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Medical Coding
Professional medical coders describe a patient’s history with codes that are used for filing healthcare claims and for the accurate diagnosis and recommendation of further procedures for the patient long after the claims have been paid.
A Pulsating Approach to Medical Coding to Keep it Updated.
In general, based on these codes, the doctor, the hospital, and everyone involved in the healthcare chain reads, communicates, and reaches a consensus on the appropriate treatment for the patient.
Our Medical Coding services add significant value to your coding and overall operations.
A single incorrect code can have a major effect on your reimbursement and revenue cycle, and that’s why we keep our emphasis on 100% compliance with the latest coding guidelines.
Denials Management
Speed Up Your Revenue By 20% or and Increase Your Cash Flow with Carefully Crafted Tracking and Managing of the Denials.
Professional medical coders describe a patient’s history with codes that are used for filing healthcare claims and for the accurate diagnosis and recommendation of further procedures for the patient long after the claims have been paid.
Denials exist for reasons such as:
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Inaccurate or insufficient Information about insurance
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Pre-Authorization code error
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Coding-related mistakes and omissions
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Filing claims outside the given timeframe
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Credentialing Mistakes, or no provider registration.
Pre-Authorization
Pre Authorization Makes the Process Smooth
Pre-authorization is a sure way to prevent payment delays, part-payments, and denials. The fastest way to a clean claim is an authorization number on the claim form at the time of the claim submission.
Obtaining the right CPT code is the secret to pre-authorization, which is always a challenging process. Leave it to us. KROD Group is a qualified and highly skilled team that works by checking with the doctor and figuring out the most realistic scenarios to achieve the right CPT. Avoid chasing claim fees, therefore. Pre-permitting means prompt payments.
The coders may have done their job, but securing the required authorization would be up to the provider. A claim rejection or part-payment impacts the supplier, so when you outsource it to us, our emphasis on obtaining the Pre-Auth for the treatment is complete and utter. To receive the Pre-Auth, we collaborate with doctors, clinics, insurance payers, and outpatient facilities to ensure that the essential pre-certification criteria are intact.
Significant AR Analysis and Follow-up Process
We Give Your Hectic Process a Sense of Ease with AR Analysis and Follow Up
A discomfort that any clinic, hospital, or physician community would love to avoid is healthcare providers running behind payments due and clearing blocks in the payment pipeline.
The essence of AR has been extraordinarily complicated by new and changing payer policies, co-insurance arrangements, patient co-pays, and the rise in patients with a high deductible health plan.
It needs the healthcare provider to revamp and re-strategize the management of the revenue cycle. The approach is now tricky and requires the expertise of experts and qualified practitioners with dedication, analytical skills, and patience.
Customer Support
Loyal Customer is the Fundamental of a Good Company.
While you focus more on customer acquisition and product development we take care of your customer support. Our customer support team has renowned professionals has expertise in Public relations and customer handling.
Eligibility Verification
Clean Cash Flow Claims
Eligibility for insurance is a critical and indispensable step in the process of medical billing, which in turn directly affects a practice’s reimbursement. Invariably, skipping the procedure of checking the patient’s eligibility for benefits leads to reimbursement delays, non-payment of claims, refusals and dissatisfied patients.
Payer & Front End Rejections
Eliminating Errors for Clean Claims
Payer and Front End Rejections or clearing house rejections are billing concerns that slow down the cash flow. These are defects in the process and can be decreased to zero. Owing to one or more errors on the claim form, rejections occur and are returned by the payer to the biller because of these errors. Mistakes! Do you want your receivables to be dented due to clerical mistakes?
Payer and Front End Rejections are treated at KROD Group by keeping informed, observing due diligence, communicating correctly and effectively, and following through. To ensure that the claim is not returned due to clerical error, we specifically inspect all the significant touch points.
Payment/Cash Posting
Payment Posting is Vital for Prompt Payment
As experts in handling small, mid-size, and large volume payments, we understand that the cash posting process marks the end of the billing cycle.
The approach also affects other vital areas of the healthcare provider, such as overall efficacy, satisfaction of patients, and cash flow. At KROD Group, Professionals with an eye for detail manage the whole payment and cash posting process with complete and detailed knowledge of the billing cycle. Any action based on a collection of procedures is performed by the professional and successful payment posting team, and last-minute errors are treated with the correct protocols.
Patient Demographics Entry
Accurate and Precise Data Regarding Patients are Vital for Successful Claims.
The key to a good claim is getting all the facts correct about the patient. A crucial move in eliminating a lot of back-tracking and mistakes in the claims process is the entry of Patient Demographics. The job involves an eye for perfection and precision since it defines the healthcare provider’s actual payment for services.
With a common exception for emergency treatment, the insurance details of a patient are verified upon entering the clinic or hospital of the physician for treatment. The patient or someone close to the patient fills out the patient demographic sheet or fact sheet. This fact sheet is electronically distributed for the prompt reimbursement of the treatment fee.
Provider Credentialing
A Rapid and Transparent Service
Healthcare providers must be mindful of the value of Provider Credentialing. As a healthcare professional, it is a validation of your knowledge and competence and your commitment and ability to provide services. Above all, you will be able to practice medicine in a cash-only mode without the privileges of hospitals or other services without qualifications. As we have a home-grown solution to suit the task, Provider Credentialing at KROD Group is quicker and more straightforward for the healthcare provider.
Provider credentialing is vital to a physician’s practice. It is not just another form that needs to be filled out. With several phases, it is a complicated process and it is continuous most of all. Provider Credentialing is approached by KROD Group as a mechanism that requires maximum and continuous maintenance and management. As a solution and as a service, we provide provider credentialing and cater to the end-to-end management of the credentialing method
Processing Appeals
Planning Strategizing and Exciting for Higher Success Rate.
Appeals are a major part of medical billing. For the healthcare provider to recover revenue, appealing to a rejected claim with sensitivity to its particular timeline is important.
Worker Compensation and No-Fault Billing
Minimizing the Errors and Maximizing the Revenue
When it comes to invoicing and collecting, worker compensation and Fault Billing are challenging fields of medical billing. The insurance industry works through the regulations and guidelines to increase government oversight and use it to their benefit.
Worker Comp & No-Fault Follow-up is subject to various requirements that differ depending on the financial class. When it comes to filing, these statements are also highly time-sensitive.