Medical coding demands high accuracy. Slight coding errors can delay payments, lead to claim rejection, and negatively affect your revenue cycle management.
Plutus Health Inc. understands healthcare practices and provides the best medical coding services. We have a team of 800+ professionals with immense experience providing tech-enabled RCM services.
Unlike traditional medical coding companies, we first analyze the patient documentation before using codes and modifiers. We understand the regulations and compliance of the medical industry. Our certified medical coders ensure a first pass claim submission.
We know the stress of medical coding and documentation. Thus, our team offers medical coding services that can thoroughly remove your stress and burden.
Medical coding is daunting. The medical compliance guidelines change continuously, and so do the medical codes. Many modifiers and codes change with a slight modification of treatment or procedure.All minor details need to be analyzed and addressed while coding. Our team understands all aspects of medical coding and RCM services.
Plutus Health is a HIPPA Compliant organization with a team of certified coders. Our professionals deliver premium quality medical coding aligned to your business and industry standards.
As medical coding services are part of our end-to-end RCM solutions, we first verify the codes entered by you or review the medical records to provide the correct coding required to be compliant and accurately reflect the services delivered. Expert coders in our team are responsible for ensuring the correct ICD and CPT codes will be used on the claims. As a final quality control, the codes finally get checked and approved by the quality assurance team.
Our automation-enabled RCM services will help you scale your business without adding IT infrastructure. We assign a team of trained professionals to provide the services according to the project's requirements. We also offer short-term coding solutions to catch you up with a backlog of medical services that require coding services and/or to augment your internal staffing shortages.
Plutus Health Inc. is SOC-2 certified and uses cutting-edge technologies like AI, ML, and RPA to provide high-end interoperability and security to your documentation, personal information, and money. We save the data in a secured cloud network. This data can be accessed anytime and anywhere by authorized people.
We reduce the chances of denials by strictly evaluating your documents and applying the accurate codes accordingly. You can stand out in the service industry by leveraging the skills and tech-enabled Plutus Health Inc. solutions of our certified medical coders and RCM service experts.
Take your healthcare business to new heights with Plutus Health Inc., one of the best medical coding companies. We streamline your process and submit flawless claims to get quick reimbursement. We give the following benefits to you.
Out of the many medical coding companies, choose the one that can assist you at any time, provide security, keeps your information safe, cover all aspects of the RCM process, ensure compliance, standardize your organization’s coding, and allow you to focus on delivering premium healthcare to the patients.
Contact Plutus Health Inc. and leverage our healthcare professionals to handle your medical coding and RCM services
Hospitals are under immense pressure to improve their financial performance while providing high-quality patient care. To achieve both these objectives, they need a hospital revenue cycle management (RCM) solution that can streamline their billing and collections process.
This is where Plutus Health Inc. comes in. We offer excellent healthcare RCM healthcare solutions to all the hospitals in the US. We are a SOC2 Type 2 and HIPPA Compliant Healthcare RCM provider.
Our team is comprised of highly qualified and experienced professionals who specialize in healthcare RCM services.
We use cutting-edge technologies and automation to develop healthcare providers' hospital revenue cycle management solutions.
Hospitals can benefit greatly from our revenue cycle management services by ensuring efficient financial management and preventing denials and delays in payments.
At Plutus Health, we understand that healthcare RCM services are a complex and ever-changing landscape. That's why we offer comprehensive, tech-enabled solutions that can simplify the RCM process for healthcare providers.
Leveraging AI, ML, and RPA cutting-edge technology allow for error-free coding so that your submitted claims get cleared quickly and reduce AR.
Plutus Health Inc. provides RCM healthcare solutions to eliminate manual tasks and manage FTEs &medical billing which will bring down your cost significantly.
With the help of automation, we will provide better customer service and enhance your RCM solutions healthcare experience which increases patient satisfaction.
Our team of professionals stays abreast of the latest rules and regulations in the healthcare industry and provides cutting-edge healthcare RCM solutions accordingly.
The hospital revenue cycle is a complex and time-consuming process that can be difficult to manage and keep up with the regulations and technology.
Plutus Health Inc. offers comprehensive and customizable hospital revenue cycle management solutions that will help you increase efficiency and grow your business quickly. We take the time to understand your needs and build a solution that fits your specific requirements, so you can focus on providing quality patient care.
