Medical Billing and Coding

RSB Systems Pvt. Ltd., Revenue Cycle Management services encompass the entire lifecycle of the patient account from creation to payment.

Following services are included with the flat-rate Billing:

  • Setting up Billing & Practice Management Software, which includes Database & Practice Set-up (at no cost)
  • Insurance Eligibility Verification using our state-of-the-art software that checks benefit information including co-pays and deductibles on real-time basis from any computer with wi-fi access (at no cost)
  • All Services related to billing and coding (see medical billing workflow below)
  • Review & updation of fee schedules
  • Updates on Industry changes including CPT, ICD and LCD, regulatory compliances, & monthly financial reporting

 

Revenue Cycle Management

 

Key features in our billing service which is designed to increase our client's reimbursement includes:

  • AAPC (American Academy of Professional Coders) certified coders to provide physicians with accurate billing & coding policy
  • 24-48 hours turnaround-time for charge entry after billing is sent to RSB
  • Utilization of best Billing softwares like Epic, Allscripts, OpenPM etc
  • An Industry leading 97.8% average reimbursement rate on all insurance claims submitted

 

Billing Process

 

Billing Process

As part of the billing service and RSB's Client Management Relationship Approach, we assign each client with 3 direct contact representatives:

1. Billing/Coding Specialist

  • Focus on proper ICD-10, CPT, and HCPCS coding
  • Review medical record documentation to validate & ensure proper charge capture
  • Report insufficient documentation issues
  • Report over-coding/under-coding issues
  • Work with Reimbursement Specialists & Account Managers to ensure minimum claim denials

 

2. Reimbursement Specialist

  • Focus on payment posting, denials management, unpaid claims
  • Responsible for managing 1°, 2°, 3° claims ageing reports
  • Communicate directly with insurance payers to resolve claims issue
  • Create & file appeals as necessary
  • Work with Reimbursement Specialists & Account Managers to ensure minimum claim denials

 

3. Account Manager

  • Responsible for coordination and quality assurance of all aspects of customer's revenue cycle
  • Provides customer service- main point of contact
  • Understands & communicates coding/billing/compliance regulations
  • Manages patient invoicing and collections
  • Works with the entire team to maximize overall account efficiency

You will also work closely with a credentialing specialist during the implementation phase of service.

 

Billing Process
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