Healthcare Solutions

MedLite

Healthcare Solutions

Medlite Pre-Authorization Services (Pre-Certs)

Claims Form

One of the Healthcare Solutions that MedLite has to offer is our Pre-Authorization service. The Pre-Cert service will collect patient information from medical providers to obtain prior authorization for inpatient and outpatient procedures, in addition to pre-certifications for hospital admissions. Our service will maximize claim reimbursements with reliable and rapid turnaround time while reducing duplication and patient data errors.

Optional Financial Review Package!

 

Patient financial analysis will provide the clinic with insight on how much reimbursement they would expect to receive from the insurance company and will also suggest how much to collect from the patient based off their coverage and remaining deductible.

(***Please see the link below for the Medlite Pre-Cert Plus pdf document for more details.)

Pricing: No up front costs – only $7 per pre-cert transaction or $9.50 with Optional Financial Review included.

Increase Profitability RCM Logo REQUEST A FREE RCM PERFORMANCE ASSESSMENT

Our RCM program improves overall revenues by 10-20% on average over a traditional billing company or an in-house solution. By performing analytics and analysis of products, services, documentation and workflows, much greater revenues can be realized.

With our newest client inside Cedars Sinai, revenues have increased 25% in just three months!

We can perform a FREE analysis for your facility. Even if you don’t sign up, you will walk away knowing how the current solution is performing.

Optional – Practice Management Software and Call Center Services (virtual billing department for your patients) where we answer the phone as your facility, not an outside service.

Our RCM service includes the following:   (***Please see the link below for the Medlite RCM Services pdf document for more details.)

ELIGIBILITY & VERIFICATION

RCM Services eligibility and benefits verification obtains all pertinent information required – not only coverage confirmation, but also specifies what kind of coverage the patient has (HMO, PPO, POS, etc..) what their deductible is, and how much has been applied, and helps generate complete payer information to bill the claims appropriately.  This verification process takes each claim to the right step of getting it paid on time and reducing your administrative cost.

CHARGE & DEMO ENTRY

Charge & Demo entry is the most sensitive of all departments in medical billing. This department holds the key to a successful claim filing. Charges and codes for every medical procedure are updated often and we stay ahead of these changes among the fellow players, emphasizing accuracy and efficiency.

EDI SERVICES

Our team is well trained in the process of pushing the claims that were entered on a given day along with claims that were set for resubmit from the previous day, through the scrubbing process of our automated internal system (EDI Services) and creating a clean claim file(s) as per your requirements.

PAYMENT POSTING

Payment posting is one of the most crucial processes involved in the full service revenue cycle management business. We are experts in handling small, mid-sized, and large volumes of payments. We have handled posting payments of up to $40 million every month and maintained a turnaround time of 24 to 48 hours. In addition, we have closed all month ends on the last working day of the month. We have 100% success ratio in closing month ends for a period of more than 25 months continuously.

DENIAL MANAGEMENT

Denials can have an adverse impact on your monthly revenue. A sub-par Denial Management system can result in lower or no reimbursement at all. MedLite Healthcare Solutions understands that an effective denial management program must address both historical and future claims, recovering otherwise-lost revenue and preventing future denials by scrubbing each claim to identify possible denial issues in our First-Pass level edits.

CREDIT BALANCE

Credit balances can be a very serious issue for any provider. Credit balances occur when payments and adjustments exceed posted charges. MedLite Healthcare Solutions addresses this issue through a complete analysis of accounts receivable (AR) to find the root causes of the overpayments. Our RCM solution significantly reduces the financial risks associated with credit balances and in turn improves the financial strength of your company.

RESOURCE LINKS:               Medlite RCM Services             Medlite RCM Brochure                Medlite Pre-cert Plus