Services

Our services are individualized to meet your particular needs; whether you need full service revenue cycle management or selected billing or claim services, we can provide as much or as little as you want. The decision is yours to make—we’re here to help.

Billing

Our Billing Team at Critical Access Billing can help streamline your processes for the most efficient workflows possible. Our philosophy is that the original billing information resides in the client’s Electronic Health Record (EHR), and no claim goes out the door that doesn’t match that record. Coding exceptions that fall outside the client’s preset parameters are queued back to the client for review, reporting any information on billing edits or payer exception information. Edits and exception reports are monitored periodically, identifying root-causes, offering the information back to the clients to resolve issues upstream, improving efficiencies and cash flow.

Account Follow-Up

We have a team of dedicated Medicare, Medicaid, and Commercial Insurance Patient Account Representatives (PARs) that are specially trained to focus on your insurance claims. Having a dedicated PAR helps economize an individual touch, having experience with the nuances inherent to the different insurance financial classes. Our PARs do more than review accounts every 14-30 days, they work each account with the goal of best resolution in mind.

Early-out Collections, Pre-bad debt review

Let’s face it, Self-pay management is the most labor intensive function of the business office processes, and yet it yields the least amount of return. However, with the rising trend of uninsured, high deductibles and numerous catastrophic insurance plans, it is becoming more crucial than ever to collect on these balances. At Critical Access Healthcare Services, we also understand the need for our community hospitals and clinics to maintain good rapport with the communities they serve. Our warm and friendly Customer Service Representatives (CSRs), whether it on an incoming or outbound call, provide accurate and compliant information to the client’s customers, focused on resolving any questions or concerns. Although trained to collect cash payments, our CSRs are also trained to be mindful of the customer’s needs, offering pre-determined payment plans or other options as provided by the clients.

Special Discount Letter Campaigns

Many clients take advantage of seasonal shifts, especially around tax refund time, to offer special discounts for eligible self-pay claims. We are able to provide targeted accounts as set by the client and offer discounts to the client’s customers. These campaigns can include outbound phone calls as per requested by the client.

Cash Posting

Recognizing that incoming deposits are often the hardest accounts for your controllers and CFOs to reconcile, Critical Access Billing has trained our cash posters to timely and accurately post daily batches, closing out the day fully reconciled and submitted to the accounting offices of our clients. Our team diligently researches questions and provides timely documentation for all transactions, including cash posting, adjustments, and refunds.

Reports

At Critical Access Billing Services, we understand that healthcare is ever evolving, and with that, the billing rules and regulations do as well. To manage those dynamics, we offer an array of reports, shared directly to your inbox. Full transparency and communication are not only vital for our relationship with our clients, but also improves processes and, in turn, improving cash flow. Reports may include such elements as

Comprehensive Daily Billing Reports
Daily Cash Reconciliation Reports
Daily Monitoring of DNFB
Monthly Revenue Cycle Metrics
Monthly Expected Reimbursement Reports
Daily Cash Projections

Credentialing

One of the most frustrating disappointments is to find out one of your physicians isn’t credentialed correctly with an important payer, causing unnecessary denials. Here at Critical Access Billing, we understand the importance of a complete and error free credentialing and payer enrollment. We have a credentialing department that is knowledgeable with each unique payer and dedicated to maintaining the credentialing processes for your facility and its providers. Our credentialing department‘s expertise and constant vigilance allows you to care for your patients while we keep those out of network denials at bay.

How can we help you?