MedCross RCM

Step-by-Step Claims Transmission Process

1. Collection of receipts

The healthcare providers gives an itemized bill that states the following info: patient treatments, the corresponding medical code for the said treatment, and the cost. At this stage, we can help you collect the required documents and receipts.

2. Filing of claim form

This form details the patient’s illness and the corresponding treatments/services he received, and whether or not the costs were claimed under his insurance provider.

During the filing of claim forms, the following details are needed: patient personal information (name, address, and date of birth), insurance policy number, reason for visit, payment he had paid out of pocket, and healthcare provider’s name and address.

3. Review claims

After filling out the form, we make a back-up copy for all the forms and documents and at the same time thoroughly review the details to eliminate any errors. Our gatekeepers ensure that before we submit the claim to the payer, it is error-free and in compliance with the payer’s instructions and the most recent medical coding.

4. Claim submission

After all the details are thoroughly reviewed, we submit the claim forms with the supporting documents to the insurance provider.

What Sets Us Apart

• Our certified medical coders receive regular training to ensure that they are compliant with the most recent medical billing and coding regulations.

• We provide you a daily report on patient’s insurance eligibility info such as co-pay, deductibles, procedure eligibility, pre-existing medical condition, and insurance pre-authorization requirements.

• We transmit claims to the insurance providers within 12 hours from the patient’s time of visit.

• We conduct follow-up with the insurance companies over the phone for quicker reimbursement.

• Our denial management team resubmits claims on the same day.

• We use accuracy metrics to promote zero claim denials.

• Our AR management team conducts follow-up phone calls to collect out-of-pocket fees from patients.

• We have a dedicated toll-free number to answer patients’ inquiries regarding their co-pay and other responsibilities.

• We provide you with summary and analysis reports that you can access any time with your smartphone or tablet.