Clear Path Medical Billing

Clear Path Medical Billing

Our Services

Indulge in the wisdom and depth of experience that our revenue cycle experts bring to the table, offering unparalleled insight tailored to elevate and refine your strategic endeavors.

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Revenue Cycle Management Services for Medical Billing

  1. Medical Billing Services

    • Comprehensive billing support from charge entry to payment posting.

    • Accurate coding for all medical specialties.

    • Claim submission to insurance companies and government programs.

    • Management of claim denials and appeals.

  2. Medical Coding Services (add on)

    • ICD-10, CPT, and HCPCS code assignment for all medical procedures and diagnoses.

    • Regular updates to coding protocols to comply with the latest regulations.

    • Specialized coding for various medical specialties, including Podiatry, Wound Care, and Mental Health.

  3. Charge Capture and Entry

    • Accurate capture and entry of medical charges from patient visits and procedures.

    • Integration with Electronic Health Records (EHR) for seamless data transfer.

    • Verification and validation of charge data to reduce errors.

  4. Claim Submission & Follow-up

    • Submission of claims to insurance companies and payers.

    • Real-time claim tracking and follow-up for timely payments.

    • Handling of claims from initial submission to payment, including resubmissions if needed.

  5. Denial Management & Appeals

    • Proactive identification and management of denied claims.

    • Detailed review and investigation of reasons for denials.

    • Preparation and submission of appeal letters to insurance providers to overturn denials.

  6. Payment Posting

    • Accurate posting of payments received from insurance companies and patients.

    • Reconciliation of patient accounts to ensure proper payment application.

    • Regular reporting on payment status and outstanding balances.

  7. Patient Billing & Statements (add on)

    • Creation and mailing of patient invoices and statements.

    • Setup of payment plans and management of patient collections.

  8. Accounts Receivable (AR) Management

    • Ongoing management of accounts receivable to reduce outstanding balances.

    • Regular reports and updates on AR aging and collections status.

    • Collaboration with healthcare providers to develop strategies for reducing AR.

  9. Insurance Verification & Eligibility Check

    • Verification of insurance coverage and eligibility before patient appointments.

    • Real-time verification for reduced claim rejections.

    • Assistance in obtaining prior authorizations for specific procedures and treatments.

  10. Compliance & Regulatory Services

    • Ensuring adherence to HIPAA and other regulatory standards.

    • Regular audits of billing practices to maintain compliance.

    • Ongoing training to stay up-to-date on coding and billing rules.

  11. Financial Reporting & Analytics

    • Generation of detailed financial reports to track revenue, outstanding balances, and payer performance.

    • Customizable reports for healthcare providers to analyze trends and improve cash flow.

    • Predictive analytics to identify potential issues in the revenue cycle and implement solutions.

  12. Contract Management & Payer Negotiations (add on)

    • Review and analysis of payer contracts to ensure accurate reimbursement rates.

    • Assistance with payer negotiations to optimize reimbursement.

    • Monitoring and compliance with contractual agreements.

  13. Credentialing Services (add on)

    • Verification and submission of credentialing applications to insurance companies.

    • Assistance in maintaining up-to-date provider credentials.

    • Ensuring that practices remain in-network with key insurance carriers.

  14. Audit & Compliance Support

    • Regular audits of billing records to ensure compliance with all regulatory standards.

    • Audit preparation for government and private payer audits.

    • Risk management strategies to mitigate audit risks.

  15. Technology Integration & Support

    • Seamless integration with EHR/EMR systems for efficient billing and documentation.

    • Implementation of medical billing software and support for automation.

    • Data security management to protect patient information and maintain compliance.

  16. Custom Revenue Cycle Management Solutions

    • Tailored solutions based on the specific needs of healthcare providers.

    • Personalized consulting services to improve internal billing and collections processes.

    • Strategy development to streamline operations and maximize reimbursements.

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Revenue Cycle Management Consulting

Medical Billing Process Consulting

  • In-depth analysis of your existing medical billing processes.

  • Recommendations for optimizing workflows and increasing efficiency.

  • Help with improving claim submission accuracy and reducing denials.

  • Tailored strategies for streamlining patient billing and payment collection.

  1. Coding Accuracy and Compliance Consulting

    • Expert review of coding practices to ensure compliance with ICD-10, CPT, and HCPCS guidelines.

    • Identifying common coding errors and offering practical solutions to avoid them.

    • Guidance on updating coding practices according to regulatory changes and payer requirements.

