What We Do
Backed by RAC audit experts and Fortune 500 business accounting experience, Redemption Revenue provides unsurpassed, world-class medical billing services to surgeons and DME providers.
Our Basic Surgical Billing & DME Billing Services
We offer all the same billing services that other companies offer, but ours come with 30+ years of regulatory compliance expertise to help you avoid audits.
Credentialing & Provider Enrollment
Credentialing and enrollment requirements, regulations, and red tape can cause a significant decrease in available cash flow to your practice.
Redemption Revenue stays on top of the changes and handles the tediousness of medical provider credentialing for you, including enrollment in government plans such as Medicare, Medicaid, and the top five commercial payers in your market.* We provide credentialing and credentialing maintenance for both new and established providers.
- Process and file documents for government plan enrollment
- Third-party payers
- CAQH maintenance and reminders regarding expiring documents, such as medical licenses and DEA registrations.
Our credentialing services are provided free of charge for each full-time provider with prorated rates for part-time providers.
*Facility credentialing and greater than 5 commercial payers are billable at a reasonable rate.
Claims Submission
Accurate and timely claims submission is the key to cash flow and maximal reimbursement.
As part of the surgical billing and DME billing process, Redemption Revenue’s fast, efficient, and compliant claim creation and claim submission promotes faster reimbursements and ensures your patients receive their statements in a timely manner. We always submit electronic claims within 24 hours of receipt. Almost all unquestioned claims are paid within 30 days, and in some cases even earlier. We process paper claims for those payers who do not have the capability of processing claims electronically.
Patient Statements & Patient Billing Inquiries
Your reputation and your patients’ satisfaction is invaluable to the stability of your practice. By submitting claims quickly and correctly the first time, Redemption Revenue is able to send statements to patients in a timely manner. We mail patient statements monthly for each account with a deductible or patient responsibility balance. We also brand the statements to match your practice’s naming and branding as you see fit.
Redemption Revenue will handle all of your patients’ billing questions about their medical statement and payment history. Patient billing inquiries can be very time consuming for your office staff, but they’re tantamount to patient satisfaction. Rest assured that we will take the time to answer any and all questions regarding your patient’s statement in a prompt and courteous manner. We will protect the reputation of your practice.
Payments & Posting
Redemption Revenue triple checks your payments and matches them with your claims and accounts receivable to confirm payments requested and payments received match perfectly every time. We know that perfect payment posting in the surgical billing process is extremely important to the trust and goodwill of a provider and its patients and payers. We will not violate that trust with avoidable errors.
Denials, Appeals, & Soft Collections
Redemption Revenue will quickly follow up on any unpaid insurance claims and claim denials. Your money is our only job and we will fight to make sure you’re paid accurately and in a timely fashion. As part of our surgical billing and DME billing services, we will consistently and proactively review, correct, and resubmit any unpaid claims and denials.
Our responsibility is to make sure you get paid in full. Collections agencies barely break even in the end. Before you turn to a costly collections agency, Redemption Revenue makes soft collection efforts via phone and mail to help your patients pay what they owe. You deserve to get paid; we’ll make it happen.
Bi-Annual Practice Analysis
Twice a year, the Redemption Revenue experts will conduct a thorough analysis of your practice that includes the following:
- Identify profitable revenue centers and opportunities to enhance your profits
- Provide in-depth analysis regarding billing and reimbursement performance, as well as recommendations for increasing your practice’s financial performance
- Practical information regarding staffing mix and your productivity
- Scheduling and workflow analysis to optimize time management, revenue generation and patient satisfaction
- Establish realistic expectations for practice revenue based on services offered and actual payer reimbursement, with enhancement recommendations that you can use at your discretion
Reimbursement Review
Every 6 months as part of our Bi-Annual Practice Analysis, we’ll dive deep into your reimbursements to find opportunities for improvement. This in-depth look includes:
- Assess current coding and medical billing protocols identifying opportunities to increase revenue and identify any issues with current compliance guidelines to potentially increase profitability and keep you safe
- Recommendations regarding methods for coding and revenue audits to maximize reimbursement, claim submission, and payment facilitation, while maintaining a strict adherence to published coding and billing guidelines for your practice or facility structure
- Recommendations to optimize clean claims submission
- Evaluate denial rate and recommend process improvements to reduce those rates. This provides an immediate enhancement to practice cash flow
Payer Analysis
As part of the Bi-Annual Practice Analysis, the medical billing experts at Redemption Revenue will provide actionable insights regarding your payers and payer mix.
- Analyze payer mix and profitability derived from that mix
- Establish reimbursement comparisons between payers for all services offered by the practice
- Provide realistic reimbursement expectations and timelines for all payers and services
- Analyze contracted payer fees for purposes of internal benchmarking and contract negotiations with payers
- Provide recommendations on patient mix to maximize actual payer reimbursement
- Provide recommendations on which patient services should be offered based on actual reimbursement
- Analyze impact of new payer contract developments on practice revenue
Annual Fee Schedule Analysis
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