Billing & Coding
AthenaPMIT provides innovative solutions and dedicated services that connect payers, providers
and patients. In addition, we also provide in-depth technical services and products to improve healthcare business processes. Right from client identification to post payment, we transform Physician Office by automating routine tasks, working closely with every aspect of revenue cycle management and generating detailed reports to provide most updated status.
We implement Electronic Medical Records, Practice Management applications and other tools to streamline processes for payers, providers and business partners. We integrate information intelligently making key administrative processes easier, simpler and automated.
Solutions that simplify physician practices :
The dynamics of operating a physician practice in the current marketplace require skills and solutions that maximize the productivity and efficiency of staff and reimbursement processes.
We provide EMR tools based on individual practice needs and services that include designing, building, implementating and post-go-live optimization. We can help providers qualify for Meaningful Use incentives.
We implement the most efficient Practice Management tools and install dedicated Revenue Management Services to reengineer current business processes, optimize workflows and promote business excellence. Our claims and billing processing solutions save provider’s time and money by automating numerous essential administrative and Revenue Management functions.
We directly connect physician practices to one of the largest health information networks in the nation for submission, remittance and payment of medical claims as well as the simplification of clinical processes such as ePrescribing, lab orders and results.
Our billing professionals work hand in hand using current technology and tools to proactively address coding issues influencing denied claims or delay in payments. We provide chart audit service for your current documentation and coding practice to help comply with ICD-9 and CPT coding guidelines. We also help you maximise reimbursements through effective documentation of your services and also through periodic analysis and enhancement of your practice codes.
Contact us today to find out our flexible coding solutions. We consistently deliver cost savings, improved accuracy, and turnkey solutions.
We employ Medicare Guidelines, proprietary softwares and established quality assurance processe’s throughout our medical coding process.
Our coding process can be applied to:
Cardiac Catheterization Lab
Labor and Delivery
Revenue Cycle Mgmt
We automate your daily chores allowing you to focus on your core competency. Let us take care of your medical billing, regulatory compliance, practice management, and accounting issues while you bring happiness to your clients.
With us, you get a dedicated account management executive to help you during the service delivery.
There are other big benefits, too. We can help you
▪ Increase collections depending on your current status. We can get a better estimate after completing a free analysis of your practice.
▪ Make your office run more efficiently.
▪ Cut or eliminate staff expenses.
▪ Significantly reduce your postage and telephone expenses.
▪ Reduce or eliminate your need to invest in costly hardware and billing software.
▪ And finally, our all-inclusive fees are based on a percentage of payments collected — so we don’t get paid until you do.
What Makes Us Better
▪ Professional and experienced dedicated Account Executives.
▪ Rapid and accurate claims submission. We submit your claims electronically to Medicare, Medicaid, BC/BS, and all commercial carriers. We do it within 24 hours of receipt.
▪ Fast billing and payment posting turnaround.
▪ Internet access to practice billing records. We give you secure access to your practice data online. Our system will allow you to look up practice information and run reports, including patient ledgers.
▪ Monitoring and advocacy regarding managed-care contracts. When we set up your account, we request copies of your practice’s contracts and related fee schedules. We use this to set up our system profiles for your practice. We then monitor expected reimbursement to realize receipts, and appeal any underpayments and/or denials. Whenever necessary, we directly contact your managed-care representative to resolve any issues. We will keep you updated with these problems and their resolution on every step of the way.
▪ Custom superbill design. We’ll design and maintain an easy-to-use superbill that is unique to your needs, so you can get the required billing information to us efficiently and accurately.
Here’s what we can do for you
▪ Manage patient billing
▪ Increase collections
▪ Provide CPT, ICD-9, and HCPCS coding expertise
▪ Evaluate reimbursement rates
▪ Professional, personalized service
▪ Reduce your expenses and maximize profits
About our Staff
On average, our staff members have over five years of experience in the medical billing and collection industry. We have account representatives who can speak Spanish, Polish, and Russian. In addition, we use state-of-the-art computer hardware and software to provide comprehensive billing and A/R services to medical practices of all sizes.
Dedicated Account Manager
We assign a dedicated Account Executive to your account to handle all aspects of your billing needs — entering charges, submitting claims, sending patient statements, following up on accounts receivable, and answering patient billing questions. This representative functions as the primary liaison with your practice.
