Accurate capture of patient information is perhaps one of the most under-rated processes in the revenue cycle process chain. Not only does the data captured in the demographic entry process form the base for the medical record, but it also affects insurance claims payment in the future. Error-free capture of patient information is essential for clean claim submission and facilitates quick claims processing by Payers.

The front-office at the place of service should accurately capture the patient information, either via paper-based registration processes or via the scheduling system. Accurate information about the patient is critical to ascertain the patient's eligibility and benefits, obtaining prior authorization, and error-free claims filing. Additionally, population health analytics is possible only by utilizing accurate patient information.

At Reliant Medical Billing Services, we have trained our staff of revenue cycle professionals to validate all information available in the face-sheets. Our team contacts the provider's office or the medical billing company if any information is incomplete or erroneous in case of any discrepancies. Our team members enter the validated data on the client's practice management software with a high degree of accuracy and within a turnaround time of 24-48 hours. We ensure accurate information is updated on the practice management system.

Efficient patient scheduling in practice management system helps healthcare providers to optimize their resources, reduce wait times, and enhance the overall patient experience. It also plays a critical role in ensuring that patients receive timely and appropriate medical care. Effective Patient Scheduling helps determination of insurance eligibility, obtaining prior authorization, and determining patient liability upfront before patient receives the treatment and is critical for improving collections for any practice.

Charge entry is the process of assigning to the patient account an appropriate $ value as per the chosen medical codes and corresponding fee schedule. The reimbursements for the healthcare provider's services are dependent on the charges entered for the medical services performed. Charge Entry must be completed without any errors, as it may increase claim denials. Reduce revenue leakage through an adequate review of medical services provided and save millions of lost revenues. Reliant Medical Billing Services ensure effective collaboration between the coding and the charge entry teams to ensure that the charges captured are accurate, all procedures all billed for, and the codes ascribed are compliant.

Accurate Medical coding is a critical factor in obtaining reimbursements from Payers as well as maintaining patient records. Coding claims accurately let the insurance payer know the illness or injury of the patient and the method of treatment and enables them to adjudicate claims correctly.

Medical coding can involve one or more of the following types of codes: ICD codes, CPT codes, HCPCS codes, DRG codes, and modifiers. All of these coding sets are important for communication and billing purposes. Not only is coding important for capture of details of diseases and creation of medical records but is also important for getting reimbursements from commercial payers as well as Medicare and Medicaid.

Reliant Medical Billing Services operates a coding center of excellence with certified coders who are proficient in multiple types of medical codes including:

• ICD Codes: The International Statistical Classification of Diseases or ICD codes is specific to classifications of diagnoses, symptoms, and causes of death in humans. The World Health Organization creates, copyrights, and oversees these classifications. These codes are a global standard and are recognized by every medical facility and practitioner worldwide.


• CPT Codes: CPT codes or Common Procedure Terminology is defined for every medical procedure and are maintained by the American Medical Association.


• HCPCS Codes: The HCPCS (Healthcare Common Procedure Coding System) levels I and II is another coding system. HCPCS codes are defined in three levels. Level I is comprised of CPT codes, and Level II includes alphanumeric codes that are used to identify products, supplies, and services not included in the CPT codes when used outside a physician's office.


• Level I CPT Codes: Made up of 5 digit numbers, managed by the American Medical Association (AMA). CPT codes are used to identify medical services and procedures ordered by physicians or other licensed professionals.


• Level II HCPCS: Alphanumeric codes consisting of one alphabetical letter followed by four numbers. Managed by The Centers for Medicare and Medicaid Services (CMS). These codes identify non-physician services such as ambulance services, durable medical equipment, and pharmacy.


• Level III HCPCS: Alphanumeric codes W, X, Y, or Z followed by a four-digit numeric code. Known as local codes, these codes are used as a miscellaneous code when there is no level I or level II code to identify it.


• Modifiers: Two-digit character set - two numbers, two-letter, or alphanumeric characters, that provide additional information along with HCPCS Codes.


