Our Process

01

- Our Process

Patient and Billing Data

Practice’s admin staff gathers patient demographics and insurance information to verify eligibility and benefits, and to acquire authorization when needed. CodeMed-AI can handle pre-auths.

Ideally, having a copy of the driver’s license and both sides of the insurance card works best to avoid errors with the patient information.

Practice sends patient info and claims data to CodeMed-AI via secure email, or we can build an electronic interface:

Required:

  • Patient name
  • Patient date of birth
  • Patient address
  • Patient gender
02

- Our Process

Claim Entry and Submission

Claims are reviewed for accurate and full required information.

Claims are entered and processed through our billing software, MedOffice, typically within 24 business hours of receipt of billing data.

Submit claims to our preferred clearinghouse. Different clearinghouse can be utilized, if necessary, based on specialty and payer list.

03

- Our Process

Payment Posting

CodeMed-AI receive ERA’s through clearinghouse account to maximize accuracy and speed of billing cycle.

Payments are recorded in our billing software to maintain accurate balances and submit secondary or tertiary claims when necessary.

04

- Our Process

Denial Management

If a claim is denied, CodeMed-AI will investigate and submit with the correction or appeal in a timely manner.

Since our percentage is based on total collections, we do not charge extra to resend claims. Once you get paid, we get paid.

If a claim is denied for a contractual issue (missing authorization, noncontracted code, non-covered charge, etc.) the practice will be notified. No claims are written off without consent.

05

- Our Process

Reports, Patient Statements, Invoicing

CodeMed-AI will provide monthly financial reports to express total collections.

If you’d like, we can also provide balance reports to show uncollected insurance portions and patient portions.

CodeMed-AI will send out patient statements for a small fee or PDF’s of patient statements at no charge if preferred.

Our percentage is based on total collections (insurance and patient payments). Any copays collected at time of service should be recorded on claims data to avoid duplicate patient billing.

Invoices for billing services are billed to practice once a month and coupled with a payment report showing total collections.