BLOG • Feb 19, 2025
Unlocking Revenue Potential: Why CARC Codes Are Essential for Denial Management
RCM CARC
🟢 Physician Billing Service
Efficient Billing for Sensitive Care: Home Health Hospice Expertise
Our hospital billing solutions blend efficiency and empathy to optimize physician reimbursement and patient satisfaction
Schedule a Call$6.3M
Total Revenue Billed
28 Days
Avg Reimbursement Time
5.5%
Claim Denial Rate
Overview
Expert Physician Billing Services for Practitioners
ASP‑RCM Solutions delivers comprehensive and up‑to‑date physician billing services, ensuring accurate data integration with your existing applications. Our services cover everything from billing and collections to No Surprise Act solutions—so you can focus on clinical duties while we handle the administrative details
Customized Solutions for Your Physician Billing Practice
Billing & Collections: End-to-end claims management. • No Surprise Act Solutions: Transparent cost estimates and fair billing. • Insurance AR Assortments: Prioritizing high-value claims. • Credit Balance Adjustments: Accurate refunds and balancing. • Payment Posting: Real-time EOB reconciliation. • Revenue Recovery: Follow-up on overdue accounts. • PMB Insurance Collections: Handling denied or partially paid claims.
Physician Billing Assistance for Multiple Specialties
Children’s Orthopedics & Emergency Care: OB‑GYN, heart disease, operations, etc. • General Practice Billing: Family practice, pediatrics, internal medicine. • Specialty Practice Billing: Oncology, neurology, dermatology. • Physician Groups Based in Hospitals: Emergency medicine, anesthesia, hospitalists, post‑acute care. • Our team is well‑versed in ICD, CPT, and HCPCS guidelines for each specialty.
Efficient Physician Revenue Cycle Management Services
Coding: AAPC-certified (ICD, CPT, HCPCS). • Claims: Daily filing. • Eligibility: Real-time verification. • Credentialing: Managed. • Rejections: Appeals handled. • Payouts: EOB review & deposits. • Balances: Invoice statements sent
Smooth EHR Integration & Data Management
We link seamlessly to your existing EHR or practice management system, employing real‑time data exchange (e.g., HL7 interfaces, secure APIs). This approach minimizes manual data entry, speeds up claim submission, and delivers robust billing analytics
Driving Compliance & Transparency
HIPAA & Data Security: We ensure strict PHI protection. • No Surprise Act Compliance: Transparent cost-sharing to prevent surprise bills. • Audit Trails: Clear logs for accurate billing records. • Continuous Improvement: Regular audits to adapt to payer rule changes.
Operations
Physician Billing Operations: A Step‑by‑Step Roadmap
Our integrated RCM framework allows you to maintain a healthy bottom line. Each stage of operations—from eligibility checks to denial resolution—undergoes real‑time monitoring, ensuring consistent revenue flow and minimal administrative burdens
Patient Demographics & Eligibility Verification
We capture and verify patient details in your EHR or billing system. This process includes real‑time checks for coverage limits, co‑pays, and prior authorization requirements to avert claim issues
Coding & Charge Entry
Our AAPC‑certified coders meticulously review provider documentation, assigning correct ICD, CPT, or HCPCS codes. Charges are then entered for swift submission, minimizing the chance of front‑end denials
Claims Submission & Tracking
We electronically submit clean claims via 837P or 837I forms, depending on specialty. Automated trackers flag rejected claims for prompt resubmission, raising your first‑pass acceptance rate
A/R Management & Denial Prevention
We categorize pending claims based on age and payer priority. Denial prevention teams identify trends—such as incorrect modifiers or missing documentation—and address them Proactively to reduce rejections
Payment Posting & Credit Balance Adjustments
Received payments are matched against claims, capturing precise details of EOB statements. Overpayments or misallocations are swiftly corrected, ensuring accurate account balances and patient statements
Comprehensive Reporting & Compliance Audits
We provide in‑depth analytics on clean claim rate, days in AR, and denial rates, alongside monthly compliance audits. This ensures ongoing revenue optimization and alignment with payers, regulators, and the No Surprise Act
Testimonials
Client Success Stories
FAQ
Frequently asked questions
Once we have safely received your patient and encounter data, we code, review, and send claims to payers. We also manage appeals and denials, track payments, and provide frequent updates. Our procedure is designed to be effective and open.
Our qualified coders and billing specialists evaluate every claim stringently. We employ quality control procedures, coding audits, and cross-referencing with payer requirements to guarantee accuracy and lower the possibility of denials.
Our denial management team examines every refused claim to identify the underlying reason. We quickly fix any problems and submit claims again, and where needed, we collaborate with payers on appeals to ensure you get the most money back.
Our pricing policy is adaptable and customized to meet every customer's demands. Usually, we charge a set fee based on volume or a portion of collections. Contact us for a quote tailored to your clinic's particular needs.
Indeed. Our specialty is smooth transfers from internal procedures or other billing businesses. To guarantee that all data is moved safely, our staff will collaborate closely with you and offer training as required.
Resources
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