Our comprehensive billing and reimbursement management service includes the following:

Client-Centered Management: Each ENGAGE client is assigned an experienced Account Executive who is responsible for managing a cohesive team of billing specialists, 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 Contract Compliance: Some managed care plans shave a few dollars off the amount they have agreed to pay you for each CPT code billed, as a strategy to save money. Over time, this can add up to a significant amount of reimbursement. To prevent this problem, we compare the actual payment received from each contract payer—for each CPT code—to the contract fee schedule. We then recover from the payer any underpayment amount.

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.