REVENUE CYCLE MANAGEMENT

Staffing and Operations

A substantial part of our service is conducted by remote operation of the client’s integrated electronic EMR and clearinghouse systems. InterHealth will maintain trained, competent staff to provide services. Our staff will be familiar with the client’s system and the client’s general operations. InterHealth’s management staff will be readily available to respond to client questions, concerns or comments about our services or the status of a particular claim.

Claims Submission

Claims are submitted and tracked electronically for immediate payment, follow up and resolution. We submit insurance claims electronically through our electronic clearinghouse eliminating substantial delays in insurance claims processing.

Insurance Follow-Up

Claims are followed up quickly. We diligently pursue your claims for maximum insurance reimbursement and appeal your denials. Once the denial is evaluated, we utilize our appeal process to handle incorrect claim denials. Claims are never written off without being appealed first. Follow up is handled utilizing our electronic clearinghouse, insurance websites and direct contact via telephone.

Timely Response to Rejected or Denied Claims

Responding to rejections or denials is an important part of InterHealth’s service. Claim payments are delayed and can be lost entirely if there is not a timely, correct response or resubmission. InterHealth’s internal policy and practice call for resubmission as quickly as is reasonably possible.

Payment Posting

We post all payments, calculate insurance write offs, coinsurance and deductibles. Our team enters in payments on a daily basis. We review each Explanation of Benefits very carefully to ensure each claim was processed properly. Write offs, coinsurance and deductibles are calculated and allocated appropriately, and we bill patients immediately upon EOB posting.

Patient Billing

InterHealth’s services include billing patients for balances due from deductibles, co-insurance, and co-pays. We generate easy to understand patient statements weekly on a 30 day cycle. This creates a continuous flow of revenue. InterHealth is not a collection agency but we make every effort to collect your money. We will send out three patient statements, and follow up with phone calls. Based on your criteria, we will work with patients to set up payment plans if needed and monitor these payments. If the patient balance remains outstanding after these efforts, we recommend that the account be turned over to a collection agency or an attorney for collections upon your approval.

Accounts Receivables Management

We work closely with collection agencies to ensure quick and efficient work on delinquent patient balances. InterHealth realizes the importance of timeliness in bad debt placement as well as the necessity to chose an agency to help maximize the revenue cycle throughout the entire process. We work directly with the agency to ensure that you patients are treated the way you would want to be treated in the same situation.

Statement Processing

After the insurance company pays the appropriate amount of a claim, InterHealth will process statements to be mailed to the patient for the balance due. Patient statements will be generated and to the extent possible, the statements will be formatted and include information pursuant to the client’s specifications.

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