine
  • Urology

Claims Transmission and Frontend Rejections

Clean claim submission is a requirement for any practice to get timely and maximum reimbursements. At Austin we ensure all the claims transmitted are completely clean and error free. Our team is well aware of any changes the Insurance requires and inculcate the updates into our process to ensure minimum rejections.

Payment Posting

Payments received from patients & insurance companies are posted to the patients accounts in the medical billing system. The posted payments are balanced against the deposit slips to ensure accuracy in payment. The payment posters also check for any under payment being made to the accounts. We also do electronic posting of payments in to the medical billing software and ensure that the EOB files are stored for future references. Austin follows electronic fund transfer process for most of its Physicians and hence the reimbursement TAT is greatly reduced.

Denial Management and AR Follow Up

Accounts Receivable analysts are the backbone to the Medical Billing Industry. Aggressive, yet professional, pursuit of payment from insurance companies and patients to resolve aging A/R is the key for success of any practice.

At Austin, the claims are worked towards resolution. Our Team is proficient in identifying root cause of the denial and working till the claims gets paid. Our Accounts Receivables management function is designed to be the complete solution to difficulties that occur in cash flows and is operated as an extension of the business section. The goal here is to recover the funds owed to as quickly as possible by continuously work on identifying and improving processes that can improve efficiencies at each step of healthcare revenue cycle management while meeting the industry's best practices.