  2. Billing System Optimization Consulting

    • Evaluation of your current billing software or system and suggestions for enhancements.

    • Support in selecting and implementing new billing technologies and software.

    • Custom workflows and automation setups for improved revenue cycle management.

  3. Revenue Cycle Efficiency Consulting

    • Assessment of your entire revenue cycle, from patient intake to final payment.

    • Strategies to reduce accounts receivable (AR) and improve collections.

    • Data-driven recommendations for enhancing payer relations and contract management.

  4. Denial Management and Appeal Strategy Consulting

    • Expert consultation on addressing denied claims and reducing rejection rates.

    • Development of a tailored appeal process to increase success rates.

    • Root cause analysis and actionable steps to prevent future denials.

  5. Compliance and Risk Management Consulting

    • Guidance on maintaining HIPAA compliance in all billing and coding practices.

    • Best practices for conducting internal audits and preventing billing fraud.

    • Strategies for managing risk and protecting sensitive patient information.

  6. Custom Consulting for Specialty Practices

    • Specialized consulting for medical practices in areas like cardiology, oncology, orthopedics, and more.

    • Assistance in tailoring coding and billing processes to suit niche medical specialties.

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Revenue Cycle Management Services Education & Training

Medical Billing & Coding Training Programs

  • Comprehensive training in ICD-10, CPT, and HCPCS codes.

  • Hands-on coding exercises and claim submissions.

  • Coverage of insurance policies, payer rules, and reimbursement methods.

  1. Advanced Revenue Cycle Management (RCM) Training

    • In-depth training in each step of the revenue cycle, from patient registration to final payment.

    • Focus on accounts receivable (AR) management and reducing claim rejections.

    • Tools for optimizing payment posting and managing patient billing.

    • Training on insurance verification, authorization processes, and payer negotiations.

  2. Training for Billing Software & Technology

    • Hands-on training for popular billing systems and practice management software (e.g., E-Clinical Works, Tebra, Elation Health).

    • Customizable software training based on your practice's needs.

    • Training on electronic claims submission and management platforms.

  3. Credentialing & Compliance Training

    • Education on the credentialing process for healthcare providers and their staff.

    • Training on maintaining up-to-date credentials with insurance carriers.

    • HIPAA training and ensuring compliance in medical billing and coding.

    • Understanding payer contracts, reimbursement rates, and avoiding compliance issues.

  4. Medical Coding Specialization Training

    • Specialized coding education for high-demand specialties such as radiology, cardiology, and neurology.

    • Advanced coding techniques and how to accurately report complex medical procedures.

    • Preparing for coding certifications (AAPC, AHIMA) and passing exams.

  5. Denial Management & Appeals Training

    • Training on how to identify common reasons for claim denials.

    • Hands-on exercises for creating effective appeal letters and improving claim approval rates.

    • Case studies and real-world scenarios to prepare teams for the appeals process.

  6. RCM Leadership & Management Training

    • Leadership training for managers overseeing revenue cycle teams.

    • Developing a strategic approach to improving revenue collection and reducing AR.

    • Insights on coaching and motivating billing and coding teams for optimal performance.

  7. Healthcare Financial Management Training

    • Financial training that covers the ins and outs of medical billing and coding revenue.

    • Budgeting, cash flow management, and financial reporting for healthcare providers.

    • Best practices for integrating financial data with clinical operations for better decision-making.

Ongoing Education & Certification Programs

  1. Certification Prep & Exam Support

    • Personalized preparation for medical billing and coding certifications (CPC, CCA, CCS, etc.).

    • Exam strategy sessions, mock exams, and review of key exam topics.

    • Resources for continuing education (CEU) credits for certified professionals.

  2. Customized Educational Workshops

    • Live or virtual workshops tailored to your team’s specific needs.

    • Workshops on current industry trends, regulations, and best practices.

    • Group and individual training options, including remote learning opportunities.

  3. Webinars & Online Training Modules

    • On-demand, online modules that cover a wide range of billing, coding, and RCM topics.

    • Regularly updated content that reflects the latest changes in coding, billing regulations, and payer requirements.

    • Webinars on emerging trends, payer policy updates, and compliance issues.

These Consultation, Training, and Educational Services will help healthcare providers and their staff stay informed, compliant, and skilled in the ever-evolving field of medical billing and revenue cycle management. Tailoring these offerings to the specific needs of clients can position your website as an essential resource for improving operational efficiency, compliance, and profitability.

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