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There are a number of different relevant standards in coding, and we are prepared to work with any and all of them. Our core coding is based on AMA and CMS guidelines, and we fully understand the LCD and LMRP requirements that are needed before we assign a payable diagnosis, in an effort to avoid rejections and denials. Our expert coding teams are fully engaged with ICD-10, and NCCI (National Correct Coding Initiatives) drive our well-trained coders, who understand the importance of correct coding, and who have a thorough knowledge of medical anatomy and terminologies, that allows them to select the most accurate and appropriate CPT/HCPCS code, and the code that will allow for the most effective reimbursement for the provided services.
We work with our customer teams to define our medical coding for diagnosis, procedure codes and modifiers to assure they meet with your guidelines and descriptions. We also understand when codes can be slightly modified and when specific insurance carriers require the standard ASA code. The coding process includes the below steps:
Patient responsibility is a hot topic in healthcare, with major trends impacting and continuing the improbability around regulatory changes, healthcare reform, and current and expected changes from a paper-based workflow to more electronic transactions. Patient bad debt and liability are on the rise as the shift away from insurance and towards personal responsibility for healthcare payments continues to accelerate. Healthcare providers are under tremendous pressure around margins and revenue due to this shift and to the extended recovery cycle for revenue. When you need to provide your patients with detailed and highly accurate descriptions of the service, GRAVITY can help support your needs.
All of our reports are technology driven, based on business and use cases that have been tested over a period of many years. GRAVITY allows you the opportunity to dive deep into the metrics around your business, checking the filing status of claims with insurance carriers, doing detailed analysis of denied claims and action by the denial management team, see how follow-up with patients is going, details of insurance follow-ups and next steps, the ability to see when insurance claims are being re-filed, and how many steps are left before customers will be able to obtain payment details from insurance carriers. All of these steps help you see where your cash flow is at each piece of the process, and make realistic projections about your future profitability.
There are several gateways to increase your overall cash flow, and we help overcome all of them. We process millions of transactions per year, and work with over 20+ different types of billing software, across 60 different specialties, and for thousands of physicians across the country. Our insurance verification processes are some of the most secure and effective in the world, and our comprehensive coding initiative is in full compliance of LMRP’s & CCI. We have a deep understanding of contracts for reimbursements and Payer procedures, and a robust denials analysis. All of these different pieces work together to form a cohesive organization that can support your needs on many different levels.
Billions of transactions are created every year in the healthcare industry, and with a large percentage of these still on paper that means there are massive opportunities for error. While digital data is more accessible and faster to process, there are still times where bad data infiltrates your systems. While high-touch processes such as claim submission, eligibility and benefit verification, claim status inquiries, prior authorization and remittance advice transactions could save millions by moving to a digital workflow, paper will not disappear anytime soon.
With the overwhelming volume of transactions, your teams can fall behind – meaning delays in billing and revenue recognition as well as data entry errors as under-qualified teams attempt to scale up. Fortunately, GRAVITY understands your needs, and offers comprehensive data entry solutions that will develop superior collections rates by improving overall efficiency and reducing costs.
Get real-time insight and visibility into your production status, auditing and exception management as well as an intuitive storehouse for images that allow you to easily retrieve just what you need, when you need it.
Insurance and eligibility verification is more critical than ever with the growth of the Affordable Care Act (ACA). Patient responsibility, when not defined upfront prior to the visit, can result in rampant growth in receivables – creating problems downstream as far reaching as decreased patient satisfaction, nonpayment, increased errors, reworks, and delayed payments.
Our Accounts Receivable analysts are experts at denials processing, claims follow-up, secondary claims submissions, appeals and even at cleaning up aged A/R accounts. Denials are processed in batches on a daily basis by our stellar team of billing personnel. Drop the number of days your accounts stay in A/R substantially by utilizing our claims follow-up team to aggressively follow up with both insurance companies and self-pay patients to clear non-payment issues and improve collections ratios.
We do not just provide you with reports. Instead, we give you actionable metrics that suggest ways to improve workflows and resolve issues that are expanding your A/R period and reducing collections so you can focus on finding big wins. Our combination of business intelligence and analytics means you will receive the tools you need to solve real business problems. Our automated and efficient workflow tools give our customers an extremely thorough and detailed view reporting all claims that are working during a specific time period.
Provider credentialing is critically important, and our credentialing specialists will work with you every step to of the way to ensure that you are always up to date with the status of your credentialing process. While the entire process can take from 90-270 days, during which time you should not accept patients who have an insurance that has not fully credentialed as insurance will not backdate effective dates.
Once your application is processed and approved, our credentialing specialist will contact you with effective dates and a Provider ID#.
We also provide the following services on an ongoing basis for your peace of mind:
Renegotiate the existing contracts with insurance companies to get better rates