Do you want to learn more about how we can help your hospital run smoothly and efficiently.
Skilled medical billers help healthcare organizations prevent payment delays and revenue shortfalls. To handle billing tasks internally is often expensive and impractical. Processing your bills means devoting considerable time and resources to paperwork, correcting errors, monitoring progress, and adjusting to ever-changing compliance regulations. This is why even the biggest and most successful hospitals outsource medical billing services to third-party providers.
Outsource your medical billing services to Plutus Health. Our customized solutions can lower your costs, boost your revenues, and free up your time.
Outsource your medical billing functions to Plutus Health. We offer customized solutions to help you manage and secure the financial viability of your healthcare organization.
Save time and improve your bottom line by outsourcing your billing and coding functions to a top medical billing company in the USA. This will allow you to focus your resources on providing high-quality care, boosting patient flow, and improving patient satisfaction.
As the best medical billing company in Dallas, Plutus Health Inc. is a medical billing company that can streamline your processes and grow the revenue. We offer comprehensive revenue cycle management solutions like provider credentialing, insurance eligibility verification, claims scrubbing and submission, denial management and appeals, and specialties like mental health billing services. We also offer out-of-network medical billing services and can negotiate underpaid claims on your behalf.
Are you looking to outsource medical billing and coding companies?
Provider needs to validate its qualifications to ensure that they are a perfect fit to deliver care to the patients. If they fail to do so, they won’t benefit from the insurance companies. Plutus Health Inc. helps steer the credentialing process and get providers & practices in-network with insurance plans.
Plutus Health Inc. is an in-network provider with all the possible payers and plans. We preserve the documents of the providers and practices with integrity in our advanced credentialing tool and keep it transparent with our clients to see the status of their applications.
Below is the type of work managed in credentialing for all providers in all states:
We work with the majority of the payers regularly and have a strong relationship with the insurance representatives. We also have strong communication lines with the payers. Our experts involved in credentialing always ensure that there are no gaps in filing and submitting the application on time.
We do all credentialing activities in one tool and track submitted applications for all work types. One glance at our credentialing management dashboard helps understand the status of the applications submitted. Our credentialing expertise will help you along every step of the way. Using our tool, we can expedite and efficiently carry out complete applications, subsequent follow-ups, renewals (Re-credentialing), and generate the reports based on the need.
We do below Enrollments as well along with credentialing.
Plutus Health Inc. is your one-stop destination for all automation-enabled medical RCM services.
Patients often delay the medical bill payment if they don’t understand their statement. It generally happens because of the complex structure of statements, and the patients claim a lack of transparency and deny or delay the payments. The medical billing staff usually tries to explain the statement to the patients, but the terminology and jargon used are tricky to understand, resulting in disappointment to both ends.
Plutus Health Inc. generates quick, easy, and accurate patient statements using automated patient billing software so that there is no delay or denial in payment caused by them. These statements have legibility and transparency to speed up the payment process.
Plutus Health Inc. leverages automation-enabled RCM services to coordinate with the practice to generate straightforward statements. We put only the relevant and understandable data so that patients do not have any confusion or difficulty while paying the bills. We arrange the following datain the patient statement to make it detailed yet simple.
Once the patient statement gets generated, it is sent to them automatically through email or SMS. Patients can directly choose to pay online through a secured payment gateway link provided along with the statement.
We work with the providers to create patient statements that are easily understandable.
If the patient has any doubts or questions regarding the payment, our team is always available to solve them.
We enable automated payment posting using our payment portal for providers to collect the amount online via credit card or other modes of payment.
Plutus Health Inc. is a Tech-enabled RCM service provider capable of generating accurate statements and collecting timely revenue from patients.
Accounts Receivables (or AR) is money owed to the provider based on the different patient accounts for services rendered. AR is payable by insurance firms and patients. It is an indication of the revenues earned or generated but not realized. The aggregate of the money that is owed to all providers, the practice can expect the money to be paid in the course of the month or over a period of time.
Accounts Receivables requires terrific management, a good monitoring and following up methodology. It is only with this process can the actual revenue earned be realized and thus bring down the percentage of accounts receivables owed to the practice. Therefore, this is one of the core objectives of any practice, healthcare facility or billing company.
