Revenue Optimization
Nexus billing’s Revenue Optimization Team Safeguards to Intact the Supreme Stage of Success
Retained & Expended Revenue Optimization
The revenue Optimization team strives for excellence and keeps the revenue elevated. Nexus Billing makes the employer satisfied at its maximum level. We review the modern procedures with a variety of angles and derive a lot of ways to have the revenue up.
Our revenue optimization team cordially evaluates the entire revenue process with the help of state regulations. By going through the system of demographic entry, decoding medical records, claim submission, payment posting, and denial management, our team creates a strong relationship with the client’s staff and devices a plan to implement in both front and back offices. Successful implementation of the plan brings a boosted cash flow revenue gets optimized.
Why Our Optimization Program is Significant
Nexus Billing proposes its Revenue Optimization Program in contradiction of the below indications
Fundamentals of Optimized Revenue
Nexus Billing has its strategies to upkeep the revenue at an optimal level. Brief Summary is here!
Examining Claims before Submission
Nexus Billing claim production team follows the SOPs to check errors before submitting a claim. These errors are based on demographic entry, pre-authorization, eligibility and benefits verification, and coding edits.
Flawless Submission of Claims
When the claims pass through the first level of examination, The Nexus Billing team specifies the billing Form (CMS-1500 / UB 04) to have it formatted. Claims are submitted via EDI format. Some claims are submitted on paper if the payer does not accept the claims electronically.
Claims Tracking
After the successful transmission of claims, Nexus Billing has a set of rules to track the claims at each level. We take care that the claim has a primary receipt available from the payer it was sent to. We follow through with the claim till the payment is received. A smart mechanism has been invented to catch denied claims and reassignment them to the AR Follow-up team. AR team takes the responsibility to grab the maximum payment from the payer.
Account Receivable & Denial Management
Payments are posted in the corresponding patient’s accounts. Unpaid and low-paid claims are assigned to the technical denial management team. They fix and resolve the issues of denied claims and submit them again for reprocessing. AR team argues with insurance companies on low-paid claims and sends reconsiderations and appeals.
Prerequisite Explorations
Nexus Billing does have analysts. They typically used to send their feedback against numerous activities happening in Revenue Cycle. This practice tells which part of the revenue cycle is weak or needs improvement. Analysts track the cycle at each stage and create multiple reports showing the exact performance of the organization.
Check & Balance should tremendously be powerful to make the practice transparent & seamless.