Our comprehensive billing and reimbursement management service includes the following:

Client-Centered Management: Many billing companies assign each function of the billing process to a different department (i.e. charge entry, payment posting, account follow-up, etc.). While this approach provides efficiency and cost savings for the billing company, it is not the best approach to maximize your reimbursement and service satisfaction.

At ENGAGE, the entire billing process is managed within a single cohesive team of experienced billing professionals. This client-centered approach fosters clear communication, simplifies problem resolution and gives focus to client service and performance. Each billing team reports directly to an account executive who is responsible for maintaining service level expectations and ensuring your constant satisfaction.

Charge Verification: Our charge verification process ensures we capture and bill every service you provide.

Claim Submission: To ensure fast payment and consistent cash flow we submit claims to all third-party payers electronically, every day.

Coding: Our staff of experienced Certified Professional Coders ensures your services are billed at the highest reimbursement level supported by the clinical documentation. We conduct routine coding reviews and provide you with feedback to improve documentation, coding, and reimbursement.

Denial Management: Our Denial Management System tracks every denial to ensure appropriate follow-up action is taken to secure payment and to identify denial trends.

Electronic Data Interface: Where needed, we work with the hospital/clinic IT staff to receive patient demographic and charge information directly from the hospital/clinic patient registration systems.

Fee Schedule Review: Each year we conduct a fee schedule review by comparing your fee schedule to current payer reimbursement amounts, the current Medicare fee schedule and local market fee data. We then provide you with recommendations to ensure your fees are always at the optimal level.

Management Reports: Information is vital to the effective and efficient management of a medical practice. Because our billing and practice management system is built on a fully relational database (Oracle), we provide you with the management reports and information you need--whenever you need it.

Payer Credentialing: Our experienced credentialing staff ensures timely and proper payer credentialing so there are no delays or problems with receiving payment from government payers and managed care plans.

Payer Fee Negotiating: All managed care plans have developed strategies to pay providers as little as possible. However, because of our extensive experience working with managed care payers, we understand their strategies and their tactics and we know how to work through these to negotiate the highest possible reimbursement rates for you. This alone can result in significant increases in annual income for a physician group practice.

Payer Reimbursement Compliance: A cost-saving strategy used by some managed care plans is to shave a few dollars off the amount they have agreed to pay you for each CPT code billed. Over time, this can add up to a significant amount of reimbursement. To eliminate this potential problem, we compare the actual payments received from each contract payer (by CPT code) to the contract fee schedule. We then recover any underpayments from the payer.

Remote System Access: One of our primary objectives is to minimize your time involvement in the billing process so you can make the most productive use of your time. By establishing secure electronic connections into the hospital’s systems we can retrieve patient information and medical records without requesting this information from you or your staff.