Physicians Billing Services

Insurance Verification

Insurance verification is an important step to ensure the timely reimbursement of claims. Our dedicated verification specialist will confirm eligibility accurately and bill primary payors on your behalf. We have an exceptional team of expert medical billers who take the required steps to guarantee insurance eligibility verification is accurate in the first instance.

We can verify the below information along with 'Insurance verification' process depending on the providers' specialty:

Patient Registration

The accuracy while capturing patient details is perhaps one of the most under-rated processes in the revenue cycle chain. The data captured ensures a strong medical record for the patient which in turn affects insurance reimbursements. Error-free capture of patient information is essential for clean claim submission and facilitates quick claims processing by Payers.

Our team understands that kick starting an effective revenue management process starts here. They get the below information as part of the process:

Charge Entry & Charge Audit

Failure to effectively document care information can lead to revenue leakage – amounting to millions of dollars of lost revenue. While deploying effective charge capture, workflow solutions can help reduce instances of lost revenue. Also, effective collaboration between coding and charge entry teams leads to a sustainable improvement in the overall process.

With expertise in multiple charge entry platforms, our team process a high volume of charge entry transactions with exceptional quality.

Charge Capture

Our charge entry transactions remain consistent throughout:

Charge Audit

Leverage ODIS’s Charge Audit services to identify missed charges, instances of over-billing, and coding errors that lead to revenue loss.

We take an analytical approach to:

Charge Audits help reveal the causes for variances in payments including problems with charge entry, provider absences, failure by providers office to report charges in a timely fashion, a change in coding pattern, unbilled services and other reasons for claim denials.

Claim Submission & Rejection

Claims scrubbing or Claims submission process involves reviewing, before submitting the claims to payers. We utilize Practice Management Systems to check the data integrity. We identify and correct the rejections before submitting to insurance payers.

Payment Posting

The payment posting process provides a view of the effectiveness of your revenue cycle. It allows you to understand trends in reimbursements and perform analytics. Accurate payment posting offers clarity on the state of your revenue cycle, and, therefore, you must choose a highly efficient team to process payments.

We process the following types of payments:

Denial Management

Our cloud-based denial management system helps to analyze remittance advice and identify opportunities for effective denial prevention. Benefit from a single, on-demand dashboard for managing claim denials and re-submission to drive the initial denial rates lesser than 4% in line with industry best practices. We ensure hassle-free health insurance claims resubmission for reimbursement approval.

Account Receivable

Accounts Receivable (AR) is the money owed to providers/medical billing companies for the medical care rendered to patients. It is important that the staff keep a tab on AR and make sure that claims are paid on time. In simple words, Accounts Receivable Management is a collection of processes such as identifying denied/unpaid claims, re-filing the corrected claims, minimizing AR days and eliminating aged AR.

Manage Denials: Identifying the root cause for claim denials is one of the important processes in Accounts Receivable management. The staff must be highly skilled to analyze the reason for claim rejection, correct the claims and re-file without delay. Also, it is essential to examine denial patterns and find proper solutions to eradicate future occurrence of denials.

Timely Follow-up: Following up on AR on a timely basis is very important for uninterrupted cash flow. A good AR management team will keep track of all claims that have been filed and execute an action plan immediately if the claims are not paid within the 30-day time limit. The team will also ensure that there is no underpayment or overdue payment.

Credentialing & Enrollment

Physicians/providers must credential themselves, i.e., enroll and attest with the Payer’s network and authorized to provide services to patients who are members of the Payer’s plans. The credentialing process validates that a physician meets standards for delivering clinical care, wherein the Payer verifies the physician’s education, license, experience, certifications, affiliations, malpractice, any adverse clinical occurrences and training. Payers may delay or refuse payments to physicians who are not credentialed and enrolled with them. These impact the financials of the practice negatively.

Our customized Payer credentialing and enrollment services support physicians in:

Our credentialing process involves

Hospital Billing Services

ODIS Healthcare Hospital Billing services to save costs on infrastructure and in-house resources. ODIS can help you maintain an effective billing mechanism to receive payments and track expenses. The Hospital Billing team at ODIS has in-depth knowledge of the US healthcare industry. We have over 20 years of experience working with hospitals and medical practitioners and can help you increase your reimbursements by more than 20%.

Hospital Billing Services at ODIS Healthcare

Hospitals require an error free operation; errors should be restricted to a maximum of 2% to achieve better rates of return. Our experience in working with hospitals in the US with a strict quality control process has consistently ensured low rates of errors for our customers.

The features of ODIS Healthcare hospital billing and collection services include:

Why ODIS Healthcare Hospital Billing?

Hospitals and health care service providers, like any other organization, need to maintain an effective billing mechanism to receive payments and also track expenses. Conducting hospital billing services in-house is not only tedious but also expensive. Staff costs, administrative expenses and overheads towards infrastructure will be some of the costs that you will have to consider if you conduct hospital billing in-house.

If you'd much rather focus on providing better care for your patients and have someone else take care of maintaining your reimbursements, outsourcing your hospital billing services might be the solution you are looking for. ODIS Healthcare brings direct cost savings on running a billing operation whilst saving costs on staff salaries and other overheads.

ODIS Healthcare has been in the forefront in providing hospital billing services coming with an acute knowledge of the US healthcare industry. We have been working with various hospitals and medical practitioners for over 20 years and can help you increase your reimbursements by more than 20%.

Dental Billing Services

Dental billing is the systematic process of submitting and following up on claims to reimburse the dental services provided by dental practitioners. This billing process is critical for dental practices to ensure accurate and timely payments for preventive care, restorative treatments, and surgical procedures.

The foundation of dental billing lies in using precise codes to identify services. Current Procedural Terminology (CPT) and Dental Procedure Codes (DPC) help categorize and standardize treatments, ensuring that insurers recognize the procedures performed and provide appropriate reimbursement. These codes must be accurate and correspond to the services offered to prevent delays, denials, or underpayments.

A well-managed billing process also involves pre-authorization checks to confirm insurance coverage and patient eligibility before services are provided, minimizing the risk of denied claims. Furthermore, billing teams manage follow-ups on unpaid claims, resolve discrepancies, and ensure compliance with regulations such as the Health Insurance Portability and Accountability Act (HIPAA).

A structured billing approach allows dental practices to reduce errors, prevent revenue loss, and ensure timely payment, ultimately improving cash flow. By handling these administrative tasks efficiently, dental billing professionals can focus on offering high-quality patient care without being bogged down by the complexities of insurance claims and billing intricacies.

However, dental practices often encounter various challenges in their billing processes. These include complexities in insurance coverage, frequent updates to dental billing codes, and potential errors in patient information or treatment documentation. Additionally, the evolving landscape of dental insurance policies can lead to misunderstandings regarding coverage limits and co-payments, complicating the billing process and potentially delaying payments.

ODIS Healthcare provides expert dental medical billing services to help dental practices navigate these challenges by:

Gathering comprehensive patient demographics and conducting real-time insurance eligibility checks to verify the accuracy of personal information, including insurance coverage specifics, preventing claim denials due to outdated or incorrect details. Managing pre-authorization by submitting ADA procedure codes and treatment plans to insurance providers for smoother claims processing, reducing the likelihood of post-treatment denials, and improving billing workflows for complex dental procedures.

Utilizing Current Dental Terminology (CDT) and Current Procedural Terminology (CPT) codes for dental services to ensure precise coding for all treatments, streamlining claims submissions, and maximizing reimbursement accuracy with payers. Electronically submitting claims via Electronic Data Interchange (EDI) platforms, ensuring full compliance with HIPAA standards while maintaining accuracy in documentation and submission.

Tracking submitted claims in real-time using advanced dental practice management software and promptly following up on unpaid claims to secure timely payment while addressing rejections or making corrections due to missing or erroneous documentation. Analyzing denied claims by handling detailed denial management, which includes reviewing Explanation of Benefits (EOBs), submitting appeals when necessary, and promptly resubmitting corrected claims to recover lost revenue efficiently.

Performing payment posting once payments are processed, ensuring accurate entries in the practice's financial accounts. This step includes reconciling discrepancies between submitted claims and received payments to swiftly resolve any underpayments or overpayments. Generating patient statements for balances not covered by insurance and managing accounts receivables through a systematic follow-up on outstanding balances, ensuring collections are done timely without impacting patient relationships.

Providing detailed reports on key metrics, including days in A/R, claims acceptance, and denial rates, to help dental practices assess their financial health, optimize revenue cycles, and make data-driven decisions to minimize cash flow gaps. Maintaining compliance with dental billing regulations, ensuring adherence to HIPAA and ADA guidelines, and conducting regular audits to uphold accuracy and avoid future discrepancies in claims or compliance issues.

Our Comprehensive Dental Billing Services

Home Healthcare Billing Services

ODIS Healthcare is committed to offering market leading home health billing services tailored to meet client specific requirements. By availing our home health billing solutions, our clients have gained significant benefits in the overall billing process, primarily in terms of profitability, substantial reductions in operational costs, efficient processes and improved productivity.

Our Home Health Billing Services

Eligibility Verification & Prior Authorization

We verify patient's eligibility for coverage under their policy and when required, obtain prior authorization before services are rendered.

Demographics & Charge Entry

We capture demographic, insurance and encounter specific information to generate claims and enter charges.

Home Health Coding & OASIS Review

We code at multiple levels and review all clinical documentation, based on your requirements.

Billing & Claims Submission

We bill no-pay RAPs and End of Episode (EOE) claims. We submit both paper and electronic claims.

Payment Posting

We review and post all payments. Our payment posting services include electronic, manual, patient and denial posting.

Accounts Receivable Management

We follow-up with payers, check payment status, research unpaid claims, respond to claim rejections and reprocess corrected claims.

Denial Management

We identify and categorize denial reasons, resubmit corrected claims and take necessary steps to prevent them from occurring again.

Credit Balance Resolution

We will analyze your credit balances, identify overpayments, correct errors and generate refund letters for unresolved credit balance accounts.

Report Generation

We provide reports customized to your requirements.

Medical Coding & HCC Coding Services

Coding service is a key activity that has a direct impact on the financial status of your practice. We have specialized expertise, niche focus, and infrastructure to support your requirements.

ODIS Healthcare has CPC, CPC-H, CCS, CCSP, and CPMB certified professionals with ICD-10-CM certification. We aim to scale up our processes to become a leading player in this business.

Our medical coding services help in:

Our coding services are available as part of our revenue cycle management services or as a separate service. Our process flawlessly integrates with your billing system to ensure the highest degree of data reliability.

ODIS Healthcare Advantages

ODIS Healthcare has an effective audit system that keeps our coding standards equivalent to the best in the industry We also constantly improve our coding skills through continuous training programs

Improving Coding quality

Our primary focus is to implement quality improvements initiatives during migration as well as during steady-state production.

With continuous processes improvement focus, we use a dedicated team to identify and mitigate any errors

Our quality approach ensures that every process is documented

We follow Top-level Six Sigma Quality management system which makes quality and essential part in project execution

Coding Audit Services

Our audit consists of highly skilled coders, certified in Quality Management Systems and Six Sigma. The key features of our QA team responsible for detecting errors are:

Medical Billing Companies

RCM services for Billing Companies - Innovative Strategies for Billing Precision and Efficiency

At ODIS Healthcare, we recognize the unique challenges that other medical billing companies face. We work as your extended business office rather than an outsourced billing partner. Our specialized Revenue Cycle Management (RCM) services are designed to strengthen your capabilities, boost your efficiency, and increase your revenue at a reduced cost. We can manage your deliverable as work on business growth. Our mission is to support you in delivering exceptional service to your clients while optimizing your own operations.

Accurate billing and coding are essential for the success of any medical billing company. As your partner, our team of certified coders and billers collaborates closely with you to ensure that claims are submitted accurately and on time. We stay up-to-date with the latest coding guidelines and payer requirements, minimizing the risk of denials and maximizing reimbursement. By partnering with ODIS Healthcare, you can refine your billing processes, deliver superior service to your clients, and build their trust in your expertise.

Our approach goes beyond just providing services; we work together to identify opportunities for improvement and growth. By fostering a collaborative partnership, we help you streamline operations, reduce overhead costs, and enhance overall efficiency. Our commitment to transparency and open communication ensures you have the insights and support needed to drive success for both your company and your clients.