RevCycle will scrub claims prior to submission. Some examples of things your biller will look at: adding necessary modifiers, diagnosis for medical necessity based on service code and payer, and cataract co-manage claims for surgeon information and billing details.

RevCycle will transfer necessary patient responsibility based on insurance processing: deductibles, co-insurance and copays. RevCycle will provide as much detail as possible using transfer reasons to describe why a transfer was done and why a patient may owe you money.

If a claim is denied, RevCycle Partners will investigate the denial and take the appropriate action. We will:• Fix the claim and resubmit. RevCycle Partners will file any appeals as needed, as long as we have the documentation to back it up.• Relay the denial back to the office for review/correction. RevCycle Partners will refile the corrected claim.• Drop the denial amount to the patient with a detailed transfer reason.

RevCycle Partners will exhaust all avenues available to get a claim paid, including filing appeals, chasing denials, and refiling claims.

With RevCycle Partners there is no long-term commitment. Our service is a month-to-month. You may cancel at any time. We ask for a 60-day termination notice so we can properly wind down the account and reallocate our resources.

No. That is the responsibility of the doctor or office to make sure all services that are performed are coded and applied to an invoice. RevCycle Partners asks that the office verify this as well as make sure that there is a diagnosis on the claim prior to authorizing it. RevCycle Partners will submit corrected claims if something was missed.

There is a relationship between the office and a patient that RevCycle Partners is not familiar with. Our team doesn’t want to risk causing any issues for the office or the patient. If the office has a question about a patient balance, they can send their biller a message and/or call. We are happy to provide further details to help explain why the balance is owed.

For items received in office, we ask that those be scanned to a designated area within your system for review by your biller. This can include EOBs, checks, and requests for records.

Sending patient statements is not included with RevCycle Partners’ billing service. That responsibility remains in-office.

RevCycle Partners does not upload EOBs into the EMR software. EOBs are accessible through the website when needed (or by calling the insurance to resend).

There are not any set-up or cancellation fees for RevCycle Partners’ billing services.

RevCycle Partners does not ensure that max reimbursement was received. Max reimbursement/fee schedules are specific to each practice and their contract with the payer. RevCycle Partners does not have access to the fee schedules. We follow the EOB, and we will pull up previous processing to review the codes/payments if needed.

A clearinghouse is required in order for us to provide our Medical Claims Management service to any practice. We are not a clearinghouse, nor do we supply the clearinghouse. Practices will need to be set up with a clearinghouse. That way, if the practice makes any changes to their billing services, nothing changes with their billing/workflow.

During onboarding, RevCycle Partners will request login access to the clearinghouse and any external payer portal websites so that we can retrieve electronic remits accordingly.

Our standard process is to access and work our accounts once daily, Monday-Friday. We will take care of any filing, payment posting, and denial follow-up on a daily basis.