One of the most tedious and time consuming tasks for any medical office is completing the paperwork associated with billing, insurance claims and the filing of those claims. Many practitioners complain of spending more time filling out forms than practicing medicine.

One of the most tedious and time consuming tasks for any medical office is completing the paperwork associated with billing, insurance claims and the filing of those claims. Many practitioners complain of spending more time filling out forms than practicing medicine.

Solutions has consistently provided ongoing administrative support that gets MORE money, FASTER, for medical providers. Our team of medical billing experts can help lower your overhead and increase your cash flow while giving you more time to spend caring for your patients.

We are committed to delivering clean claims well within the required 60 day period. Don't let denials, payment errors and rising healthcare costs cut into your bottom line! Let Competent help you focus on practicing medicine, not billing. We can also help you make the transition into an electronic claims processing system now required by recent mandates in Medicare. Call us today for a free consultation at +1 973-206-9340! Paperwork doesn't have to be your headache!

Our Proccess

Charges and Demo

In this department, we have reliable individuals who first enter the patient personal information from the demographic sheets. They then check for the relationship of the Diagnosis and CPT code. Then they create a charge, according to the billing rules pertaining to the specific carriers and locations. All charges are accomplished within our agreement with the client.

Patient Billing

After the received payments have been applied, the patients are billed for deductible, co-pay, and co-insurance or for any non covered service, if payment is not received after 3 statements; we refer the patients account to our collection agency (per provider instructions). When billing the patient directly, it is important that the bill contains any and all information pertaining to entire transaction and making sure this information is accurate and clear is done in order to ensure the patient understands his or her financial responsibility, and will help avoid any potential complication in receiving reimbursement from the patient

Accounts Receivable Call

Revenue Management is the most significant feature in the business of Healthcare. Our expertise in AR calling constantly focus on enhance the revenue management and cash flow by reducing the accounts receivable days and bad debit. Many healthcare providers have tried managing accounts receivables, in the process ended up mismanaging the whole thing, resulting in reduced cash flow and increased collection cost and negligence. Our account receivable service improves cash flow, reduces account receivables, increases collection ratios, and enhances customer relationships with timely Accounts Receivable Follow-Up Service.

Review of EOB'S/ERA’S

The carrier Utilization Review department would then review the claim. Once the review is completed, the claim would then be adjudicated and processed for payment. Then the EFT and ERA is sent electronically. Once we have received the explanation of benefits it is reviewed to make sure every single line item have been process and paid accurately. If any inaccuracies are detected the insurance companies are called immediately to review the claim or appeals are files for reconsideration of the unpaid claim

Audit & Claims Submission

The daily charge entry then needs to be audited to double check the accuracy of this entry, in other words, this is the check and balance to make certain the billing rule is being followed accurately. Also this department verifies the accuracy of the claims based on carrier requirements to be sure we have a clean claim. The transmission department prepares a list of claims that go out on paper or through electronic media. Once claims are transmitted electronically, confirmation reports are obtained which are filed after all verification processes, transmission rejections are analyzed and appropriate corrective action is taken. Paper claims are printed and attachments are done, and put into envelopes and sent to the US postal service for mailing.

Reports & Collections

Physicians need professional reports that are accurate, organized, and insightful. That's why we provide practice-specific and enterprise-wide reports that are customizable and cross-linked which you can view on screen, print, or save to Microsoft Excel or Adobe PDF file formats. It gives you flexibility, control, and immediate access to your clinical and financial performance