T. Lunn & Associates offers a comprehensive range of professional services to meet all your medical billing needs. Our team of experts is dedicated to providing top-notch service and ensuring a seamless experience for our clients. Whether you need a helping hand to assist with your day-to-day operations or to have all of your billing, coding, and credentialing needs fully managed, we've got you covered. Get in touch with us today to find out how we can assist you.
PROVIDER CREDENTIALING
A key process where healthcare providers are verified and authorized to deliver services. It involves validating their qualifications, such as education, training, licensure, and professional history. This process ensures that providers meet the necessary standards and comply with regulatory requirements before they can be reimbursed by insurance companies for their services. Proper credentialing helps maintain high standards of care and ensures that the billing and coding practices are accurate and compliant with payer requirements.
CHARGE ENTRY
&
CODING
Charge Entry: Charge entry involves inputting data related to medical services provided to patients into the healthcare provider's billing system. This includes details like the date of service, type of service, and the patient's insurance information. The accuracy of this information is vital because it directly affects the billing process and ensures that healthcare providers receive appropriate reimbursement for their services. Coding: Medical coding is the process of translating healthcare diagnoses, procedures, medical services, and equipment into universal medical alphanumeric codes. The two main code sets used in medical coding are the International Classification of Diseases (ICD) for diagnoses and the Current Procedural Terminology (CPT) for procedures. Accurate coding is essential as it determines how much will be reimbursed by insurance companies and ensures compliance with regulations and standards. Together, charge entry and coding ensure that healthcare providers are accurately compensated for their services while maintaining compliance with healthcare regulations.
CLAIMS SCRUBBING
Claims scrubbing in medical billing and coding refers to the process of reviewing and correcting claims before they are submitted to insurance companies. The goal is to ensure that claims are error-free, complete, and accurate, thereby increasing the chances of timely and full reimbursement. This process involves: 1. Verification of Data: Ensuring that all patient information, service codes, and provider details are correctly entered. 2. Compliance Check: Making sure that the claim adheres to the specific rules and guidelines set by insurance companies and regulatory bodies. 3. Identification of Errors: Detecting common errors such as incorrect coding, missing information, and typographical mistakes. 4. Corrections: Making necessary adjustments to correct any identified issues. By performing claims scrubbing, healthcare providers can reduce the likelihood of claim denials or rejections, streamline the billing process, and improve cash flow.
DENIED CLAIM MANAGEMENT
Denied claims management in medical billing and coding refers to the process of handling and resolving claims that have been rejected by insurance companies. This involves several steps to ensure that the healthcare provider receives the reimbursement they are entitled to. Key aspects include: 1. Identification of Denials: Reviewing the reasons provided by the insurance company for the denial, which can range from incorrect coding to missing information or non-covered services. 2. Analysis: Understanding the root cause of the denial by examining the claim and related documentation to identify any errors or discrepancies. 3. Correction and Resubmission: Making necessary corrections to the denied claim, such as updating codes, providing additional documentation, or correcting patient information, and then resubmitting it to the insurance company for reconsideration. 4. Appeals Process: If the claim is still denied after resubmission, initiating the formal appeals process with the insurance company, which may involve providing further evidence or making a case for why the claim should be paid. Effective denied claims management helps healthcare providers recover lost revenue, improve the efficiency of their billing processes, and maintain a steady cash flow.
Billing
we specialize in
Internal Medicine (Primary, Family care) Dental (DDS) Outpatient / Inpatient Behavioral Health Weight Loss Mangement and more...
Integrated clearinghouse
We utilize integrated clearinghouses with our systems to streamline the process of submitting, verifying, and processing claims. The clearinghouse electronically checks claims for errors, ensures they are formatted correctly, and then forwards them to the appropriate insurance payers. This integration reduces claim rejections, speeds up payment processing, and helps ensure compliance with industry standards and regulations.
ACCOUNTS RECEIVABLE MANAGEMENT
Accounts receivable management in medical billing and coding refers to the process of overseeing and managing the outstanding payments owed to healthcare providers for services rendered. It involves several key tasks aimed at ensuring timely and accurate collection of payments. These tasks include: 1. Monitoring Outstanding Claims: Keeping track of all claims submitted to insurance companies and ensuring they are processed and paid promptly. 2. Follow-Up on Unpaid Claims: Regularly contacting insurance companies and patients to follow up on unpaid or partially paid claims, addressing any issues or discrepancies that may arise. 3. Handling Denials and Appeals: Managing denied claims by identifying the reasons for denials, making necessary corrections, and resubmitting or appealing the claims to secure payment. 4. Patient Billing and Collections: Sending out bills to patients for their portion of the payment, setting up payment plans if necessary, and following up on overdue accounts. 5. Reporting and Analysis: Generating reports to analyze the status of accounts receivable, identifying trends, and implementing strategies to improve the collection process. Effective accounts receivable management ensures that healthcare providers maintain a steady cash flow, reduce the amount of bad debt, and improve overall financial health.
FLEXIBLE SERVICES
We will custom tailor a service plan for the services you need from the services we offer, based off your consultation with our trained staff. This ensures you are only paying for what you actually need and we are providing the best and most cost-effective service to you.