We enable extensive visibility to your Revenue Cycle Processes. We will design reports based on Key Performance Indicators you select. We provide comprehensive monthly closing reports that typically include a summary of charges, receipts, adjustments, accounts receivable analysis, and multiple productivity reports. We also offer a wide range of custom reports that will enable you to evaluate the unique structure of your practice. We regularly consult you to review your monthly reports.
We supply the most current CPT, ICD-9, and HCPCS coding expertise to minimize denials and unnecessary delays in reimbursement.
We electronically bill all payers and handle third-party billing.
We review all unpaid claims within 30-45 days of the initial billing date, appeal denials (bundling, medical necessity, etc.), resubmit claims for review when initial payment is inconsistent with typical doctor profile, and maintain managed-care contract profiles to assure proper reimbursement — a critical factor in maximizing collections.
We post payments received, to patient accounts (line item application allowing tracking of CPT reimbursement history). We post adjustments according to provider’s managed-care contract profiles and monitor the profiles for reimbursement accuracy as outlined above.
We send monthly statements to patients and follow up on non-payments via phone and mail. The patient billing cycle includes multiple statements, followed by delinquency notices.
We advise physicians on any changes in HCFA requirements, CPT, and ICD-9 coding, to achieve claim compliance for the fullest reimbursement for services.
Fee Schedule Review
We assist in fee-schedule review and updates to maximize the practice’s profitability.
Our Provider Enrollment and credentialing services make your physicians trusted and reliable for a better tomorrow.
We take away headaches normally associated with credentialing, mounds of paperwork, and confusion with the insurance companies and perform the service for you.
Who We Work With:
- PAs/ NPs
- Ambulatory Surgery Centers
- Urgent Care Facilities
- Clinical Laboratories
- Diagnostic Testing Facilities
- Sleep Labs
- Dentists/ Orthodontists
- Behavioral Health Providers
- Other Specialties
What Enrollment and Physician Credentialing Services We Help With:
- Commercial Insurance Provider Enrollment and Credentialing
- Medicare and Medicaid Provider Enrollment and Credentialing
- Medicare Revalidation
- CAQH Registration
- NPI Registration (Type I and Type II)
- Reimbursement Issues
- Managed Care Contracting Issues
- We handle the entire enrollment and physician credentialing process from start to finish for one flat fee!
- Save you on average at least 2-3 months of time and over 120 or more hours of work!
- Take away all the headaches due to the mounds of paperwork and endless applications!
- We will assure that contracts and applications are setup correctly and follow up with payers until the process is completed!
- Complete all necessary credentialing requirements for each payor and follow through to completion.
- Dedicated project manager assigned to your project!
- We make all the phone calls, follow-ups, and submit all applications, e-mails and faxes for you!
- 24/ 7 access to the status of your project and any documents related the project via our online project portal!
- The service is typically provided at a cost less than for you to do it yourself.
- A credentialing manager to represent you with commercial and government payers.
Healthcare IT Solutions
According to Forbes, our healthcare system is loosing “patients”, grappled with more then 500 killings per day from errors, accidents and infections in hospitals alone. At the same time, mortality and sufferings are on a rise from millions of procedures conducted which are not required in the first place.
The Big FIVE challenges aptly embodies the present situation…
1) Too Much Unnecessary Care
2) Avoidable Harm to Patients
3) Billions of Dollars are Being Wasted
4) Perverse Incentives in How We Pay for Care
5) Lack of Transparency
Amidst this clamouring, there is an increased uproar to make the industry inclusive and affordable. Technology is often overlooked, what significant role it plays in helping the industry achieve its main objectives. AthenaPMIT healthcare IT solutions and services can sustain healthcare organisations in meeting their current and future needs.
Our team of healthcare and IT experts empower the providers to deliver quality, customer centric care more effectively and efficiently. APMIT services focusses on addressing the key customer pain points including both payers and providers. Our spectrum of services spans from Electronic medical records to HIPAA and remote managed services that consistently meets the industry guidelines for the best practices in this industry.
We partner with our clients to support their dynamic business and enhance their clinical efficiencies, outcomes and satisfaction. Together we can make this partnership a catalyst of change in the healthcare industry.