Full Cycle Revenue Management
Insurance verification and real-time data including accumulation on deductibles and stop-loss of primary, secondary, and tertiary patient policies are possible through our physician revenue cycle management services. Our claims billing services use AAPC (The American Academy of Professional Coders) certified coding which is done by professionals who are prepared for the ICD-9 to ICD-10 code transition. Charge entry for any volume of charges and coding analysis, including all modifiers, is used as well to ensure that all claims maximize the allowable payer reimbursement.
Our revenue cycle management services use claim scrubbing to ensure there are no coding or claim information errors with immediate electronic transmission of claims. All claims are filed with the payers within 48 hours, thus allowing consistent cash flow for your practice. Our services allow you to receive claim status verification within 24 to 48 hours after submitting the claim, allowing our claims-acceptance rates to be above 96% with more than 98% of claims being processed by the payers in fewer than 19 days.
All required insurance claim forms are generated from the Ambit office and receive immediate insurance follow up. This allows a timely follow up on electronic remittance advice from the insurance companies.
Payment posting is accurately completed through our revenue cycle management services utilizing dedicated staff that is experienced in analyzing EOBs / ERAs, and payer rejection codes. Our EOB / ERA follow up process then analyzes the processed claims detail and then takes the necessary actions to recover the amounts due. We utilize denial management to allow minimal days in accounts receivable, in which highly effective specialists perform claim-by-claim denial review, pursue payment, and execute appeals on your behalf.
New Practice Start Up
Ambit Medical Professional Services can assist providers with all the necessary step-by-step processes involved in beginning a new practice. These include but are not limited to the acquisition of the FEIN (Tax Id's) and Individual Type 1 and Organizational Type 2 NPI numbers, Credentialing, Contracting, and more.
Patient Set up
As a part of our service, Ambit Medical Professional Services provides full patient demographic setup in our Software. This ensures that we gather all pertinent information and all the information is in the system accurately "prior to the patient receiving services".
With medical billing, demographic accuracy is key to submitting and receiving payment on claims.
Ambit Medical Professional Services is an innovative Medical Billing and Practice Management Consulting Company with more than 10 years in the market dedicated to providing your practice with the latest reimbursement strategies & information and technology services available to the health care industry. Our #1 goal is to get you the reimbursement that you are entitled.
Ambit Medical Professional Services knows by taking on the challenges of the changing healthcare environment we help physicians and ancillary providers improve the financial health of their practice and the efficiency of their workplace. We also know when it comes to your money "experience counts"! As for that, we have been providing medical revenue management services for over 10 years. Our staff supports you with a state of the art system to bill , track, and report all of your collectible services.
We are an organization built on strong partnerships with an approach that allows providers to concentrate on what they do best. Our revenue cycle management solutions are the single most powerful tool you have in accelerating cash flow and reducing the expenses of your practice.
Verification of Benefits / Policy Compliance Management
The initial Verification of Benefits (VOB) is performed once a year and with any new Insurance Policy change. The provider will be notified of these requirements and limitations: "if a pre-authorization/pre-certification is required, any policy limitations, if there is a set limit on the number of allowable visits or treatments, if a clinical submission is required, and more.
We supply the most current CPT, ICD-9, and HCPCS coding expertise to minimize denials and unnecessary delays in reimbursement.
We review all unpaid claims within 30-45 days of the initial billing date, appeal denials (bundling, medical necessity, etc.), resubmit claims for review when initial payment is inconsistent with typical doctor profile, and maintain managed-care contract profiles to assure proper reimbursement — a critical factor in maximizing collections.
Accounts Receivable Management
“Soft Touch” collection methods are used with patients through our revenue cycle management services and allows submissions of patient statements. Daily reports, month end reports, and capitation reports are always available in "real time". If at any time you are in need of any special (custom) report, we will be happy to provide you with it free of charge
Our Appeals department is in charge of claims tracking and denial management. All appeals are rigorously tracked in our Department center and provide your practice with continuous follow up with both patients and insurance carriers.
Payment Posting Service
We also post payments received to patient accounts (line item application allowing tracking of CPT reimbursement history). We post adjustments according to provider's managed-care contract profiles, monitoring the profiles for reimbursement accuracy as outlined above.