Provider Management Services
Protect the bottomline
We're always up-to-date on coding regulations and we're ready to support your business today and into the future.
Medical Coding
We have a team of at least 3+ years of experienced staff members who are familiar with the US healthcare system and dedicated to ensuring 95%+ accuracy and we can help you catch up on backlogged work or manage the entire coding process for you.
With so much to keep track of, like ICD-10 and changes in payer trends, it's easy to lose focus on what's most important - the patient. Our Coding and Auditing services can help you ensure ICD-10 compliance, reduce AR backlogs, decrease DNFB, improve quality of care, improve provider documentation, reduce turnaround times, and receive more reliable data reporting.
76 claims were processed
and impacted revenue was $88,058
Our client from Alabama had been experiencing ongoing issues with payments and timely filing
when we took over. Our revenue consultants checked on the basics to understand the root cause of
this issue and found that most payers were not set up electronically in the practice management
system. Our Rev Consultants swiftly acted on this and started updating electronic setups for almost
all payers. This resulted in a significant improvement in collections within a few months.
Clinical Documentation Improvement
Clinical Documentation Improvement (CDI) is a process of reviewing medical records and ensuring that they are complete and accurate. This process can help to improve coding accuracy and prevent lost revenue.
CDI experts at Centaur use the latest technology and tools to review medical records and identify any missing charges or errors. They also provide targeted education to healthcare providers to help prevent future mistakes. By improving clinical documentation, CDI can help to improve the overall quality of healthcare.
We obtain an itemized bill from the healthcare provider listing all services provided by them to the patient along with the cost and relevant code of the treatment provided. Our Centaur collection team will assist you in collecting all the required documents and receipts.
We will help you fill out your insurance claim forms, make a cpy of all the forms and documents for our records, then review the details to make sure everything is correct. Once all the required documents are attached to the form, we'll submit it to the insurance company on your behalf.
We will resolve any problems with the claims during submission with the help of our work edits and rejection management team. By addressing these quality, payment, and reconciliation issues upfront, the number of denied claims and the amount of work required to fix them can be reduced.
We Capture
Centaur's charge automation and patient data entry features help you streamline your billing process and make strategic financial decisions.
- Receive documents in the form of superbills, charge tickets, sources, etc.
- Receive documents through FTP /SFTP, document management system, or client’s system.
- Capture the date of service, billing provider, referring provider, POS, admission date, CPT/procedure codes, ICD-10, number of units, and modifiers.
- Import charges directly from the EMR. These charges are reviewed for accuracy before being sent for billing.
We Audit
Centaur’s audit services help identify and correct missed charges, over-billing, and coding errors that result in revenue loss.
- Validate written orders for level of care, and all treatments rendered.
- Necessary modifiers are appended, and exact numbers of units are billed.
- Comparing charges by patient’s accounts.
- Verifying charges against updated fee schedule. Identifying undercharges, duplicate posting, and overcharges.
- Verifying the charges with various department billers and coders.
EOBs are commonly sent to us in the form of scanned documents. We have a secure process for accessing and batch-processing these documents, which includes applying the client's specific business rules for adjustments, write-offs, and balance transfers to secondary insurance companies or patients.
We have a secure process for accessing and batch-processing the EOBs sent to us as scanned documents, which includes applying the client's specific business rules for adjustments, write-offs, and balance transfers to secondary insurance companies or patients.
We record each claim denial in the practice management system and take appropriate action, such as rebilling the secondary insurance company, transferring the balance to the patient, writing off the amount, or sending the claim back for reprocessing.
We have experienced payment processing professionals who account for patient payments received via different channels like POS cash collections, cheques, and credit cards (patient portals). They transfer the pending balances to secondary insurers and resolve any credit balances.
We process high volumes of ERAs (Electronic Remittance Advisory) from payers. We import them into our clients' practice management systems and generate exception reports that our team corrects. We also verify batch totals to ensure accuracy and efficiency in our process.
1442 claims were processed and impacted
revenue was $573,104
At Centaur, we are always up-to-date on diagnosis changes and we recommend corrections specifically on an ICD basis according to the current update. We have resolved many claims from first-level rejection and our experts share the inference and revenue impact with our clients. We educate them on the importance of having a good CCR% to improve collections and the importance of adhering to current CMS coding guidelines to avoid rejections. Our revenue consultants consistently improved the CCR for a speciality located in Pennsylvania we handled this way .
Our value proposition for payment posting service
Analytics
We provide inputs on trends in denials,non-covered services, prior authorization, and deductible or co-payment collection issues at the point of service.
Develop Policies For Write-Off And Adjustments
We help our customers develop clearly defined policies for write-offs and adjustments, and we report any unusual contractual adjustments.
Denials Management
We route denied claims to the appropriate coding and denial management team for rework and re-submission to payers in a timely manner.
Filing Claims With Secondary Payers
We help identifying claims with secondary payers and processing claims for any remaining balances.
Knowledge Management
Organized business and process rules stored in our knowledge management tool SOP’s helps us keep track of all the updates by providing an effective service.
Dashboards
Dashboards that provide instant access to process health indicators and enable continuous improvement.