Claims Submission

Our claims management process is designed to maximize reimbursement efficiency and minimize denials by ensuring every claim is clean, complete, and compliant before submission. Through comprehensive claim scrubbing and validation, we identify and correct errors related to coding, patient demographics, and payer-specific rules. This proactive approach significantly improves first-pass acceptance rates and accelerates the revenue cycle. Claim Scrubbing & Submission
We meticulously review all claims for accuracy and compliance prior to submission, using advanced rules-based engines and payer-specific edits to catch issues that could lead to rejections.
• Seamless integration with clearinghouses and direct payer portals for streamlined claim routing and real-time feedback
• Automated and manual edits to validate critical fields, including NPI (National Provider Identifier), POS (Place of Service), CPT-ICD code linkage, and modifier accuracy
• Support for both batch and real-time electronic claim submissions using industry-standard formats (CMS-1500 for professional claims, UB-04 for institutional claims)