Problems

Claims

  • Do your claims get rejected? 
  • Missing PQRS? 
  • Incorrect modifier? 
  • Incorrect code for established patient?
  • Receiving less money than you expected or no payment at all? 
  • Constantly sending overpayments to patients or worse sending out patient bills?
  • Are your claims clean claims?

Communications

  • Is your staff using up their time dealing with question on claims?
  • Do other patients look uncomfortable when a upset patient comes in waving a bill?
  • Are your phone lines being tied up with lengthy calls explaining a bill?
  • Does your staff have the training and information they need to resolve a patient bill?
  • Is taking the questions about a bill or claim out of the office right for you?

Eligibility

  • Do you get all of your patients verified ahead of time for a smooth work day?
  • Does your staff know how to interpret all of the different eligibility results?
  • Do you get claims returned for bad authorization numbers?
  • Denied because the patient is not actually a member?
  • Is getting eligibility out of the office right for you?