Managing Authorizations and Eligibility
We verify patient coverage and obtain authorizations when required by the payer for advanced imaging like CTs and MRIs. This facilitates claims approval.
Claim Preparation, Submission, and Follow Up
Leveraging correct coding and adhering to policies, we accurately complete electronic claim forms and submit them to commercial/government payers for faster processing. We follow up diligently to resolve any pending, denied, or underpaid claims.
Denial Analysis and Appeals
Using historical claims data analytics, we identify patterns and root causes of denied OMR claims. We appeal improper denials through clear letters citing evidence to recoup lost revenue.
Patient Balance Collections
We assist in collecting any applicable coinsurance, deductibles, or non-covered services from patients through statements, calls, and customized payment plans.
Guidance on Evolving Payer Regulations
Billing rules, fee schedules, and policies specific to OMR are constantly changing. We advise on all updates from major payers and regulators to ensure your practice always maximizes appropriate reimbursement.