Accounts receivables include managing reports that deals with insurance, collection investigation, write-offs, bad debt reviews and ratio breakdown. It also includes insurance contracts analysis as this ensures that healthcare providers are reimbursed promptly and properly.
On a daily basis, providers or physicians provide consultation, treatment and different types of services to their patients. For this, the patients have to pay or owe a certain amount of money to their providers. This is either directly paid by them or paid on behalf of them by their insurance provider. Therefore, this aspect of medical billing is gaining a lot of importance as it is a crucial part and one that keeps a practice going and also ensures definite translation of all the money owed to them. Before this process, there are many processes that precede and which also have to be followed and done correctly. Processes like charge entry, patient registration, insurance eligibility verification, payment posting etc. has to follow the set procedural norms so that the A/R is attainable.
Typically, after approval the claim is sent to the insurance company for processing. But the claims that are sanctioned also include denials and hence an experienced team in place, performs regular checks and follow-ups to reduce the denial rates. So there is a great deal of work or processes to be carried out before a physician actually realizes their money.
The A/R team has to analyze and scrutinize the denied claims, rejected or partial payments and also non-payments. If in case, there is a wrong submission, the same is rectified and sent out again. It is the A/R team that is in touch with the billing office, or client, insurance company, practice and the patient. Good analytical skills and knowhow, an eye for detail all make up the qualities of a good A/R analyst. As it is the A/R analyst’s effective handling of cases that determine the financial wellbeing of the medical practitioner, hospitals and medical offices.
Accounts Receivables (AR) management engenders all areas of a medical practice. Accounts receivable management techniques that have proven to be successful need a complete understanding and knowledge of the different areas that contribute towards its success in realizing revenue that is owed or outstanding.
The most important feature in the medical billing cycle is Accounts Receivables Management. Therefore, it is but reasonable to have experienced personnel and a proper system to manage the accounts. A well-devised system that has a good internal and external reach and control over all the accounts would help recommend solutions to recover the money that is owed to providers in a quick pace. It is the A/R team that works closely with the providers, insurance companies and patients to realize the amount.
The benefits of engaging the A/R services rendered at Plutus Health Inc. include:
Denied claims represent billions of dollars in lost revenue for the US healthcare sector. Effective denial management in medical billing and coding can plug the leaks draining your revenue flow. It's essential to work with experts who can take over the time-consuming task of resolving medical billing accounts receivable (AR) denials and deliver real results.
Plutus Health Inc. offers complete solutions for denial management in healthcare. Our team will do the below mentioned:
Our custom approach to each denial case ensures effective and timely resolution. We will do what needs to be done to reverse the denial. Depending on the case, we may:
We will also address any systemic front-end gaps in your current process to prevent denials from recurring. We can identify facility-specific or practice-specific issues within your revenue cycle management (RCM) chain that may result in denied claims. As your denial management partner in RCM, our goal is to reduce denial percentage over time and help your healthcare organization thrive.
Are you looking to outsource the management of your medical billing AR denials but have some reservations about outsourcing? Talk to us today. Plutus Health Inc. has been providing denial management solutions in healthcare for 14 years. Our team of certified medical coders can resubmit, and repair denied claims quickly and effectively following a proven process.
Denial management is an integral part of the medical billing RCM process. It is critical in a successful revenue cycle management as it will lead to healthy cash flow. Effective denial management in medical billing and coding can plug the leaks draining your revenue flow.
We need to keep up with the latest changes in medical billing, and it's essential to understand and reciprocate challenges and solutions. Our denial management in healthcare will help you stay in compliance with the latest regulations and rules.
Incorrect coding is a significant loss of potential revenue.Getting the perfect code for the claims is a complex task; we have PlutusHealth Inc. which has some rich experience with denial management in medical coding and enable good coding practice, which improves correct payment collections.
Timely filing denials are a potential loss of revenue, and without the proof of timely filing, these denials will not be paid. Transmission of claims on a timely basis is significant in the medical billing process.
Scrubbing your claims before the submission is one of theproven methods to reduce the chances of denials. We at PLUTUS HEALTH have our teamwith expertise in scrubbing claims to ensure an excellent first pass ratio withour denial management in RCM.
