Core RCM Processing: Expert Medical Coding & Claims Submission
(The Technical Engine)
PATEL RCM ANALYTICS Solutions
The Technical Engine of Your Financial Health
The engine of your revenue cycle is precision. Patel RCM Analytics’s core processing services transform patient encounters into clean, compliant, and reimbursable claims. Our certified experts and rigorous processes in medical coding, charge entry, and claims management ensure you capture every dollar you’ve earned, right from the start.
We handle the critical middle office functions with unparalleled accuracy, minimizing denials, ensuring compliance, and accelerating your reimbursement cycle. Our expertise turns your clinical work into steady revenue.
Medical Coding (ICD-10, CPT, HCPCS)
Precision Coding for Maximum Reimbursement & Compliance
Ensure every diagnosis and procedure is accurately translated into the correct billing codes. Our certified professional coders are specialists in over 20 medical fields, minimizing audit risk and maximizing appropriate reimbursement.
Our Medical Coding Services Include:
- Certified Expertise: Our coders hold credentials like CPC (Certified Professional Coder) and CCS-P (Certified Coding Specialist – Physician-based).
- Specialty-Specific Coding: Deep knowledge of coding nuances for specialties like Pain Management, ASCs, Pediatrics, and Behavioral Health.
- Ongoing Compliance Audits: Regular internal audits ensure ongoing accuracy and adherence to the latest CMS and payer-specific guidelines.
- ICD-10-CM, CPT®, & HCPCS Level II: Comprehensive coding across all required code sets.
Key Benefits:
- Maximizes Reimbursement: Accurate coding prevents under-coding and ensures all billable services are captured.
- Reduces Audit Risk: Compliant coding protects your practice from costly audits and penalties.
- Minimizes Denials: Eliminates denials based on incorrect or mismatched codes.
Charge Entry & Capture
Capture Every Billable Moment Without Fail
Prevent revenue leakage from the moment a service is provided. Our team ensures charges are captured, entered, and scrubbed for errors on the same day, creating a clean and efficient claims pipeline.
Our Charge Entry Process Includes:
- Same-Day Charge Entry: Rapid entry from superbills, encounter forms, or EMR data feeds.
- Charge Scrubbing: Pre-claim review for missing information, invalid codes, and incorrect modifiers.
- Documentation Review: Reconciliation of charges against clinical documentation to ensure accuracy.
- Daily Audit Trail: Maintains a clear record for compliance and tracking.
Key Benefits:
- Prevents Revenue Leakage: Ensures no charge is left behind.
- Accelerates Billing: Same-day entry gets claims into the billing cycle faster.
- Creates Cleaner Claims: Pre-scrubbing reduces errors before submission.
Claims Management & Submission
Flawless Claim Submission for Faster Payment
Move clean claims through the system efficiently. We manage the entire claim lifecycle from final scrubbing to submission and initial follow-up, ensuring a high first-pass acceptance rate.
Our Claims Management Services Include:
- Advanced Claim Scrubbing: Utilizing industry-leading software to perform thousands of edits for coding accuracy, payer-specific rules, and patient eligibility.
- Electronic & Paper Claim Submission: Secure, HIPAA-compliant submission via CMS-1500 forms.
- Claim Tracking & Follow-Up: Monitoring claims for rejection (within 48 hours) and resolving issues promptly.
- Rejection Management: Immediate identification and correction of technical rejections (e.g., invalid ID number).
Key Benefits:
- 98% Clean Claims Rate: Our benchmark for first-pass claim acceptance.
- Faster Reimbursement: Clean claims are processed and paid more quickly by payers.
- Reduces Administrative Burden: We handle the complex submission process from end-to-end.
Ready to Unlock Your Revenue Potential?
Ready to Power Your Revenue Cycle with Precision?
Stop losing revenue to coding errors and claim rejections. Partner with Patel RCM Analytics to install a high-performance engine at the core of your financial operations.