Billing Solutions

Medical Billing Office

Sterling HCS provides solutions for the entire cycle of Claim generation to Receivables Management. We achieve this by our deep insight into processing each transaction with a "getting it right the first time" attitude.

Also See other essentials from the links below.

Billing Solutions

Claim Generation
  • Capturing services rendered – Accurate charge capture by certified coders for maximum reimbursement.
  • Eligibility verification – Validation/updating of patient information using internet tools
  • Balancing visits versus claims – Accounting for all visits through efficient database management
Claim Submission
  • Reconciliation & Tracking – Effective tracking mechanism of claims filed to carriers.
  • Tracking payor communications – Archiving and follow up of payor communications for timely implementation of updates/process change requests.
  • Handling secondary claims through efficient tracking
  • Tracking timely filing – Periodic report generation and analysis to keep track of claim status.
EOB Processing
  • Tracking and handling unpaid claims – Effective denial management through analysis of EOBs. Result-oriented trend analysis to minimize denials.
  • Validating payments against fee schedule – Auditing payments received to make sure reimbursements are done per negotiated contracts.
AR Management
  • Handling refunds – Periodic verification of credit balance accounts and identification of the third party to be refunded.
  • Handling pending claims – Planned schedules to work on pending claims to eliminate timely filing issues and improve reimbursements.
  • Co-pay collection and tracking
  • Self-pay administration – Using a custom-built process for efficient monitoring and administration of patient balances. Effective patient resolution techniques.
  • Old AR management – Efficient handling of old AR projects using proven methodologies/ templates to bring in maximum possible reimbursement.
Process validation & automation

Sterling process experts assist in mapping the existing process and validate against industry benchmarks. We use automation tools to optimize process efficiencies and remove redundancies.