Experienced professionals who collect and manage patient demographic information, including names, addresses, contact details, insurance information, and any other data that can affect billing and insurance claims, ensuring the accuracy and completeness of patient data in your system. In addition to their industry experience, each of our employees also undergo rigorous HIPAA training in SourceCycle’s training academy.
Specialists who ensure that all services provided to patients are accurately captured and entered into the billing system.
These professionals focus on verifying patients’ insurance coverage and benefits before services are rendered, liaising with insurance companies to confirm coverage details, including deductibles, copay amounts, and benefit limits, to ensure accurate billing and minimize denials due to eligibility issues.
Specialists who accurately post payments, adjustments, and denials into your accounting system. They process payments received from insurance companies and patients, reconcile accounts, and ensure that payments are applied correctly to specific charges.
Whether you’re a medical billing provider looking to scale, or a healthcare provider who needs assistance in optimizing their revenue cycle management, SourceCycle is here to help. We offer free consultations and budget-friendly, highly transparent solutions that will help you to reach your goals. Our senior team has over 30 years of experience in medical billing and we have seen, and solved, almost every kind of issue. So let us help you start getting the most out of your revenue cycle today.
These resources manage the accounts receivable ledger, working to ensure that payments are collected promptly from payers and patients. They follow up on outstanding claims, resolve discrepancies, and work on appeals for denied claims. Their goal is to reduce the amount of outstanding receivables and improve cash flow.
These A/R specialists focus on out of network billing, claims and collections.
This specialist role is dedicated to the preparation and submission of medical claims to insurance companies and payers. They ensure that claims are accurate, compliant with coding standards, and submitted in a timely manner. This role involves detailed knowledge of medical codes (depending on experience), payer policies, and billing procedures to maximize reimbursement and reduce denials.
Senior Medical Billing Specialists take on a more advanced role within the billing department, often handling complex billing issues, overseeing billing operations, and providing guidance to junior staff. They play a key role in analyzing billing processes and implementing improvements to enhance efficiency and accuracy in claims submissions and follow-up.
Certified Coding Specialists possess expert knowledge of medical coding systems, including ICD, CPT, and HCPCS codes and are certified by an accrediting body such as the American Health Information Management Association (AHIMA). They are responsible for ensuring that medical services are coded accurately for billing and compliance purposes. This role often involves auditing medical records and providing coding consultation to prevent coding errors and denials.
These professionals focus on managing and resolving denied claims. They analyze reasons for denials, appeal unjustified denials, and work with insurance companies to resolve issues that prevent payment. These specialists play a crucial role in recouping revenue that might otherwise be lost due to initial denials.
Electronic Data Interchange specialists manage the electronic submission of healthcare claims, eligibility inquiries, payment advice, and other transactions.
These experts are responsible for the credentialing and recredentialing process of medical providers with insurance networks and health plans. This includes verifying the qualifications, licenses, and certifications of healthcare providers to ensure compliance with regulatory and payer requirements. Their role is essential for enabling providers to offer services under various insurance plans, thereby facilitating billing and reimbursement processes.
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