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Medical Billing and Coding Services

The GroupOne Electronic Medical Records Billing Center will help you take control of revenue cycle management processes and your entire practice workflow. Our EMR 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.

 Overview of EMR Billing & Coding Services

Superbill Redesign Fee Schedule Review
Coding & Abstracting Patient Registration
Insurance Verification Charge Entry
Electronic Claims Submission Payment Posting
Monthly Reporting/Financial Review Patient Statement Generation
Semi-annual E/M Chart Review Benchmarking
A/R “Clean-up” Program Spindown Projects
IT Conversion Projects Interim CBO Management/Staffing

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Key Features

We provide full workflow management, including

  • online access to the provider’s office for patients
  • scheduling
  • document management
  • scanning
  • document routing
  • pharmacy callbacks
  • electronic fee tickets
  • electronic medical records
  • recall
  • and much more

The GroupOne Billing Center is staffed by certified professional coders to maintain the database and communicate with our clients regarding payor-specific, practice-specific and patient-specific information by CPT code. This produces extremely comprehensive, client-specific data that ensures clean claims and corporate compliance.

Our real-time rules engine updates CCI edits, bundling and LMRP updates, and searches for diagnosis compatibility. Eligibility verification services are available, based on payor specific capabilities and access.

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.

Powerful Tools and Reporting

Contract and fee schedule management tools provide a detailed picture of the accounts receivable for the practice, including the variance between scheduled and actual payments. These tools help the provider ensure that accurate and appropriate payments are received.

Tracking and management of denied claims helps uncover deficiencies in coding and billing practices. Denial management is used as a tool for the provider or office staff to address coding and billing errors and inconsistencies up-front, instead of correcting a denied claim. Clean claims translate to quicker, more complete payments and an improved bottom line.

The reporting package is developed and customized for each practice, based on the requirements and objectives of the physician(s) and administrative staff. Once in place, the system emails periodic reports to the appropriate recipients, including physicians, administrative staff and any outside parties such as the practice accountant.

 

Specialties We Work With

GroupOne works with a number of specialties for complete revenue cycle management services and has experience in nearly every medical specialty. If you would like to request a medical billing quote for your specialty, click on the appropriate specialty and complete a brief form. One of our RCM consultants will contact you to help you determine if GroupOne's billing services are a good fit for your practice.

 Don't see your specialty listed? Don't worry, we can still help you. Click here to request a discovery phone call with one of our RCM experts.

 

Other Services 

eClinicalWorks - Medical Billing and Coding - Medical Transcription - OneRate Bundled Package - Medical Practice Startup and Management - Medical Consulting