Elico provides solutions for the entire cycle of Claim generation to Receivables Management. We achieve this by our deep insight into processing each transaction with a "getting it right the first time" attitude:
Claim Generation
- Capturing services rendered - Accurate charge capture by certified coders for maximum reimbursement.
- Eligibility verification - Validation/updating of patient information using internet tools
- Balancing visits versus claims - Accounting for all visits through efficient database management
Claim Submission
- Reconciliation & Tracking - Effective tracking mechanism of claims filed to carriers.
- Tracking payor communications - Archiving and follow up of payor communications for timely implementation of updates / process change requests.
- Handling secondary claims through efficient tracking
- Tracking timely filing - Periodic report generation and analysis to keep track of claim status.
EOB Processing
- Tracking and handling unpaid claims - Effective denial management through analysis of EOBs. Result oriented trend analysis to minimize denials.
- Validating payments against fee schedule - Auditing payments received to make sure reimbursements are done per negotiated contracts.
AR Management
- Handling refunds - Periodic verification of credit balance accounts and identification of third party to be refunded.
- Handling pending claims - Planned schedules to work on pending claims to eliminate timely filing issues and improve reimbursements.
- Co pay collection and tracking
- Self pay administration - Using custom-built process for efficient tracking and administration of patient balances. Effective patient resolution techniques.
- Old AR management - Efficient handling of old AR projects using effective methodologies/ templates to bring in maximum possible reimbursement.
Process validation & automation
Elico process experts assist in mapping the existing process and validate against industry bench marks. We use automation tools to optimize process efficiencies and remove redundancies.
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