Provider services
Medical Billing
You didn’t pursue the profession of medicine to practice accounting. That’s why Vertex Billing Solutions handles every aspect of your medical practice billing and collections with the same attention to detail you would yourself. Add to that, our extensive industry experience, total access and transparency, passionate commitment, and you’ve got the solution you’ve always deserved. Because we excel in superior physician medical billing, you can excel in caring for your patients.
Medical billing dictates the financial success of a medical practice. It is the component of the medical revenue cycle that propels every moving part of a physician’s medical practice. Therefore, it is essential you deploy the best medical billing methods, standards and practices to compliantly optimize revenue in this ever-changing medical environment.
Medical Billing Services includes, Appointment and Scheduling, Patient Registration, Referral Verification, Prior Authorization, Eligibility Verification: Call/Web, Charge Entry, Charge Audit, Claims Filing, Rejections, Electronic Payment Posting and Manual Payment Posting.
Medical Coding
Correct Coding Initiatives (CCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD) and the impending implementation of ICD10 continues to present challenges for all medical providers when seeking reimbursement from 3rd party payers for services rendered. Coding expertise is no longer a luxury, but rather a valuable necessity in the complex healthcare industry.
At Vertex Billing Solutions, all of our medical coders are Certified Professional Coders (CPC) and receive ongoing continuing professional education in response to the evolving coding requirements. When Vertex Billing Solutions is providing medical coding services, you can be assured that our 15+ years of depth of expertise are working for you.
Accounts Receivables
Insurance payers are constantly changing payment rules that may lead to denials. These denial edits create reasons to significantly delay or deny payments. At Vertex Billing Solutions, our agents are trained to manage many types of denials, underpayments or no-payments. We know that timelines is of utmost importance in the follow-up process and manage the aging accordingly. We segregate AR by Denial types and Insurance type. We have coders review denials for medical necessity and file written appeals as needed. Our agents are well trained on proper handling of phone calls to payers and elicit immediate resubmissions where possible. Our team is not a Claim status team, we are action driven to recover revenues with efficiency. Our goal is one-touch AR process to payment.