MedCross RCM

Why Choose Us

Reduce Your Overhead Cost

You don’t need to hire a team of professionals to do your medical billing services. Thanks to our streamlined services, our clients could expect up to 50 percent cost reduction.

Enjoy Our Powerful RCM Tools

Our healthcare-specific automation and tracking tools can accelerate your revenue cycle and reduce AR backlogs. We’re passionate about optimizing your financial performance.

On top of it, we use powerful data security systems to protect your data.

Have Your Very Own Specialized Staff

We are a team of specialized staff with technical skills and certifications whose goal is to minimize downtime and delays, and at the same time help you streamline your medical billing operations.

Enjoy Medical Coding Accuracy

Our clients are raving about our high first pass claim acceptance rate thanks to our certified medical coders who are obsessed with accuracy.

We Offer Internal Quality Control

Everyone’s work is scrutinized before it’s submitted. We are passionate about accuracy, which is the key to faster payments, reduced AR backlogs, and fewer claim denials and rejections.

Have Your Very Own Account Manager

Maintaining an open line of communication is the key to accuracy, efficiency, and productivity. Hence, you will have your very own account manager to handle your questions and issues.

Our value proposition

- As experts in processing claims, we know what it takes to file a claim for a First Claim Resolution

- Payer Analysis - To identify payer-specific denial rates and trends

- Organise and prioritise denial appeal work process to maximise productivity and outcomes

- Identify contract clauses that are routinely used by health plans to delay payments

- Utilise State and Federal laws in denial management process

MedCross RCM Services Assurance

- Bringing Account receivable days below national average

- Eliminating unbilled/pending claims

- Data input accuracy and quick TAT for payment

- Reduction in denial and transmission error rate

- Accelerated cash flows

- Higher first pass payment and no claims left behind

- Best attributes in focus on improving your collections and reducing AR days

Value-added Services in Medical Billing

We bring plenty of value-added services which include:

- Reimbursement Audit - Monitor that all procedures are paid on time and at the contracted fee rates.

- Insurance verification - Ensure that claims are sent to correct insurance payers.

- Reconciled visits - 100 per cent reconciliation of visits with appointment logs to ensure no missed revenue opportunity.

- High pre bill acceptance – A very tight audit protocol to ensure clean claim submission, resulting in a very negligible rejection of claims.

- High 1st pass payments - Well-documented protocols ensure that we submit clean claims to achieve high degree of claims getting paid on first submission.

- Diligent follow up - Experienced staff supported by automated workflow tools ensures that all open claims are appropriately addressed resulting in claims getting paid faster.

- Charge Master Review - Provides indepth analysis of current CPT codes and charges established within your facility.

- For Oncology practice, Drug Audit - Track all drug usage from flow sheets to billing sheets to ensure that all the drugs purchased and administered are billed to payers.

- For Oncology practice, Oncology Chart Review/Audit - Through expert chart review services, we could assist an organisation in evaluating lost charges, documentation and revenue capture. The audit further reviews your organisation’s level of compliance with regulatory bodies.

- Radiation Oncology and Medical Oncology Billing Audit - Services include chart audits to review correct codes, modifiers, and necessary documentation needed to ensure your facility/practice is capturing all pertinent charges.

Value Proposition

The engagement has benefits in both the near-term and the long-term for doctors. The partnership will deliver the following benefits:

- Revenue-enhancing synergy: Operationally strong delivery center enables a competitive advantage that will be difficult to replicate in the mid-market segment.

- Reduce risk: MedCross RCM brings its strong operational capability coupled with experienced and certified resources. This diminishes risks associated with delivery and talent management for the client.

Operational Effectiveness

- On an average all our Billing/Coding resources are 5 years.

- Each resource is specialised with at least 3-4 specialities and 5-6 practice management systems.

- We work as an extension arm to your practice/office. Transitioning is seamless and your workflow does not have to go through drastic changes.

- Daily processing and submission of claims for faster reimbursement.

- Quick turnaround in claims processing 24/48 hours.

- Improves process efficiency.

- Reduce your operating costs by at least 30 per cent.

- Quick capacity ramp-up without cost.

- Submit ‘clean’ claims that result in fewer denials.

- Increased collections due to prompt follow-up of unpaid claims.

- Aggressive follow-up with payers for faster reimbursements.

- 100 per cent HIPAA complaint processes.

- Highly competent billing specialists and certified coding team (CPC).

- Easily accessible via email and phone.

- Requests are acknowledged and completed within the desired time frame provided by the client.

- Transparency and control on process.

- Contract review once in every six months.

- Bi-weekly/monthly scheduled conference calls on the billing and collections.