• DRG Codes: Diagnosis-Related Grouping (DRG) codes are used for coding of inpatient claims. The DRG codes define the accuracy of all the inpatient service components used by the facility. As these groupings are logical, most insurance.

Ensuring a smooth and efficient healthcare process begins with accurate patient eligibility verification. At Reliant Medical Billing Services, we prioritize the seamless integration of technology and expertise to streamline this crucial aspect of healthcare administration.

Our patient eligibility verification services are designed to alleviate the administrative burden on healthcare providers and enhance the overall patient experience. Leveraging advanced technologies, we meticulously verify patient insurance details, coverage, and eligibility in real-time. This proactive approach not only reduces claim denials but also facilitates faster reimbursement cycles, optimizing the financial health of your practice.

By implementing robust verification processes, we aim to minimize errors and discrepancies in patient information, contributing to enhanced data accuracy across your healthcare system. Our dedicated team of professionals ensures that every patient's coverage is verified comprehensively, allowing your staff to focus on delivering quality care rather than navigating complex eligibility issues.

Partnering with Reliant Medical Billing Services for patient eligibility verification means embracing a more efficient, cost-effective, and patient-centric healthcare model. We understand the evolving landscape of healthcare administration and are committed to providing reliable solutions that empower your practice to thrive in the digital age. Experience the confidence that comes with precise patient eligibility verification – an integral component of our commitment to transforming healthcare delivery.

Ineffective eligibility and benefits verification and/or prior authorization processes can result in increased claim denials, delayed payments, additional effort on rework, delays in patient access to care, decreased patient satisfaction, and non-payment of claims.

Reliant Medical Billing Services has a team of experts to help you accelerate your client’s accounts receivable cycle. We confirm the patient’s eligibility and obtain necessary prior authorization before the patient visits the physician’s office.

Our staff will do the following as a part of the verification processes:

• Receive patient schedule from the healthcare provider’s office – hospital and/or clinic


• Perform entry of patient demographic information


• Verify coverage of benefits with the patient’s primary and secondary payers:
  • Coverage – whether the patient has valid coverage on the date of service
  • Benefit options – patient responsibility for copays, coinsurance, and deductibles
• Where required, the team will initiate prior authorization requests and obtain approval for the treatment


• Update the hospital’s revenue cycle system or the patient’s practice management system with the details obtained from the payers

Reliant Medical Billing Services offers market-leading SLAs for accurate and timely payment posting services. Our well-defined payment posting process not only ensures efficient processing but also helps you identify opportunities to increase revenue by watching for trends of payments, and denials. Our services include the following components to make your billing process more efficient and lead to an improvement in revenue.

Our payment posting platform prioritizes security, employing cutting-edge encryption technology to safeguard your sensitive financial information. Whether you're making a one-time payment or setting up recurring transactions, our system ensures the confidentiality and integrity of your data.

• EOB and ERA posting and reconcilement – We meticulously capture the data from EOBs, lockboxes, and ERAs, ensuring a high degree of accuracy of payments posted on the revenue cycle system.


• Denial prevention- We examine each denial to identify issues such as denial for medical necessity, non-covered services and prior authorization to provide constructive feedback to the entire chain of physicians, front office staff, billers and coders to avoid such errors in the billing cycle and improve reimbursements.


• Denials posting and reworking - We rework each denial and resubmit the claim to responsible payers in an efficient manner to enable recovery of as much reimbursement due as possible.


• Patient responsibility for Payment - Patient dues are identified and the balances are moved to patient responsibility to ensure faster patient billing and initiation of the patient collections cycle.


• Write-offs and adjustments – We process write-offs, adjustments and look into contractual adjustments and passing them to management when issues are identified. We work with the provider’s office to help develop the write-offs and adjustments policies to ensure that the accounts receivable data shows the right view to the management. Often, practices with ineffective write-off and adjustment policies have erroneously inflated A/R views and such situations can be avoided through effective policies.


