Revenue Cycle Services
Powered by Centricity™ Business from GE Healthcare
While automation derived from technological innovation can take care of many repetitive tasks, human intervention is still necessary to correct inevitable errors, choose the most relevant medical codes, proactively follow-up on late payments or analyze reasons for denials. Consequently, the powerful Centricity Business Platform will be supplemented by Data-Core’s experienced taskforce who will service the worklists, ensuring that all necessary processes are performed in a timely manner with the desired level of accuracy.
For Payers participating in EDI, the eligibility verification is performed through GE’s Clearinghouse. In cases where this mode of verification is not possible, trained associates will verify eligibility by manually visiting the carrier website or calling.
Planned procedures requiring pre-authorization are flagged from the eligibility check and associates reach out to the payers to obtain the authorization prior to the visit.
Coding & Billing
Accurate coding of patient charts establishes the foundation of proper billing, improves rejection rates, helps prevent under/over-billing and minimizes the reimbursement lifecycle.
Scrubbing & Submission
Claims are scrubbed using a rules-based engine prior to submission. This step significantly improves the clean-claims rate and ensures quicker reimbursements.
Our robust Lockbox process is geared towards timely handling of mailed remittances on a daily basis. Payments are deposited to the designated bank via Image Cash Letter.
Payments from all sources are consolidated and analyzed to post correctly into the respective patient accounts and reconciled with total reimbursements.
Our expert follow-up team proactively pursues all unacknowledged, unpaid or partially paid claims that have crossed the set time period within Centricity Business.
Denied claims are addressed on a priority basis - our Denial Analysts perform a root-cause analysis to identify why the claim was denied and re-file or appeal the denial.
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Revenue Cycle Services
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