The GroupOne Billing Center will help you take control of claims management processes and your entire practice workflow. Our billing and coding services eliminate unnecessary claim denials and delays through a complete integration of workflow, billing and reimbursement management. Along with a powerful electronic medical records package, this enables us to communicate effectively with your staff and third party payors. Clean claims and a practice-specific rules engine will dramatically increase your bottom line.
GroupOne Claims Management – How It Works
The GroupOne Billing Center creates the charge in the system after review and verification of the coded charges by Certified Professional Coders. The center submits insurance claims to the appropriate payors, generates periodic patient statements, and maintains data files. All claims are submitted electronically, except for those payors who do not accept electronic claim submissions or appealed claims that require additional documentation.
The GroupOne Billing Center allocates payments, denials and denial codes, and determines appeals in payment variance from negotiated contract to actual insurance payment.
Our team of reimbursement specialists follows every claim from submission to adjudication, ensuring proper handling of each submitted claim.
Claims status is tracked online and in real-time for continued reimbursement management. Claims submission dates, re-filing, as well as follow-up billing and collection notes are recorded and monitored by the billing staff, who are accountable for all activity in the system.
Reimbursement specialists promptly follow up on claims when payors fail to adjudicate within the specified time frame. At the same time, the center researches denied claims, re-files and updates the practice’s internal database to alert staff to changes in payor requirements.
The GroupOne Billing Center staff has online and immediate access to information requested by payors. This helps expedite claims adjudication with minimal interruption to the practice.
To learn more about how to maximize your revenue with the GroupOne Billing Center, call 800-769-5288 or email us