Medical Billing & Revenue Cycle Management (RCM) are critical components of healthcare administration that ensure healthcare providers are reimbursed for the services they provide. At Global Sky BPO, we specialize in offering comprehensive medical billing and RCM services designed to optimize your revenue cycle, reduce operational costs, and improve financial outcomes for your practice, hospital, or healthcare facility.

Our team of experienced professionals handles everything from claim submission to payment follow-up, ensuring a seamless process that maximizes reimbursement and minimizes administrative burdens. With our tailored solutions, healthcare providers can focus on delivering quality patient care while we take care of the billing and revenue cycle management.

What is Medical Billing and RCM?

Medical Billing involves the process of submitting claims to insurance companies and following up on claims to ensure healthcare providers are paid for their services. Revenue Cycle Management (RCM) is the overall process of managing the revenue cycle, which includes the entire lifecycle of a patient’s encounter with a healthcare provider, from appointment scheduling to claim payment.

Together, medical billing and RCM ensure that the healthcare provider receives accurate and timely reimbursement for services rendered, while also streamlining administrative processes to improve operational efficiency.

Why Medical Billing & RCM is Critical for Healthcare Providers

• Maximized Reimbursement
• Effective billing and RCM systems ensure that your claims are submitted accurately and on time, leading to fewer claim denials and quicker payments.
• Compliance with Regulations
• Healthcare billing must comply with complex rules and regulations (such as HIPAA and ICD-10 codes). Our team is well-versed in these standards to ensure your practice stays compliant.
• Reduced Administrative Costs
• Outsourcing medical billing and RCM tasks to experts helps reduce the overhead associated with in-house billing departments, saving time and resources.
• Improved Cash Flow
• With timely claim submissions, prompt follow-ups, and diligent denial management, you can maintain a steady cash flow and improve your overall financial health.
• Focus on Patient Care
• By delegating billing and revenue cycle management tasks to us, healthcare providers can focus on what they do best: providing exceptional patient care.

Our Medical Billing & RCM Services

At Global Sky BPO, we offer end-to-end Medical Billing and RCM solutions that cover every aspect of the revenue cycle. Our services include:

1. Insurance Verification & Eligibility Checks

• Insurance Verification: We verify patient insurance details before services are provided to ensure that the patient is covered for the treatment.
• Eligibility Checks: Our team conducts thorough checks to confirm eligibility and coverage, ensuring accurate billing from the start.

2. Coding Services

• ICD-10 and CPT Coding: Our certified coders ensure accurate diagnosis (ICD-10) and procedure (CPT) coding, minimizing the risk of errors that lead to claim denials.
• HCPCS Level II Coding: We also handle coding for medical supplies and services that require HCPCS codes, ensuring complete and accurate documentation.

3. Claims Submission

• Electronic Claims Submission: We submit claims electronically to insurance carriers using the latest technology, ensuring fast and efficient processing.
• Paper Claims Submission: In cases where electronic claims are not possible, we ensure timely and accurate submission of paper claims.

4. Payment Posting & Reconciliation

• Payment Posting: We post payments from insurance companies, Medicare, Medicaid, and patients into your system, ensuring that your accounts receivable (AR) are up to date.
• Reconciliation: Our team conducts a detailed reconciliation of payments received and amounts billed, helping identify discrepancies and ensuring accurate financial records.

5. Denial Management & Appeals

• Denial Tracking: We closely monitor denied claims, identify the reasons for denials, and take necessary steps to rectify the issues.
• Appeal Process Management: Our team handles the entire appeal process, resubmitting claims with additional documentation or corrections to ensure proper reimbursement.

6. Accounts Receivable (AR) Management

• AR Follow-Up: We proactively follow up on unpaid claims, working directly with insurance companies to resolve outstanding balances and accelerate payments.
• Aging Report Management: Our team reviews aging reports regularly, focusing on overdue accounts and ensuring that collections are made in a timely manner.

7. Patient Billing & Collections

• Patient Statements: We generate and send patient statements, ensuring that all charges are clearly explained and that patients are aware of their financial obligations.
• Patient Payment Follow-Up: We follow up with patients on outstanding balances, offering flexible payment plans and ensuring that payments are collected promptly.

8. Financial Reporting & Analytics

• Revenue Cycle Reporting: We provide comprehensive financial reports that give you a clear overview of your revenue cycle, from claim submission to final payment.
• Performance Metrics: Our team tracks key performance indicators (KPIs) such as claim rejection rates, payment turnaround times, and AR days, providing actionable insights to improve your revenue cycle.

9. Compliance & Risk Management

• Regulatory Compliance: Our team stays up-to-date with healthcare billing regulations, ensuring that your practice complies with all federal and state laws, including HIPAA, and ICD-10/CPT coding requirements.
• Audit Preparation: We help you prepare for audits by ensuring that all billing documentation is complete, accurate, and in compliance with industry standards.