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We offer transparent data, pertinent reporting, and meticulous follow-up, enabling error reduction, revenue maximization, and a comprehensive understanding of your organization’s financial well-being.
It’s crucial to recognize that Revenue Cycle Management (RCM) extends beyond billing. While billing entails submitting claims and ensuring payment, RCM involves collaborating with clinical staff, enhancing documentation, refining processes, managing denials, addressing patient balances, and providing real-time financial reporting.
Therefore, organizations must prioritize efficient revenue cycle practices, leveraging technology and collaboration to empower employees to focus on exceptions. Healthcare providers must balance controlling operating costs with delivering high-quality care.
01.
Enrollment Services
At Sazs Health, we recognize the significance of enrollment services with your primary payers for claims and electronic data interchange.
Our dedicated team will guide you through the enrollment process for all major payers, guaranteeing smooth electronic transactions for claims processing, remittance receipt, and eligibility verification. Moreover, Sazs Health's can lend support with enrollment for new payers when seeking to become a network provider.
02.
Eligibility / Authorizations
Ineligibility of insurance stands as the leading cause for claim rejections and denials by payers. Certain services necessitate pre-authorization from the payer, adding to the complexity. Sazs Health recognizes the critical nature of these tasks and offers insurance verification and pre-authorization services to prevent claim denials and ensure consistent cash flow for our clients.
03.
Charge Capture
Sazs Health ensures charge capture remains a priority by meticulously reviewing claims, verifying accurate coding, and avoiding under or over-coding pitfalls. We work closely with clients to optimize revenue while minimizing patient impact.
04.
Medical Coding
Compliance with coding guidelines is essential for consistent and accurate data, crucial for informed financial decisions. Sazs Health ensures claims are submitted cleanly to insurance companies, adhering to coding guidelines such as NCCI Edits, MUEs, and CPT to ICD-10 crosswalk relationships. We also review carrier policies to keep clients informed of any changes affecting treatment protocols and revenue.
05.
Claims Submission
Sazs Health's experienced billers understand the intricacies of various insurance plans, including Fee-For-Service, HMOs, POS, and PPOs, across diverse healthcare settings such as laboratories, long-term acute care, ambulatory surgical centers, physician practices, and ancillary services.
06.
Payment Posting
Accurate payment posting is crucial for identifying underpayments and ensuring proper reimbursement according to payer contracts. Sazs Health emphasizes line-item posting to guarantee reimbursement for all services rendered.
07.
Accounts Receivable
Recognizing the significance of accounts receivable management, Sazs Health assigns dedicated team members to manage accounts from claim submission. Our AR team monitors claim receipt and status, providing regular communication to clients to address any issues impacting cash flow promptly.
08.
Analytics
Sazs Health's analytics serve as a comprehensive business analytics and workflow tool, seamlessly integrating with major EMRs to streamline and automate the revenue cycle. Our analytics offer transparency into key trends such as average reimbursement per sample type and payer, actual reimbursement versus expected, net revenue per patient day, payer mix, and denial trends.