Insurance Eligibility Verification
We verify patient benefits before appointments whenever possible, reviewing coverage details, annual maximums, deductibles, waiting periods, frequencies, and limitations. This helps reduce billing surprises and improve initial claim accuracy.
Insurance Claim Preparation
Every claim is reviewed against current CDT codes, payer requirements, and supporting documentation before electronic submission. We check patient information, provider details, and attachments so claims arrive clean.
Electronic Claim Submission
We manage claim submission through your Eaglesoft workflow, ensuring claims go out promptly with complete information and required attachments.
Insurance Claim Follow-Up
Submitting a claim is one part of the process. We monitor outstanding claims, communicate with carriers, respond to payer requests, and resolve issues before they become long-term AR. Typical response window: 48 business hours for payer requests.
Payment Posting and Reconciliation
We post insurance payments, patient payments, ERAs, adjustments, and contractual write-offs while reconciling against submitted claims. Underpayments are flagged for review against your contracted fee schedules.
Accounts Receivable Management
We prioritize aging insurance claims by reviewing unpaid accounts, identifying delays, following up with payers on a documented schedule, and escalating claims that hit defined aging thresholds (typically 30, 60, 90+ days).
Insurance Appeals and Denial Resolution
When a claim is denied, we investigate the reason, correct billing issues where applicable, gather supporting documentation, and prepare appeals according to payer requirements.
Financial and Performance Reporting
We provide monthly reporting on collections, aging A/R, claim status, denial trends, and key billing metrics you define. Reports are delivered by the 15th of each month covering the prior month's activity.