Medical Billing

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Billing Services Overview

CodeOne is committed to putting you in financial control of your practice. In order to have a pulse on your finances, we provide timely, inclusive, relevant information to allow you to make the best possible decisions for your patients and practice. We provide the tools for you to understand the clinical and financial components of your practice, enabling the financial health of your practice to prosper and thrive.

Service Setup

Upon forming a billing partnership with a practice, CodeOne’s initial mission is to understand the goals and priorities of the practice being served. Forms, including and not limited to: Superbills, patient registration forms, and Fee Schedules are created and/or updated. Present processes at the practice are reviewed and contracts are assessed to ensure the practice is appropriately tied to all payers contractually. CodeOne installs the necessary equipment in the practice’s office (device and scanners), and the billing service process commences.

Service Components

Coding Support

Claims are regularly examined for accuracy of coding, proper sequencing, and modifier use. Diagnosis codes, CPT codes, and fee schedules are updated annually or as needed.

Precise tracking and management of every claim

Patient demographic and encounter information is received, sorted, and packaged into virtual folders. CodeOne’s highly skilled employees utilize proprietary, state-of-the-art technology to track every line of every claim, for every patient, every day.

Accurate, timely reimbursement

CodeOne’s main objective is to ensure clients receive timely reimbursement for their efforts. CodeOne promptly submits clean claims and carefully monitors the reimbursement timeline.

Aggressive appeals of non-payments and underpayments

CodeOne’s audit and appeals departments analyze the adjudication of every claim. Variances in payment amounts are researched and professionally appealed. Our extensive, multi-specialty knowledge base allows us to anticipate trends and problems with certain codes and particular payers.

Management of the patient statement process

CodeOne generates all patient statements and makes any necessary follow-up phone calls. All client and patient questions concerning benefits, payments, and patient portions are referred directly to CodeOne. CodeOne communicates with each client about aging patient balances, refunds, write-offs, and when to utilize an outside collection agency.

Instant access to critical information

CodeOne’s Physicians Insight Report includes detailed and specific information about each procedure, provider, and payer. It is immediately accessible through CodeOne’s color-coded software product, allowing company/client transparency 24/7.

Regular assessment of contract performance

Negotiated rates are equally as critical as the contract performance on promised rates. CodeOne continually monitors performance against contract promise to ensure accurate reimbursement with one goal in mind: your prosperity.

Superbill and Fee Schedule management

CodeOne works with clients to develop a Superbill and Fee Schedule unique to their practice. Annual and necessary changes are made promptly.

Service Benefits

Transparency

Monitor our performance and the health of your practice daily; CodeOne provides the automated tools you need for the most up-to-date information regarding your practice.

Compliance

Rest assured knowing your practice meets HIPAA and government requirements; CodeOne’s billing, adjudication, and provider/group enrollment are compliant with all local, state, and federal governing authorities.

Protection

Secure your hard earned dollars; CodeOne protects against embezzlement through reconciliation of posted receipts, deposits, and bank statements.

Information

Gain immediate online access to daily detailed reports; CodeOne provides daily online reports regarding the financial and clinical activity within your practice.

Assurance

Achieve your financial potential; CodeOne monitors payers and analyzes industry trends to provide measurable benchmarks and set viable financial goals.