Revenue Cycle Management Services

Patient Demographic Entry

Patient Demography entry is the key to timely reimbursement from Payer. Post completion of appointment at Provider’s office, our team enters the demographic information of the patient accurately in the billing system. In case the patient is already available in system, then our team will cross-check and update the new /missing details. Accurate demographic entry is highly essential in ensuring the success of clean claims submission to the Payer. COB is verified and updated as well.

Implementation models:

• Receive patient information from clients and billing offices
• Verify the patient insurance information
• Enter patient information in the billing system

Charge Entry Services

Our medical billing professionals enter charges based on standard medical billing rules pertaining to specialties, insurance carriers, and locations.. The charges are created within the agreed timeframe (generally, a 24 hour turnaround time). Our charge entry team is well trained to work with numerous software packages such as Misys Tiger, AdvancedMd, Practicemate, Practiceadmin, Ezclaim, SequelMed, Medisoft, Medtron, and MD Net.

• Charges are entered into the client’s medical billing system based on account-specific rules.
• Pending or held documents are sent to the client for clarification on a pre-determined schedule.
• Final charges are audited by the quality team and the clean claims are filed.

Insurance Verification Process

An accurate insurance verification ensures, claim submission to the correct Payer. eNoah Insurance verification team verifies patient’s insurance coverage with Primary, Secondary and Tertiary payers through authorized insurance portals.

Information with regards to Non Participating providers, Non Covered services, Deductible limit, Copay /Coinsurance is provided to the Doctor’s office. The billing system is updated with eligibility details like Member ID and Plan specific benefits.

Electronic Claim Submission

A crucial step in the medical billing process is Claims transmission. The claims contain sensitive information including patient data and insurance information. Claims transmission through electronic submission reduces processing delays and ensures high readability.

This guarantees that no claims are rejected due to illegibility. With electronic submission, the carrier confirmation report is also instantaneous, preventing any time delays due to transmission. Tracking claims has also become easier and claims can be corrected to avoid rejection.

Cash Posting

At eNoah, payments received from patients and insurance companies are posted to the patients’ accounts in the client’s billing system. The posted payments are balanced against the deposit slips to ensure accuracy. We also process electronic posting of payments into the billing software and ensure that the EOB (Explanation of Benefits) files are stored for future reference.

The payment posting team also checks for any underpayment being made to the accounts and moves the accounts to the accounts receivable team for reprocessing.

Denial Management

Denial Management is critical in the process of medical billing. Our dedicated denial management experts execute a thorough analysis of denied and underpaid claims to determine the reason behind the denial or underpayment.

Corrective measures are taken on the basis of the analysis without any time delay, and the claims are re-submitted for acceptance by the insurance provider. After re-submission, the denial management team regularly follows up on the claims with the insurance provider to track status and expedite the payment.

Patient Billing

Insurance companies may apply a portion of the allowed amount to patient responsibilities such as Co-Pay, Coinsurance, and Deductibles. Our billing professionals review accounts which have an outstanding balance after insurance payments and print patient receipts in the client system.

As per the client’s requirements, we perform small balance adjustments, bad debt adjustments, sending discount letters, and courtesy adjustments.

Medical Coding Services

Our certified coders provide a key step in the medical billing process, assigning appropriate codes by reviewing the documentation received from the physician’s office. We understand that medical coding is a vital process in medical billing. Proper coding is critical to reducing Insurance denials and increasing revenue.

Accounts Receivable Management and Follow Up

Collection of receivable funds, is a challenging task. eNoah employs the industry’s proven and efficient professional and efficient strategies to recover receivables and also excels in converting aged AR receivables into collections through effective follow-up with insurance providers. Dedicated AR callers follow up with patients to get missing patient information by sending emails, notices, or making phone calls.

Our Accounts Receivable management solutions also include the following optional services: