Physician Billing
Medical billing businesses face numerous challenges when managing individual or group practices. Effective communication with commercial insurance companies and government payers requires a technically skilled staff. Our team stays fully informed about upcoming code additions and is well-equipped with the necessary medical billing terminologies.
Increased Revenue
Sense of Financial Security
Job Satisfaction
Fundamentals of Optimized Revenue
1-Examining Claims Before Submission
HealthUnits’ claim production team follows SOPs to check for errors before submitting a claim. These checks include demographic entry, pre-authorization, eligibility and benefits verification, and coding edits.
2-Flawless Submission of Claims
Once claims pass the initial examination, the HealthUnits team formats the billing form (CMS-1500 / UB 04) for submission. Claims are submitted via EDI format, with paper submissions used for payers that do not accept electronic claims.
3-Claims Tracking
After claims are successfully transmitted, HealthUnits tracks them at each level. We ensure a primary receipt from the payer and follow the claim until payment is received. Denied claims are reassigned to the AR Follow-up team to maximize payment recovery.
4-Account Receivable & Denial Management
Payments are posted to the corresponding patient accounts. Unpaid and low-paid claims are handled by the denial management team, which resolves issues and resubmits claims for reprocessing. The AR team negotiates with insurance companies on low-paid claims and sends reconsiderations and appeals.
5-Prerequisite Explorations
HealthUnits employs analysts who provide feedback on various revenue cycle activities, identifying weak areas needing improvement. Analysts track the cycle at each stage and generate multiple reports to show the organization’s exact performance.