Looking for a reliable Orthotics & Prosthetics billing partner that can help you eliminate proven challenge areas. Sunknowledge promises to be by your side and offer comprehensive solutions in RCM , eliminating gaps and elevating billing experience for our clients. We have currently set benchmarks with an excellent front/ back office RCM approach in Orthotics & Prosthetics segment, making us a champion healthcare services company.
Our team is versatile across all major Orthotics & Prosthetics billing software in use and offer seamless proficiency even at this time of crisis. We are confident to offer you unparalleled support and offer niche assistance for any operational stagnancy due to a shortage of employees and finding the right expertise.
We are ready to work with you immediately at $7 per hour/ Deliver fast and effective Orthotics & Prosthetics billing services
Our action plan in Orthotics & Prosthetics billing
- Initial visit appointment Setup (Done by Practice)
- Order entry.
- Patient Account Creation.
- Patient’s demographic entry.
- Prescription information entry.
- Initial Eligibility Verification.
- Creation of Insurance verification form.
- Checking general eligibility and benefits information and Updating in Software.
- Creation of Insurance verification form.
- Initial Evaluation Appointment (Done by Practitioner)
- LCodes assignment.
- (If required)
- Creation of Evaluation form/Notes/Other Medical Records
- Detailed Eligibility Verification & Authorization Requirement Checking
- Re-verification of eligibility with assigned codes.
- Updating detailed code specific benefits.
- Checking authorization requirements. (Code Specific)
- Creation of Service Estimates (Payer Specific and Reasonable and Customary)
- Sending detailed written order/diabetic verification form and other paperwork’s to Doctor’s office for signature.
- Re-verification of eligibility with assigned codes.
- Doctor’s office follow-up.
- Contacting Doctor’s office for pending detailed written order/ diabetic verification form and other paperwork’s.
- Authorization / Pre-Determination / Referral Initiation.
- Creation of Insurance Authorization Form.
- Requesting Authorization/Pre-Determination/Referral (Via Phone/Fax/Email)
- Authorization / Pre-Determination / Referral Follow-up.
- Follow-up with payer on Authorization/Pre-Determination/Referral status.
- Completion of authorization form based on the outcome of the request.
- Final Eligibility verification or Pre-delivery Check.
- Creation of patient financial responsibility form.
- Notes Update.
- Work In Progress (WIP) updating.
- Office coordinator notification.
- Patient responsibility
- ABN creation
- Schedule Delivery.
- Delivery (Done by Practice)
- Signing Delivery Ticket. (Soft copy / Hard copy)
- Claim Submission
- Primary/Secondary/Tertiary Claim submission (Via paper/fax/electronic)
- Rejection Management.
- Online Rejection checking (Via Clearing House)
- Correction and resubmission of the rejected claims (Via Clearing House)
- A R follow-up & Denial Management
- Follow-up on pending AR balance and working on denials
- Follow-up on possible reconsideration requests
- Filing Reconsideration Requests
- Filing Appeals.
- Payment posting
- Patient payment posting and adjustments
- Insurance payment posting and adjustments
We will be glad to demonstrate our best practices in Orthotics & Prosthetics billing with you over a no commitment call. Leverage the Sunknowledge opportunity in transforming your revenue cycle management approach.
