





You will see massive growth in your revenue every month by 35%
ELECTRONIC SUBMISSION HELPS US GETTING OUR CLIENTS PAID FASTER.
OUR MONTHLY DENIAL RATE IS LESS THAN 7% WHICH IS BETTER THAN THE INDUSTRY AVERAGE!
98% FIRST PASS CLAIM ACCEPTANCE RATE WHICH IS 3% HIGHER THAN THE INDUSTRY AVERAGE!
EHR & EMR Softwares
States Across The Country
Healthcare Specialties
We confirm every patient’s insurance eligibility to streamline your process, shorten account receivable days, and avoid denials.
Get timely reimbursements as our detailed and error-free charge entry process ensures first-time approved claim submission. Our first-time pass rate is over 98%.
Our top-of-the-line electronic claim scrubbing ensures error-free and clean claims are submitted for faster reimbursement and minimum denials/rejections.
Claims are submitted electronically to lower administrative, postage, and handling costs. Electronic submissions make complex medical billing process comprehensible and effective.
We post ERAs and EOBs in a timely manner. Our team of experts verifies each claim for appropriate payment while our A/R team follows up on any denied or rejected claim.
For any denial, our AR specialists will take swift and effective action to ensure timely reimbursements, keeping you up-to-date on appeals and reprocessing.
We Send clear patient statements that are simple, easy to read, understandable, and more likely to get paid on time.
Our medical billing software are compliant with HIPAA regulations. We ensure no leakage of patients’ data while processing any information.
We create performance reports each month to track and analyze financial performance of your practice to identify areas of improvement.
Our professional medical coders have expertise to assign appropriate codes to the services and procedures provided by healthcare providers and physicians, in order to accurately bill for these services to insurance companies and patients.
We quickly identify, analyze and apeal denied claims to ensure timely and accurate reimbursement for healthcare providers.
Our medical coding team reviews and verify the accuracy and completeness of medical coding assignments against clinical documentation, in order to ensure compliance with industry regulations and to identify and correct any errors or inconsistencies.
01.
For staying on top of business we provide daily, weekly, monthly, quarterly & yearly practice analysis reports to our clients.
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EFT is a system of transferring money from one insurances bank account directly to clients’ accounts without any paper money.
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We will make sure that our clients don't miss timely revalidation that can result in delayed payments.
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Any change in address or TIN – we will update with insurance companies.
We make sure your Practice or Group has the most varied, popular and effective in-network payor mix. Our credentialing team has extensive experience in enrolling physicians with Medicare, all Medicaid’s Managed Care plans along with all commercial payors. Our team reaches out to each shortlisted payor that you want to enroll with and gets accurate timelines and open panel availability.
We send you a complete checklist of all the information and documents that are required to file the applications. As soon as we have the details from you, our Enrollment team goes ahead and files the appropriate contract applications and makes sure it’s a flawless submission in the first go, owed to our extensive experience. As a result of our first-time correct application submissions, we proudly boast of the shortest turnaround time in getting the contract.
Our team follows up on the submitted application every two weeks, to ensure that the submitted application has been received and is in the payor’s system and that no additional information is being requested and everything is smooth. We follow-up regularly until the contract comes through and is delivered to your physical location.
Payors like UHC, Aetna and BCBS sometimes have closed panels for Labs for a particular area. We make sure to send an extensive appeal outlining the key points of your service, including niche services and details on how you bring exceptional patient care in your area. All these details are included in your business plan.
This is for all providers who choose to stay out of network with certain payors. Or if due to any closed panels, are forced to stay out of network. Our team helps with out of network enrollments, NPI registrations on the payor’s website etc. so that your medical practice is in the payor's system to start receiving out of network payments.
We help with all basic and complex demographic changes such as updating a new TAX ID with all payors in your payor mix, updating a new address, bank account, etc. We also help set up all ERA and EFT enrollments.
For larger healthcare facilities with multiple providers, accurate provider database management is pivotal. We manage and maintain all your providers’ and physicians’ credentialing data on our credentialing portal. It’s a very comprehensive, transparent and HIPAA compliant tool that we specifically designed to make sure we upkeep your database with the utmost efficiency and accuracy
Keeping up to date PECOS and CAQH profiles is of utmost necessity in today’s healthcare environment. The biggest payors are all turning the CAQH route to credential and enroll medical providers. We maintain and upkeep your CAQH and PECOS profiles, making sure all your information is accurately profiled and compliant.
We not only get you the contracts, but we do fee rate negotiations for you as well. We have an extensive database of all payors’ latest fee schedules. We study your competition and this data helps us to make sure we get you the best possible rates for your procedures, thus solidifying optimum reimbursements for your medical practice. We revisit your older contracts and try and get better rates as per availability from the payor at the current time.
Medicare – Medicaid – Aetna – Blue Cross Blue Shield – Cigna – Humana – United Healthcare – Anthem – Kaiser Permanente – Health Net-Molina Healthcare – Centene – Highmark -WellCare – Amerigroup – CareSource -Coventry Health Care – Gateway Health – HealthPartners -Independence Blue Cross – Medica -MercyCare – Optima Health – Oscar Health – Premera Blue Cross -Priority Health – Quartz Health Solutions -Regence Blue Shield – SummaCare -Tufts Health Plan-UPMC Health Plan – Vibra Health Plan – Virginia Premier – WPS Health Insurance -Molina Healthcare – Western Health Advantage
However, you also need to know which local insurance companies may be valuable. To determine this, consider asking a peer or another practice in your area which local health insurance companies best meet the needs of your patient base.
Advanced RCMS LLC stays ahead of the curve with digital marketing trends. Our success has us leading the pack amongst our competitors with our ability to anticipate change
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1200 Brickell Avenue, Suite 1950 Miami, FL 33131
453 S Spring St Ste 400 Los Angeles, California 90013
+1 786-406-6218 | [email protected]
Welcome To Advanced RCM Solutions For Your Healthcare Business!