Our Services

Clinical Coding

One of the most important tools of revenue generation is correct ICD, CPT, and HCPCS coding. Claims Care team consists of experienced, credentialed (CCS, CCSP, CPC, CPC-P, CPC-H) coders who utilize the latest and précised diagnostic/procedural coding methods to ensure accurate reimbursement of medical services healthcare providers are legally entitled to.

  • Organization
  • Individual
  • Technology
  • Clinical Task

Claims Management

Claims Care responds to simple as well as complex issues with quality claims services and cutting-edge technology, delivered by a professional claims staff. Having a partner like Claims Care means complementing your claims management program with the expertise empowered to meet future challenges.

Submission:

  • Our claims managers, representatives and medical coders review and verify your claims in the light of HAAD’s regulations before submitting to payers, which in turn dramatically reduces rejection rates.
  • Our advanced billing system sends electronic claims to all payers and efficiently receives/maps RA files leading to faster reimbursements.

Resubmission:

We aggressively follow-up on all pending, unpaid, or partially paid claims to increase your overall revenue.

Denials Management

Identify, Monitor, Prevent, Report

Most claims are adjudicated promptly and for the full contracted amount, but a notable minority is returned unpaid. Claims Care has developed a unique system, which helps analyze and report on denials, allowing systematic management and resolutions – with the result of improved cash flow. Our team of experts identifies the areas of concerns, resolves them with efficiency and accuracy and tries to get the approvals for reimbursement from the parties involved. A detailed report – standard or customized – is delivered to you for your official record.

Claims Audit

Provider/Payer

Led by an exclusive team of coders specialized in coding, legal and contractual obligations, and proven healthcare practices, Claims Care provides a wide range of audit services including on-site, off-site or online.

  • Inpatient Audits
  • Outpatient Audits
  • Billing and Coding Compliance Review
  • Medical Necessity
  • Insurance Review/Appeals

We take pride in designing and implementing audit and monitoring programs based on accuracy and transparency of the report tailored to meet your specific needs.

Coding Education

We go with the flow at Claims Care. Our professionals continuously strive to adopt new trends and best practices in order to enhance their efficiency. We plan and organize customized as well group training sessions for physicians and coders to upgrade their skills and knowledge in various disciplines such as:

  • Documentation guidelines
  • Coding guidelines
  • Specific regulator and payers reimbursement principals

Medical Documentation Improvement and related software enhancements

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Contract Negotiation

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Special Projects

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Monthly Reports

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