Problems With Denials
Medical practices should aim for a 95% clean claims rate; otherwise, it is equivalent to dropping the money on the table. Maintaining a high clean claims rate increases your medical practice's efficiency and overall profitability.
If your practice continues to have claims denied, your insurance reimbursements will decline. Many practices work on small margins, and even a slight change could put your practice a risk. This is why Plutus Health Inc. provides denial management in medical coding to avoid even the slightest errors
Why Choose Us?
It's essential to work with experts who can take over the time-consuming task of resolving medical billing accounts receivable (AR) denials and delivering accurate results.
Plutus Health Inc. offers complete solutions for denial management in healthcare. Our team will do the below mentioned:
Partnering with PLUTUS HEALTH will bring youthe best denial management system and processes with our medical billing AR denials management. We help medical practices streamline their revenue inflow and provide access to a knowledgeable team that prevents denials from small clinic clients to large physician groups. Our denial percentage is the least in the industry.
Plutus Health's Approach for Denial Management
Our custom approach to each denial case ensures effective and timely resolution. Depending on the case, we may:
What Makes Us different?
We at PLUTUS HEALTH create a team of staff that understand denials specific to your location, making identification, analysis, and prevention of denials much easier.
Daily tracking of current denials and pushing back to insurance within 48hrs makes a massive difference on the collections for those claims. We take a multi-step approach to resolving denials linked with faster claim payment and a better time to pay for the claims.
We can identify facility-specific or practice-specific issues within your revenue cycle management (RCM) chain that may result in denied claims. We will also address any systemic front-end gaps in your current process to prevent denials from recurring. As your denial management partner in RCM, our goal is to reduce denial percentage over time and help your healthcare organization thrive.
Are you looking to outsource the management of your medical billing AR denials but have some reservations about outsourcing? Plutus Health Inc. has provided denial management solutions in healthcare for 15 years. Our team of certified medical coders can resubmit, and repair denied claims quickly and effectively following a proven process.
While processing the claim, it is essential to correctly enter every piece of patient and provider data. Providers need specialists to handle this kind of RCM process. Plutus Health Inc. is a one-stop solution for all tech-enabled RCM services. We know that Charge entry is a crucial process in the medical billing cycle. Every piece of the data entered in this process should be accurate as a slight error in the entry could lead to denial. We have a team of professionals with enormous medical billing knowledge to provide you with perfect charge entry. We carefully work on your charges to ensure minimum denials.
Each patient account created should be assigned with the correct monitory value according to the coding, even the reimbursement of services given by the provider to the patient depends on the proper charge entry. Hence we use automated coding techniques to avoid errors.
We use automated medical records upload facility to collect and upload all relevant documents like charge sheets, medical Records, superbills., etc, on a secured cloud.
We enter the patient’s demographic and billing reference data.
In the case of incorrect or partial information, Plutus Health Inc.’s automated patient billing software connects with the billing manager via text, email, or IVR to collect the required information.
In case of denial, Plutus Health’s denial management team conducts a detailed analysis on the reason for claim rejection and makes necessary corrections.
We constantly take the feedback from the clients and keep on improving the process to provide the best experience to our users.
Attention to detail is essential for an error-free charge entry. and robust communication needs to be established between medical coding and charge entry teams. The claim submitted gets approved only if the data entered is correct. Plutus Health Inc. makes sure that you get the best services possible with minimum turnaround time.
The processing speed of medical claims is a vital factor in the medical billing practice. Everyone wants that their claim goes through the first time. If the claim is processed faster, it saves patients, providers, and payers time, effort, and frustration. Claim scrubbing and submission are the two strong pillars of the medical billing process; approval or denial of the claim depends on these.
Plutus Health provides the best healthcare AI-enabled RCM services and ensures a high clean claim percentage with minimum conversion time. We know that a proper claim gets submitted only after a thorough scrubbing. With our precise claim submission and scrubbing, we try that every claim submitted by Plutus Health Inc. gets approved on the first go and the clients get maximum reimbursement. We also reduce the AR by enabling faster payments.
Claim scrubbing ensures that there is no mistake in the claim that would leverage the payers to reject it, and hence we use automated claim status check software to keep track of your claim.
