HIPAA Compliance
Avernus follows a set of rules and regulations to ensure that we provide you with high-quality services and protect the privacy of patient information. Our billers and coders also ensure compliance with HIPAA.
Healthcare Revenue Cycle Management (HRCM) services focus on healthcare's financial, administrative, and clinical aspects. The goal is to minimize the risk and maximize the value of your health system by ensuring efficient and effective operations. RCM includes revenue collection, charge entry, payment posting, accounts receivable, denial management, and appeals.
Accounts Receivable Management includes managing debts owed to you and collect payments from those who owe money to you. The accuracy of the claims and the time it takes to retrieve the money are crucial factors in maximizing revenue collections. Our medical billers aim to increase your profitability by raising the collections ratio and decreasing days in accounts receivable to boost the cash flow.
We also identify combinations of categories and payers and seek to resolve those that produce the highest levels of collections.
Denial Management requires analysis, and our billers can help you do that. Once the core cause of denial is identified, resolving it and being reimbursed for it is not difficult. Denial claims also demand "Appeals." They are requests for clarification of the earlier claim submissions and the criteria under which the claim is now once more eligible for payment.
Certain appeals have deadlines. Our billers examine your most frequently refused claims, prioritizing them based on volume and dollar amount, and promptly submit them.
Filing claims for patient services is the first step in the medical billing process. Medical codes are applied to charts in charge entry, and patient demographics are correctly checked. To decrease the chances of a claim being rejected, every claim is checked for the following items: DOS, POS, Provider Info, Units, Modifiers, CPT code, Facility billed from, and Referring Doctor. Your charge schedule increases bills after taking that into account.
The next essential step in medical billing is the Payment Posting process. The payment posting process is also evolving with the arrival of ERAs from payers (Electronic Remittance Advice). Our billers help healthcare providers by confirming the payments that are posted.
At Avernus, our professionals cover the most complex electronic remittance scenarios, such as denials, underpayments, overpayments, multiple adjustments, automated cross-overs, secondary remittances, reversals, and more
This is the process of obtaining prior approval from the patient's insurance company for a specific medical treatment or procedure. Our billers perform this to ensure that the treatment or procedure is covered under the patient's insurance policy and to determine the extent of coverage.
This step involves checking the patient's insurance coverage to determine what services and treatments are covered under their policy. This includes verifying the patient's coverage, checking for any restrictions or exclusions, and verifying the patient's eligibility for benefits.
Once a treatment or procedure has been completed, our billers submit a claim to the patient's insurance company for reimbursement. The claim will include information about the treatment or procedure, the costs associated with it, and any relevant documentation
After the insurance company has reviewed and approved the claim, it will issue payment to the medical facility. In this step, we record and apply the payment to the patient's account.
If the insurance company denies a claim, our billers will review the denial and determine the next steps. This involves resubmitting the claim with additional documentation, appealing the denial, or negotiating with the insurance company to try to get the claim approved.
At last, Avernus’s billers and coders track the status of claims, analyze payment trends, and generate reports to help healthcare-providing facilities improve their financial performance.
Our team follows an integrated approach to managing the revenue cycle, from patient registration and coordination through a collection of payments.
Avernus follows a set of rules and regulations to ensure that we provide you with high-quality services and protect the privacy of patient information. Our billers and coders also ensure compliance with HIPAA.
Protecting the security and confidentiality of patient data is our top priority. This involves implementing strict security protocols, using encrypted data storage systems, and conducting regular security audits.
ISO (International Organization for Standardization) certification is a quality management standard that is recognized globally. Avernus is ISO-certified so we can meet high standards for quality, safety, and efficiency.
We also offer 100% coverage providing services for all aspects of the revenue cycle process. This includes patient pre-authorization, insurance eligibility, and verification, claims submission, payment posting, and denial management.
Avernus has a fast TAT to complete tasks and processes efficiently, which helps to reduce delays and improve overall efficiency.