• In-person collection issues – Front offices of the provider’s office make mistakes with the collection of deductibles and/or co-payments when processing insurance remittances and this has a major impact on the overall billing process. Through Reliant Medical Billing Services’s best practices in identifying these issues, the front-office gets constant feedback on missed opportunities which leads to behavioral corrections at the front-office.

Better cash flow, better collections, faster identification of issues and resolution of these issues across the chain, these are some of the value propositions that Reliant Medical Billing Services’s payment posting services offer. Secondary billing effectiveness and initiation of patient collections processes ensure that the entire medical billing process runs effectively.

Efficient management of accounts receivable is paramount for a thriving business. Our comprehensive approach ensures that your organization maintains a healthy cash flow by optimizing the accounts receivable process. From invoicing to timely follow-ups, we streamline the entire cycle, reducing outstanding payments and enhancing financial stability. Our dedicated team employs cutting-edge technologies and industry best practices to seamlessly integrate invoicing systems, track receivables, and facilitate quick and accurate payments.

Navigating the complex landscape of healthcare reimbursements requires a robust denial management strategy. We specialize in minimizing claim denials and maximizing revenue recovery for healthcare providers. Our proactive approach involves thorough analysis of denied claims, identifying root causes, and implementing corrective measures to prevent future denials. With a focus on transparency and collaboration, we work closely with your team to enhance billing accuracy, reduce denial rates, and optimize the revenue cycle. Our denial management solutions are tailored to the specific needs of your organization, ensuring a more efficient and financially sound healthcare operation. Partner with us to elevate your revenue cycle management and drive sustained financial success.

Reliant Medical Billing Services provide comprehensive patient statement services. We generate patient statements every 15 days to ensure quicker payments. Further, we address any queries that a patient may have on our services through a customer service number to reach us.

Overview of our Patient Statement Services - Generation and support

Our global delivery model helps our customers reduce costs and save time by billing your patients quickly and efficiently. Our Patient Statement Generation Services include:

• Print and Mail services
  • Generation of statements
  • Printing of patient statements
  • Mailing of statements


• Patient Friendly Billing. We work with you to create patient-friendly statements that are easy to read and understand


• Implement Patient Portals. We enable you to accept patient payments through a credit card via the patient portal


• Address Patient Queries. We can also support any calls that you may be receiving from the patients regarding their bills.

We provide ongoing Credentialing services for all doctors and hospitals (including new ones) to check the contact and verify their Credentials on a time to time basis. This process ensures a good rapport and deal with payment delays from the payers in an effective way.

Physicians/providers must credential themselves, enroll and attest with the Payer’s network and authorized to provide services to patients who are members of the Payer’s plans. The credentialing process validates that a physician meets standards for delivering clinical care, wherein the Payer verifies the physician’s education, license, experience, certifications, affiliations, malpractice, any adverse clinical occurrences, and training.

Payers may delay or refuse payments to physicians who are not credentialed and enrolled with them. These impact the financials of the practice negatively. Our customized Payer credentialing and enrollment services support physicians in:

• Starting or joining a new practice
• Switching from one physician practice group to another
• Join or become affiliated with new groups or practices
• Enroll with new payers
• Maintain their credentialing services

Reliant Medical Billing Services is committed to ensure the Confidentiality, Integrity, and Availability of information of all stakeholders and its customers, by adopting a formal Business Risk Management Framework and establishing an Information Security Management System. The Information Security Management System is aligned to the business objectives and ensures the security training, business continuity requirements; applicable contractual, statutory, regulatory and legal requirements of the business environment are complied with.

Reliant Medical Billing Services’s Payment Integrity Audit services generate “Wealth from Waste” for hospitals, physicians and physician groups. It is estimated that the providers are underpaid 1-3%. These underpayments result in the loss of millions of dollars which can hit the bottom line of your systems. We offer an investment free approach to recover unclaimed revenue from closed claim inventory. Our expertise lies in interpreting Medicare, Medicaid, Managed Care and Commercial health plans.