Our Services

Why Choose Our Services

Akurate Management Soultions – Team of certified individuals with expert knowledge and vast experience in the field of Medical Billing, Coding and Transcription Services. Akuratems team has an experience of more than 10 years in the US Healthcare Industry.

Medical Coding

Akurate Management Soultions Coders are certified from AAPC (American Association of Professional Coders) and AHIMA (American Health Information Management Association). Our coders have several years of expertise on both physician and reimbursement sides. We offer high quality medical coding services to healthcare providers across US, ensure highly accurate as well as compliant coding services in accordance with CCI, NCCI and LCD (Local coverage decision and medical policies) as per set rules for different states across US.

All our coders are updated with the US coding polices and participate in CEU (Continuing Education Unit) programs from various institutions keeping their certificates current.
We use online tools like Optum, which provide updated codes and for scrubbing the claims. We follow the books like Z’ Health and other pink sheets for being current with the coding guidelines.
Coding for Commercials and Federal payers is done as per the payer specific guidelines, which decreases the denial rate and faster reimbursement.
Coders provide documentation guidelines to the providers, so that their claims are not undercoded due to lack of documentation. 

Evaluation Management

Inpatient

Interventional Radiology

Radiology

Pathology

Interventional Radiology

DME (Durable Medical Equipment)

HCC (Hierarchical Condition Categories)

Auditing Services

Medical Billing

 

REVENUE CYCLE MANAGEMENT

Akurate Management Soultions follows the below billing cycle for Revenue Cycle Management. We assure our providers with a payment cycle of 30 days.

Medical Transcription

Akurate Management Soultions offers high quality transcription services by experienced medical transcriptionists with quick turnaround times. We provide customized Solutions of highest standard with low per line rates. We can proudly say that we have the best transcriptionists in the industry with more than 10 years of work experience, who can handle any kind of specialties, work types, online platforms, and second language English dictators.

Precision and Accuracy:
Akurate Management Soultions maintains higher than AAMT Standard of 98.5% accuracy. The files Go through multiple levels of QA to ensure quality.

  • Our Transcribers have a minimum of 2 years of experience. There is a rigorous screening process to ensure only the very best get hired.
  • Our Editors have at least 5 yrs of experience in the industry. They review each document for accuracy and completeness.
  • Our QAs have a minimum of 8 years of experience they verify each file and review the entire document for overall quality of transcription.
  • The Production Managers are ultimately responsible for Quality Assurance and to ensure that the entire process works in a timely and effective manner.

TAT:
We support Clients requiring 2 – 24 hour TAT with 24 hour Customer Support.

For clients whom we handle Transcription, Coding and Billing, a claim is submitted within 24 hours of patient being seen in the office !!!

Patient Scheduling

This service is offered to provide doctors a convenient way to book more patients on a consistent basis. Scheduling is done as per the requirements of the office which include working hours, total providers, procedure type, locations, etc… The actual appointments are scheduled directly into the provider’s Practice Management system.  For patients that are “no shows” or have missed their appointments a reminder call can be given on a routine basis to reschedule their appointment with the office.  Also recall lists generated based on certain medical conditions can also be used to schedule patient visits.   Appointment reminders are done by calling patients at a set time before the scheduled visit.

Denial Management

Our Denials and Appeals Managementservice is designed to increase Revenue Collection for Physician offices.
Our expertise includes managing denials for following reasons:

Authorization Issues

Referral Issues

Medical Necessity and Medical Records requests

Non-Participation with Insurance Network

Coordination of benefits

Terminated Insurance

Wrong Diagnosis

Partial Payments

Out-of-network claim status and deductibles

EDI Rejections

Letter of Protection from Attorney cases

No status and No claim on File

Workers’ Compensation

PIP cases

Provider Enrollment

 

Provider Enrollment refers to the process of requesting participation in a health insurance network as a Participating Provider.  The provider enrollment process involves requesting enrollment/contracting with a plan; completing the plans credentialing/enrollment application; submitting copies of licenses, insurance, and other documents; signing a contract; and any other steps that may be unique to a carrier.  Many commercial carriers utilize CAQH to obtain credentialing information from a central location, and require that providers have a complete and up to date profile in the CAQH system as part of the enrollment process.

When receiving a provider enrollment request, health plans use the credentialing process to ensure that the provider is properly educated, trained, and meet any other specific insurance network enrollment requirements for participation.  After credentialing process is complete, then the network will offer a contract for participation to the provider.

