Accurate and timely
claim submissions that minimize denials
Demographic and charge entry
Electronic and electronic-to-paper claims submission
Payment posting and bank deposit verification
Dedicated professionals that increase cash flow and reduce A/R
Insurance and guarantor follow-up
Monthly patient statements
Appeal and denial management
Credit balance resolution
3rd party collections
Consistent maintenance to
Medicare, Medicaid, Individual NPI, Group NPI, BCBS, and Commercial Carriers
Provider privileges at hospitals and facilities
that monitor and
Statutory and regulatory compliance
Fee schedule maintenance and monitoring
Detailed monthly reporting packages
Managing Your Revenue Cycle
Demographic Charge Entry
Incorrect demographic entry is another frequent cause of payer claim rejections and denials. Our account representatives have a proven track record of accuracy and quality control that can accommodate a high volume of claims. We handle patient and payer inquiries, and keep our inquiries with your practice to a minimum so you can stay focused on patient care.
Payment Posting and Bank Deposit Verification
We make it easy for our clients to follow their claims and cash flow with timely payment posting and bank deposit verifications.
AMS provides full revenue cycle management (RCM) services for physicians that elect to outsource their billing and collections. Choosing to outsource is a great option for physicians that want to maximize their income potential by reducing unnecessary costs and overhead expenses. Dedicated account representatives work with your practice to ensure consistent cash flow and optimize revenue potential. This is the perfect solution for a practice that does not want to hire and maintain billing personnel.
Maximizing Your Collections
Insurance and Guarantor Follow-Up
Our account representatives work hard to ensure claims are received, overdue payments are recovered, denied claims are followed, and claims that are kept pending for information are addressed. As a result, our clients enjoy reduced time to payment for outstanding accounts, helping them to maintain a healthy cash flow and financial stability.
Appeal and Denial Management
Failing to adequately work claims denials translates to lost revenue for your medical practice. Our account representatives expertly research reasons for denials, collect necessary documentation, and submit appeals that maximize your reimbursement. Our appeals services are backed by state of the art strategies that have developed out of a long history of data collection that helps us optimize our approach to both standard and exceptional denial cases.
Credit Balance Resolution
AMS has over 30 years of experience negotiating with insurance companies, appealing claim denials, and following up with guarantors. We keep track of all A/R, analyze opportunities carefully, and strategically follow-up. Three decades of specialized experience have generated a suite of tools, processes, and best practices that we use every day to increase cashflow and keep A/R at a minimum for your practice.
Credit balances arise due to incorrect adjustments, erroneous credits, improper use of procedure / debit codes, duplicate payments, and overpayments. By law, credit balances must be resolved, and failure to do so in a timely manner can keep your credits accumulating, making your practice liable for fines. When payment is posted, we carefully analyze the charge amount and payment distribution, report credit balances to both the provider and the payer, and resolve credit balance accounts in a timely manner.
Streamlined Credentialing Across Insurers
A typical physician has to be credentialed by each of the payers covering each of his or her patients. Managing the disparate credentialing requirements across all of these insurers can be tedious and expensive, and keeping up with renewals is another challenge entirely.We streamline the credentialing process for you and keep you in check with Medicare, Medicaid, BCBS, and other Commercial Carriers.
We also handle individual NPI and group NPI credentialing to keep you compliant for all claims submissions.
Provider Privileges at Hospitals and Facilities
Obtaining provider privileges at a new facility can be just as cumbersome and time consuming as getting set up with insurers. To ease this process, AMS also provides streamlined facility credentialing and privileging services. Our account representatives have worked with a number of facilities, equipping them with the experience to anticipate the information and documentation that your new facility will require.
Keeping You Compliant With Insurers and Facilities
One of the frustrating issues practices deal with all the time is finding out that they are filing claims to a carrier that you are not participating with. We continue to see a large movement towards carrier acquisition which leaves many providers with patients that they can no longer see. Your practice needs to be up to date on what is happening in the healthcare industry and have a partner that can assist with credentialing. This will save your staff time and reduce the risk of delayed or lost revenue by billing out of network.
Sharpening the Operations of Your Practice
Statutory and Regulatory Compliance
AMS helps protects your practice against data entry errors, incorrect coding, and missing information. These mistakes can lead to costly delays, denials, and re-submissions. We are HIPAA compliant and uses several proprietary methods to ensure protection of patient information.
Fee Schedule Maintenance and Monitoring
The AMS team will help you develop the right fee strategy to capture the maximum reimbursement. Our proprietary databases allow us to provide charge recommendations that are specific to the major insurance carriers in your local market. By continually monitoring specific insurance carriers, we provide you with the data needed to support fee increases.
Detailed Reporting Packages
Our monthly reporting suite includes physician earning reports, provider activity reports, and detailed aging summaries so you're fully informed on the financial performance of your services.
Practice Management is a catch all phrase for many healthcare industries. At AMS, this is what we focus on every day while performing credentialing and billing tasks for our clients. We strive to monitor not only your practice but the carriers and the industry overall to ensure that we are communicating the updates and upgrades that you need to stay in compliance and on top of state of the art technology. We are another layer of support and protection for your business.