GoTelecare understands the claims adjudication mandates of the industry better than any medical billing and collections company. We are working with leading Skilled Nursing Home Facilities and proficient across all major practice management/ billing software in the country. We work as an extension to your Long term care billing demands.
Our A/R follow-up service is designed to increase the Revenue Collection for our clients. The process begins after the Provider creates and sends Health Insurance Claims (Electronic/Paper claims or Manual HCFA forms) to various Insurance Companies. Depending on the transmission type and length of time since submission, we begin our follow-ups. Patients today are looking for more personalization in their care and they look for proactive assistance. A smooth connect between your front and back office will be important and you need specialized assistance especially with Skilled Nursing Facility Billing. How we attend your accounts receivable collections Online Claims Follow-Up Using various insurance company websites and Internet payer portals, we check on the status of outstanding claims. Automated Claims Follow-Up (IVR) By calling insurance companies directly, an Interactive Voice Response (IVR) system will provide the status of unpaid claims. Insurance Company Representative If necessary, calling a ‘live’ insurance company representative will give us a more detailed reason for claim denials when such information is not available by the first 2 methods. GoTelecare Ensures • Reduction in accounts receivable by 30% within 1 month • Demonstrated expertise in working on difficult-to-recover aging A/R • Expert handling of accounts receivable by highly experienced staff • Over 7 years’ experience in claim adjudication for major US insurance plans Best practices in rejection management There are multiple reasons due to which a claim is denied. We provide our end to end implementation assistance that betters your denial management attributes in your (Skilled Nursing Facility Billing. Some of the causes: Authorization Issues • Referral Issues • Medical Necessity and Medical Records requests • Non-Participation with Insurance Network • Terminated Insurance • Coordination of benefits • Wrong Diagnosis • Inclusive Procedures • Partial Payments • Out-of-network claim status and deductibles • EDI Rejections • No status and No claim on File • PIP cases • The GoTelecare approach Claim Correction and Resubmission These are the claims which are corrected, modified, and resubmitted as a corrected claim to Insurance companies. For such claims, every effort is made to resolve the denial to avoid billing the patient. Patients' Responsibility These are claims which cannot be further worked upon and the final bill is sent to the patient for payment collection. The reasons for sending the patient a bill generally include In-Network deductibles and non-covered benefits as per the insurance plan. Patients receive a statement with a clear explanation for the balance due.
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Guaranteeing reduction of accounts receivable by 30% in the first month of partnership, Gotelecare sets the benchmark in nursing home accounts receivable services. We have demonstrated experience in handling difficult to recover A/R with an experienced team of medical billers that understands claims adjudication mandates better than any other medical billing company. As a next gen medical billing and collections company, Gotelecare has been working with major insurance companies helping them in their claims adjudication, credentialing needs over the last 10 years.
Our A/R follow-up service is designed to increase the Revenue Collection for our clients. The process begins after the Provider creates and sends Health Insurance Claims (Electronic/Paper claims or Manual HCFA forms) to various Insurance Companies. Depending on the transmission type and length of time since submission, we begin our follow-ups. The key steps in our accounts receivable follow up process
We provide our disciplined intervention in
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