Claim submission is finding the amount of money the providers will receive from the payers. Hence, we use machine-enabled billing services to know the exact amount that the payers would approve.
Claim scrubbing and submission are crucial as they save a lot of money and time. While scrubbing, many pieces of data like patient and providers, insurer, medical necessity, process followed by medical professional like diagnoses and treatment go through deep analysis and review. All the errors found get fixed before the submission.
Almost every misinformation or mistake on the claim can cause the payers to reject it. Even the errors like misspelled names or wrong birth dates will cause the claim denial.
Patient demographic information is the heart of the claim. We maintain accurate patient data and ensure that updated patient data reaches the payers during claim submission. We have automated medical records upload for faster results.
We use an automated eligibility verification process to verify the patient's eligibility before submission thoroughly.
We have automated coding software for effort-free coding. We also know the latest medical coding compliance and work with the same.
We have a thorough quality check on the claim for coding errors and clean submission.
At Plutus Health Inc.. all the errors in the claim get rectified before submission and checked with an automated claim status verification algorithm. We are the mediator between providers and insurance companies, making the billing process smoother. We ensure medical professionals do not need to bother about the technicality of the billing process and can spend more time giving a better treatment and experience to the patients.
Many patients are not aware whether their insurance plan covers the particular treatment they are willing to take. They repeatedly declined to pay for the services not covered in their insurance plan. Several healthcare providers face revenue loss because of this. To combat this loss, Plutus Health Inc. Provides automated insurance eligibility and benefits verification services to all healthcare providers to stay protected from losses.
Eligibility Verification (EV) is the checkpoint used to verify and confirm the patient's eligibility to take the service from the assigned provider. It increases the revenue and decreases the providers aging days.
The automated eligibility verification process can also reduce claim denials from non-covered services, members not active, providers not eligible to render assistance, etc.
A good EV can quickly increase the first pass and clean claim ratios. But, for flawless results, the providers must set a definite process, and the same need to be maintained in the log for future references.
Plutus Health Inc. is a tech- enabled RCM service provider where we verify eligibility using automations. This Automation is derived by connecting the APIs of the respective practice management systems, Payer portals, Clearinghouse, and Third-party solutions.
We have designed the AI-enabled RCM tools to provide the input file for verification. It will connect through the source web API and get the output.
We have full insurance coverage to verify the eligibility using electronic payer IDs. We also provide a manual insurance eligibility and benefits verification services for payers who do not have EPID.
Anesthesiology, Cardiology & Cardiovascular Surgery, Critical Care, Dermatology, Diagnostic Radiology, Emergency Medicine, Family Medicine, General Surgery, Internal Medicine, Long-Term Care, Mental Health, Neurology & Neurosurgery, Occupational Therapy, Pain Management, Physical Therapy, Podiatry, Psychiatry, Radiology’s, and Urgent care.
Patient registration is the first and most important step in medical billing. It determines the smoothness and ease of claim processing. Correct patient registration and patient demographic entry are the key deciders on whether the claim will get through the first submission or will get denied.
It is the responsibility of the front office of the practice to capture patient demographics using the system or paper-based registration.
Proper patient registration is essential to establish patients’ benefits and eligibility, submit an error-free claim, and obtain prior authorization.
At Plutus Health Inc., we have expertly trained staff with a detailed understanding of the medical billing and are expert in automation-enabled revenue cycle management process. We validate all the information given by the patient through our automated eligibility verification software before submitting the claim. Our team is in regular touch with the payers, and we quickly update the data in case of any missing information or discrepancy.
We review and upload the following data on the provider management system:
We enter the patient information accurately and perform a re-check before submission.
Once the patient details get entered, we capture insurance information and check for its eligibility and benefits using our automated eligibility verification software.
We collect medical documentation and check for medication, allergies, need for special assistance, etc.
We finally review the payer information and submit clean information for quick payments.
Correct patient information is a blessing for providers as it generates timely reimbursement and reduces A/R. We use automated medical records upload software to input accurate patient information. Our team is excellently trained for error spotting and rectifying, and we work closely with practices to provide them with the following benefits:
Plutus Health Inc. ensures you get your money quickly, and no claims get denied due to improper patient registration or demographic entry.
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