Medical Billing + Coding

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End to End
Revenue Cycle Management

Streamline workflow + Increase Revenue

Divit-Medical-Billing-Co

divit

Our Process | End to End RCM Services

At Divit we understand the importance of a smooth and efficient revenue cycle for the financial success of your healthcare practice. With our expertise and dedicated team, we offer a wide range of services to optimize your revenue cycle and streamline your billing and collections processes.

The Basics

Before Patient Visit ->

  • Eligibility  Checks & Verifications
  • Prior Authorizations

After Patient Visit ->

  • Coding
  • Charge Entry,
  • Claim, submission and Tracking
  • Payment Posting
  • Denial Management
  • Account Receivable 
  • Patient Statements

Support

  • Patient's Inbound/Outbound calls
  • 24/7 Customer support
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DIVIT | End to End Revenue Cycle Management

How it works

End-to-end revenue cycle management (RCM) involves a series of coordinated steps to ensure the financial success of a medical practice. Let’s walk through the key components of the DIVIT MBC method:

Eligibility Checks

Accurate eligibility verification is the first step towards a successful revenue cycle. Our team conducts thorough eligibility checks to ensure that patients have active insurance coverage and that the services provided are covered. By verifying eligibility upfront, we minimize claim denials and reduce the risk of non-payment. We update the patient records with copays,  deductibles, and coinsurance so that these can be collected at the time of patient visit

Prior Authorization Service

Navigating the complex world of prior authorizations can be time-consuming and challenging. Our experienced team handles the entire prior authorization process for you. From gathering necessary documentation to submitting requests and following up with insurance companies, we ensure that prior authorizations are obtained in a timely manner, helping to streamline your revenue cycle. Our goal to stay updated with a goal to obtain prior authorizations atleast 3 days prior to the Procedure for scheduled visits. We also scrub the appointments on the day of visit to ensure completion of prior authorization before the visit.

ICD-10

Coding:

Accurate and compliant medical coding is vital for maximizing reimbursements and minimizing claim rejections. Our certified coders are well-versed in various coding systems and stay up to date with the latest guidelines. They meticulously review medical documentation and assign appropriate codes, ensuring that claims are processed correctly and promptly.

Charge entry:

Charge entry is an essential step in our revenue cycle management process. It involves thoroughly verifying and correcting errors on medical claims before they are submitted to insurance companies. By meticulously reviewing claims, we identify and rectify any inaccuracies or missing information that could lead to claim denials or delays in payment.

Claims Submission & Tracking:

Our dedicated team strives to submit claims promptly, with a target turnaround time of 48 hours. Claim submission is the crucial process of sending medical claims to insurance companies for processing and payment. Clean claims are processed more quickly and result in faster payments. The clearinghouse sends a report of accepted/rejected claims. Claims that are rejected are corrected and resubmitted. Claims that cannot be sent electronically are sent via paper.
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Custom Solutions

DIVIT MBC WILL CRAFT A BUSINESS SOLUTION
TO FIT YOUR PRACTICE NEEDS.

Divit MBC is dedicated to supporting medical practices by offering custom service packages tailored to their unique administrative needs. With our expertise and personalized solutions, we ensure efficient operations, seamless workflows, and optimized revenue cycles. Trust us to handle the intricacies while you focus on delivering exceptional patient care and growing your practice.

Denial Management:

At our company, we have developed effective techniques and standard operating procedures (SOPs) to minimize denials, resulting in a significantly lower denial percentage compared to other billing companies. We prioritize daily cleanup of denials and provide comprehensive summaries on a daily, weekly, or monthly basis, depending on our clients’ requirements. By promptly addressing denials, we reduce the aging of outstanding claims and prevent revenue loss for healthcare providers.

Our experienced team is well-versed in handling all types of denials. We utilize insurance web portals and call insurance companies in a timely manner to resolve denial claims efficiently. Additionally, we manage all queries, correspondences, and appeals related to denials. To continuously improve our denial management processes, we conduct regular meetings and conduct training and feedback sessions. Our operations team excels in conducting root cause analysis to identify and address the underlying reasons for denials. Rest assured, we take responsibility for cleaning up your old accounts receivable (AR) and aim to refund provider money from insurance companies whenever possible.

Payment Posting:

Timely and accurate payment posting is essential for maintaining an up-to-date accounts receivable (AR). Our team handles payment posting promptly and accurately, ensuring that all – ERA, EOB, and EFT – payments, adjustments, and denials are recorded correctly. By keeping your AR records current, we provide real-time visibility into your practice’s financial health.

Patient Statements:

Clear and concise patient statements are instrumental in facilitating timely payments and enhancing patient satisfaction. Our dedicated team generates patient statements that are easy to understand, providing a breakdown of the services rendered and any outstanding balances. We prioritize prompt delivery of statements and offer comprehensive support to address patient inquiries regarding billing. Our goal is to provide exceptional customer service, ensuring that patients are well-informed and confident about their financial responsibilities.

Patient Communication:

We recognize the importance of effective patient communication, particularly when it comes to billing inquiries. Our dedicated team handles outgoing and incoming patient calls regarding billing promptly and professionally. We listen to patient concerns, provide clear explanations on billing matters, and offer guidance on various payment options available. Our commitment is to provide exceptional customer service and efficiently resolve any billing-related issues, fostering positive patient experiences.

Financial Reporting and Analysis:

Comprehensive financial reporting and analysis offer valuable insights into the performance of your revenue cycle. Our reports include key performance indicators, revenue trends, and actionable recommendations. By closely monitoring financial metrics, we empower you to make informed decisions and implement strategies that optimize revenue generation and financial outcomes for your healthcare practice. Our team is dedicated to helping you achieve financial success through data-driven insights and proactive management.

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