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Medical Billing Services

Medical Billing and Claim Submission Services for Small to Mid Practices

TechStar MDs provides efficient medical billing services through a well-defined and streamlined revenue cycle management process that covers the entire billing workflow, from patient registration to claim submission and payment posting. We ensure accurate and complete patient registration by collecting and verifying all necessary demographic and insurance information along with insurance eligibility and benefits upfront to minimize claim rejections or denials. We maintain accurate and comprehensive documentation to support the services provided and ensure coding compliance with established coding guidelines, payer policies, and regulatory requirements. We submit claims promptly to maximize reimbursement and avoid timely filing rejections by establishing processes to ensure claims are reviewed, edited, and submitted within the required timeframes. We prioritize financial clearance and insurance verification to confirm coverage, eligibility, and obtain any necessary authorizations or referrals to prevent billing delays and minimize denials due to coverage issues. 

TechStar MDs maintains open and transparent communication channels with patients, healthcare providers, and insurance companies. We implement performance monitoring systems and utilize analytics to track key performance indicators (KPIs) such as claim submission rates, denial rates, average reimbursement time, and collections by regularly review data to identify bottlenecks, areas for improvement, and implement strategies to enhance efficiency.

Medical Billing Cycle
Eligibility Verification

Eligibility Verification

Checking patient insurance eligibility is crucial for accurate claims processing and revenue cycle management. We verify insurance eligibility before scheduled appointments and confirm the patient's coverage, any pre-authorization requirements, and the patient's financial responsibilities. This helps prevent surprises or billing issues during or after the visit. 

Moreover, we always familiarize ourselves with the specific services that typically require prior authorization and we confirm in advance whether prior authorization is necessary for the particular service to ensure a smoother authorization process and minimize delays in claims reimbursement.

Claims Scrubbing

Effective claim scrubbing helps optimize claims accuracy, minimize denials, enhance revenue cycle efficiency, and ensure compliance with billing regulations. We always review claims for errors such as missing or invalid patient information, incorrect or incomplete diagnosis and procedure codes, mismatched modifiers, and other data discrepancies. We provide reporting and analytics features to track and analyze claim performance, error trends, denial reasons, and other key metrics. This data helps identify areas for improvement and informs strategic decision-making.

Medical Claims Scrubbing

Demographic Entry

We have established a standardized process for collecting patient demographic information which includes electronic forms or templates that capture all necessary details, including patient name, date of birth, gender, contact information, insurance details, and any other relevant data. We regularly review and update patient demographic data to ensure accuracy and encourage patients to provide updated information during each visit or when there are changes to their personal details or insurance coverage. We have established quality control measures to monitor the accuracy and completeness of demographic data entry. We also conduct periodic audits or reviews of entered data to identify and correct any errors or inconsistencies. 

Moreover, we adhere to all relevant privacy and security regulations, such as the Health Insurance Portability and Accountability Act (HIPAA), when collecting and storing patient demographic information. And we implement appropriate safeguards to protect patient data from unauthorized access or breaches.

Demographic Entry

Charge Entry

We conduct regular reviews of clinical documentation to ensure accuracy and completeness. We verify that the documentation supports the services provided and that all necessary information is captured for billing purposes. And we have established quality assurance protocols to review a sample of charge entries periodically and to identify errors or inconsistencies. We monitor denial trends related to charge entry errors and take proactive measures to address them.

Moreover, we always stay informed about changes in coding guidelines and regulations, such as updates from the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other relevant organizations. And we regularly update our coding resources and ensure that our staff has access to the latest information.

Payment Posting

Efficient payment posting is crucial in medical billing to accurately record and reconcile payments received from insurance companies, patients, and other payers. We have developed standardized payment posting processes and workflows that clearly outline the steps to be followed. This ensures consistency and reduces the likelihood of errors. Before posting payments, we verify the accuracy of the payment details, such as the payer name, patient name, claim number, date of service, payment amount, and any adjustments or denials and Cross-reference the information with the remittance advice or Explanation of Benefits (EOB) received from the payer. We apply contractual adjustments based on the contracted fee schedule or agreement with the payer to ensure that the payment posting reflects the expected reimbursement based on the contracted rates. 

Moreover, we allocate the payments to the appropriate accounts based on the type of service rendered, patient responsibility, and payer requirements. We identify any discrepancies or denials during payment posting and take appropriate action. Besides, we investigate and resolve discrepancies, such as underpayments or overpayments, by following up with the payer or initiating the necessary adjustments or appeals. We record any adjustments, write-offs, or contractual allowances associated with the payment and apply these adjustments according to the payer's contractual terms, policies, and billing guidelines. We continuously monitor payment posting trends, such as average payment amounts, denial rates, or payment timeliness.

Payment Posting Process

Claim Submissions

TechStar MDs helps you with the best claim submission process by staying up-to-date with the latest coding guidelines, payer policies, and regulatory changes in medical billing. We always double-check the patient's demographic details, insurance information and policy coverage and ensure that all information is accurate and up to date. We assign the correct medical codes (CPT, HCPCS, ICD-10) to the procedures, services, and diagnoses performed during the patient's visit so that we can use the most specific codes available to accurately represent the services provided. We also review the claim for any errors or missing information before submission and keep track of insurance payer's deadlines for claim submission and submit claims within the specified time frame to avoid potential rejections due to late filing.

Moreover, we maintain a detailed and accurate documentation of the patient's visit, including the medical records, treatment plans, test results, and any other relevant information to support the medical necessity of the services rendered and we do keep a record of the claims submitted, including their tracking numbers or confirmation receipts to monitor the progress of each claim and follow up on any delayed or denied claims promptly.

We specialize in the following service areas, but of course are not limited to:

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Why choose TechStar MDs?

TechStar MDs specializes in billing and revenue cycle management. We have dedicated teams of experienced professionals who are knowledgeable about the complex coding, billing, and reimbursement processes. Their expertise ensures accurate and efficient claim submission, reducing the risk of errors and claim denials. We have streamlined processes, advanced technology, and economies of scale to handle billing tasks efficiently. 

By outsourcing TechStar MDs, you can focus on your core competencies, such as patient care and practice management. Medical billing can be time-consuming and requires continuous training and staying updated with changing regulations. Offloading these tasks to us allows you to dedicate more time and resources to delivering quality healthcare services. We have processes in place to streamline the claims submission and payment collection process. We ensure that claims are submitted promptly and accurately, leading to faster reimbursement. Our timely and efficient billing processes can significantly improve your cash flow. We always stay updated with the latest healthcare regulations, coding guidelines, and billing requirements. And ensure compliance with regulatory changes, reducing the risk of billing errors or non-compliance. This can help you avoid penalties, audits, and potential legal issues. 

We adapt to your changing needs. Whether a practice is expanding, downsizing, or dealing with seasonal fluctuations, we can scale our services accordingly. This flexibility allows you to receive the necessary billing support without the challenges of staffing and resource management. Moreover, we provide regular reports and performance metrics, offering insights into the financial health of a practice. We generate customized reports that analyze key performance indicators, reimbursement trends, and claim denials. This data can help you make informed decisions and optimize your revenue cycle management.

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