Provider Services

Revenue cycle management services Overview

Trust Clarus RCM to take your healthcare revenue cycle management services to a whole new level. You will see reduced claim denials, be able to identify causes of revenue leakage and improve revenue and reduce days in A/R. We strive to create a seamless process between the healthcare professionals, payers, and patients to infuse agility in your revenue cycle.

Eligibility Verification

We emphasise on quality over quantity and that is why we focus on re-checking process details. Authentication of critical aspects such as eligibility of insurance, benefits verification, co-ordination of benefits is considered a big priority at Clarus. Topping it all, we perform instant amends to rejected claims, which gives Clarus an edge over other players in today’s market.

Medical Billing - Patient Registration & Charge Capture

Clean claims are a reality at Clarus. Our billing professionals are exceptionally trained to send claims to payers at a much faster pace. Inaccurate capture of patient demographic and charge information could cause reduced reimbursement. Our team focuses on delivering high quality patient registration and charge capture services.

Medical Coding

Our expert team of AAPC certified coders complies with CCI coding edits to ensure accurate application of procedure and diagnosis codes to the patient’s medical records. We adhere to the guidelines of Local Coverage Determination (LCD) and match the right Current Procedural Terminology (CPT-4) with the ICD-9 CM codes, to prevent coding denials and prove medical necessity to the payer making sure clients don’t suffer a revenue loss.

We believe in constantly evolving to stay ahead in today’s competitive RCM service market and are currently ICD-10 compliant. This transition will help our clients experience higher quality processes and productivity gains. A Six Sigma level company, Clarus uses high-end quality tools and prevents the unethical ‘upcoding’. What’s more, certified professional coding auditors monitor and quality control the coding process, vigilantly for impeccable results.

Medical Coding and Billing - Specialties Supported

  • Allergy and Immunology

  • Anesthesiology

  • Anesthesia Pain Medicine

  • Cardiology

  • Cardiovascular Surgery

  • Chronic Pain

  • Dermatology

  • DME

  • Dental

  • Emergency Medicine

  • Endocrinology

  • Internal Medicine

  • Interventional Radiology

  • Nephrology

  • Neurological Surgery

  • Obstetrics and Gynecology

  • Ophthalmology

  • Orthopedics and Orthopedic Surgery

  • Otolaryngology (ENT)

  • Pathology and Lab

  • Pediatrics

  • Physical Therapy

  • Plastic Surgery

  • Podiatry

  • Psychiatry

  • Radiology

  • Rehabilitation

  • Urgent Care

  • Urology

  • Wound Care

Claim Submission and Clearing-House Rejections

We resort to electronic transmissions of all claims, as paper transfers are more risky and rather outdated. What sets Clarus apart is the fact that we follow claims until they reach the payer and continue our follow-up until the payer acknowledges the receipt of claims. In case of clearing-house rejections, we keep track of it on a daily basis and work on transmitting it instantaneously.

Payment Posting

The perfect blend of advanced technology, cost effective solutions and qualified billing professionals, we can get all payments posted in the billing system precisely. Clarus takes payment posting a step ahead by religiously following-through the process and accounting for denied claims. Our team is well-versed in posting 835 Electronic remittance advice (ERA).

Accounts Receivable Management and Analysis

Our perfect billing and coding system make A/R calling non-existent. But we believe in being prepared for any situation and extend our support to A/R, ensuring that our clients get paid promptly at a much lower cost.

Our AR team works effectively that all the 30+ accounts are touched within 30 biz days and gets forwarded to the next level. 0-30 aging bucket accounts are touched within 20 – 30 biz days depending on the insurance carrier.

Correspondence and Appeals

At Clarus, we are well-prepared to deal with medical billing disputes. In case of such a scenario, we diligently resubmit any claim that is not received by the payer or needs to be corrected and resubmitted. All submissions are confirmed with the insurance company to prevent any denials for untimely filing.

Based upon the information gathered by the calling support team, our team will take necessary action on the unpaid claim to correct and resubmit it. This may include re-billing, re-coding, or sending appeal letters.

Provider Credentialing and Enrollment

Our team of professional credentialing experts assures that all relevant information required for credentialing is obtained from the health practitioner. Each insurance carrier has a specific format to be followed and we customize the information to meet it. After submission, Clarus saves the information in a data base for future use and follow-up the enrollment process with the insurance carriers. Clarus makes sure to follow up with the insurance company in order for the providers to get enrolled.

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