Billing Services

Excelsior services

Partner with Excelsior Healthcare Solutions LLC’s industry knowledge and specialized expertise. Raise
your billing standards and achieve optimal financial results.

CMS HCFA 1500 /Professional, Institutional, APG, and ADA Billing

Our billing services are designed to improve the accuracy and efficiency of your billing processes, resulting in faster payments, fewer denials, and higher revenue. We maintain high collection rates with our aggressive appeals and claim tracking workflows. We use the latest technology and industry best practices to streamline your billing operations, reduce administrative burdens, and ensure compliance with all relevant regulations.
We service:
o Part B Providers
o Article 28 DTC
o Article 28 ASC
o Article 31 OMH

Provider Credentialing and Enrollment

We credential and enroll providers with all payers. We complete the credentialing process quickly, monitor credentials ongoing, and continuously improve the process, to ensure that your billing processes run smoothly and accurately.

EDI Issues and Rejections, Claim Appeals, and Tracking

Our systematic approach to claims tracking and appeals ensures that each claim is given the best shot for maximum reimbursement. Our expertise of common billing denials and appeals processes allow us to quickly and effectively manage denied claims, resulting in faster reimbursement. We ensure that the EDI transfer to payers is fast, efficient, and timely.

Customized Analytics and Reporting

We provide comprehensive reporting and analytics that give you insight into your financial performance and help you identify areas for improvement. We customize descriptive and comparative analytics to provide our clients with detailed reports on their revenue cycle performance, allowing them to make data-driven decisions about their billing processes and overall financial health.

Consulting Services for Licensure and Compliance, and APG Methodology of Payment

We offer consulting services to help healthcare providers navigate the complexities of the healthcare industry and optimize their revenue cycle management practices.

APG Payment System Consulting

We understand the nuances and complexities of the Ambulatory Payment Group (APG) payment system. Our consulting services for the APG payment system can help healthcare providers navigate the intricacies of this payment system and ensure they are receiving appropriate reimbursement for their services. Under the APG system, outpatient services are grouped into clinically similar categories, known as Ambulatory Patient Groups (APGs). Each APG has a set payment rate that is based on the cost of providing the services within that group. The payment rate is adjusted based on the severity of the patient's condition and any complications that may arise during treatment.

Managed Care Contracting and Credentialing

We negotiate contracts with payers to ensure that reimbursement rates are competitive and reflect the value of the services provided. We conduct market research to identify competitive reimbursement rates and contract terms. We offer analysis of existing contracts, development of negotiation strategies, Negotiation support, and Contract review and implementation.

Full Service Coding and Prospective/Retrospective Audits

Our team of certified coders and billers have a deep understanding of the complex medical billing codes and regulations, allowing us to accurately code and bill claims and identify opportunities for improvement. We boast an impressive understanding of medical terminology, anatomy, and physiology, as well as an up-to-date knowledge of coding guidelines and regulations. We offer prospective audits to review medical records before billing to identify potential errors or compliance issues. We also provide retrospective audits to reviewing billed claims to identify errors or areas for improvement. By offering these services, our team can help healthcare providers identify and address issues in their billing and coding processes, improve accuracy and compliance, and optimize revenue cycle management.

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