We leverage our proprietary billing solution BASCONNECT™ (Connect).
Whether we take an electronic file from your EMR or HIS system or entering charges manually from superbills, our team ensures accuracy through system checks as well as physical quality control audits. All charges are reconciled against client systems. We can use whatever is available from manual schedules to electronic surgery schedules. In addition, if required, patient eligibility can be completed prior to claim submission.
A team of Certified Professional Coders accredited by AAPC assigned diagnosis (ICD-9/ICD-10 and procedure (CPT) codes for each of your procedures. Through a complete review of all available patient data both on paper files and HIS systems, the coder will assign the applicable codes to each encounter. Should missing information be identified, the coders will work with client contacts to obtain missing elements to appropriate bill.
Both internal and external audits are completed on each client and documentation feedback is provided to improve clinical documentation.
As a primary reason for delays in cash flow, Bolder Billing Services provides payer enrollment services to all of our clients. Payers constantly change rules, amend requirements and use these tactics to delay reimbursement. Our team uses our broad national exposure to identify these changes early and apply those changes across the client base.
Through the ACA as well as other legislation, credentialing has become more difficult and thereby even more important to the RCM process. Our credentialing analysts are assigned by client such that the uniqueness of each practice can be appropriately addressed.
Bolder Billing Services understands the impact delays in resolution of A/R can have on its clients but also knows that payers will use this fact against clinicians. A/R is not deemed resolved just because a payment has been received from a payer or patient.
Through customized requirements from each client, we create a workflow to identify and resolve claims that are underpaid based on contracted rates or incorrectly adjudicated based on payer commitments/legal requirements.
Our team constantly checks status on all open accounts. Appeals are submitted as appropriate, and settlement negotiations are handled based on specific client instruction.
Specific workflow is designed for clients with significant volumes of worker’s compensation or litigation cases. These cases are handled by staff trained on the intricacies of these complicated cases. Bolder Billing Services will work with client legal representatives to resolve each case within the guidelines provided.
Payers will deny claims for a myriad of reasons. The resolution of those denials can be extremely complicated and time-consuming but can result in increasing overall Gross Collection Rates (GCRs) by up to 7%. These are real dollars that the payers are hoping are ignored.
Bolder Billing Services has workflow designed for each type of denial and will work with clients to obtain the information needed. It’s hard work but differentiates a quality solution for an adequate one.
Bolder Billing Services provides a patient customer service solution focused on patient satisfaction. In today’s complicated healthcare environment patients receive numerous statements, EOBs and collection letters and can become extremely confused.
Our team is trained specifically to resolve these complicated questions with compassion and dedication to the patients. We can even create client specific patient solutions for things such as county indigent funding, charity care, state/federal grants or any other program.
To ensure a successful patient experience their accounts must be resolved appropriately and dollars applied as instructed. Our team is focused on applying payments to the line-item on each case/encounter to allow for effective A/R management and minimize patient confusion.
Additionally, all deposit batches are reconciled daily to ensure that dollars received are applied to patient accounts.
Every compliance plan requires the prompt resolution of credit balances. Bolder Billing Services provides such a solution through a dedicated team focused on overpayments. They prepare all supporting documentation and provide that information, as appropriate, to clients for review and approval.
In addition, we can provide check processing services for our clients.