The provider enrollment processing time varies by payor.  Some commercial plans take as long as 180 days to complete the credentialing process and then another 30 – 45 days for contracting, while other have the entire credentialing and contracting complete within 90 days.  When submitting documents for enrollment, contracts, or following up on applications it is important to document your steps by utilizing certified mail, overnight mail services, email, fax logs, and documenting phone conversations with agent names and numbers.

There are many service companies that assist healthcare providers with the enrollment process for a fee.  These companies handle all the paperwork and follow up with the insurance companies on behalf of the provider.  The value of these services lie in the time saved and general expertise of dealing with insurance companies on a daily basis.

Scanning, Indexing and Refiling

Documents scanned in at the doctor’s office are categorically filed into the patient charts as per the requirements of the clinic. Clinical Reports will be given a time and date stamp to allow for more organized indexing. Other types of images which can be filed include Insurance card scans, inbound faxes, and hand written medical notes.

Auditing

Medical auditing entails conducting internal or external reviews of coding accuracy, policies, and procedures to ensure you are running an efficient and hopefully liability-free operation.

There are many reasons to perform medical audits:

There are many reasons to perform medical audits:

o determine outliers before large payers find them in their claims software and request an internal audit be done.

To protect against fraudulent claims and billing activity

To reveal whether there is variation from national averages due to inappropriate coding, insufficient documentation, or lost revenue.

To help identify and correct problem areas before insurance or government payers challenge inappropriate coding

To help prevent governmental investigational auditors like recovery audit contractors (RACs) or zone program integrity contractors (ZPICs) from knocking at your door

To remedy undercoding, bad unbundling habits, and code overuse and to bill appropriately for documented procedures

To identify reimbursement deficiencies and opportunities for appropriate reimbursement.

To stop the use of outdated or incorrect codes for procedures

To verify ICD-10-CM and electronic health record (EHR) meaningful use readiness

Superbill Preparation

 

Important things to understand about superbills:

  1. A superbill is a form used by medical practitioners and clinicians so they can quickly complete and submit the procedure(s) and diagnosis(s) for a patient visit for reimbursement. It is generally customized for a provider office and contains patient information, the most common CPT (procedure) and ICD (diagnostic) codes used by that office, and a section for items such as follow-up appointments, copays, and the provider’s signature.
  2. Blue Cross Blue Shield Association started with a model superbill created by the American Academy of Family Practitioner’s practice management journal, Family Practice Management (FPM). The back of the superbill shows 164 ICD-9 diagnosis codes identified by FPM as being those most commonly used by family physicians.
  3. About half of the 164 ICD-9 codes on the superbill are general codes such as “unspecified” or “not otherwise specified.” These general codes exist so that all information encountered in a medical record can be assigned a code. While they lack the specificity necessary to infer diagnosis details, they are often used on superbills due to space limitations. Continuing their use in ICD-10 will only further prevent realization of the code set’s increased granularity.
  • CMS has published “Generalized Equivalency Mappings” or “crosswalks” that relate every ICD-9 code to one or more ICD-10 codes. We used these crosswalks to convert each ICD-9 code on the superbill to its equivalent ICD-10 code or codes.
  • In some cases the CMS crosswalks were incomplete or possibly inaccurate, and conversion to ICD-10 actually produced far less clinical detail than had been provided by the original ICD-9 code. In these few instances we tried to provide an equivalent mapping, while still using more general ICD-10 codes as is typical with superbills. For example:
    • The AAFP superbill includes the ICD-9 codes for “845.00 Sprained/strained ankle, unspecified”. The CMS crosswalk maps this to two codes: 1) “S93.409A Sprain of unspecified ligament of unspecified ankle, initial encounter,” and 2) “S93.409D Sprain of unspecified ligament of unspecified ankle, subsequent encounter.”However, this is incomplete because it does not include a code for a strained ankle. Therefore, we added 1) “S96.919A Strain of unspecified muscle and tendon at ankle and foot level, unspecified side, initial encounter;” and 2) “S96.919D Strain of unspecified muscle and tendon at ankle and foot level, unspecified side, subsequent encounter.”
    • The AAFP superbill includes the ICD-9 codes for “919.0 Abrasion, unspecified”; “924.9 Contusions, unspecified”; and “919.4 Insect bite”. The CMS crosswalk simply maps these to either of two catch-all ICD-10 codes, “T07 Unspecified multiple injuries” or “T14.90 Unspecified injury of unspecified body region”.Such general diagnosis codes submitted by a provider would be insufficient to determine the medical necessity of a procedure. We therefore listed the most residual ICD-10 codes available for each injury type*, e.g. “S90.519A Abrasion, unspecified ankle; Initial encounter”.

Reach Us

Akurate Management Solutions,
19C Trolley Square,
Wilmington, DE 19806

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