Our Top 7 Specialties in Revenue Cycle Management
Insurance Verification
and Pre-authorization
Before the patient’s appointment, the healthcare provider checks their insurance to confirm eligibility, coverage benefits, and any pre-authorization needs. This ensures proper billing and may require pre-authorization for specific services.
Clinical
Documentation
and Coding
Healthcare providers use coding systems like ICD-10-CM and CPT/HCPCS to document services rendered during patient encounters, crucial for accurate reimbursement.
Payment Posting
Upon receiving payments or Explanation of Benefits (EOB) from insurers, healthcare providers update patient accounts, ensuring accurate financial records.
Denial Management
and Appeals
Healthcare organizations investigate denied or underpaid claims and may appeal with additional documentation. Effective and timely denial management is crucial for maximizing revenue.
Patient Billing
and Follow-up
Healthcare organizations generate patient statements for remaining balances after insurance payments and communicate payment options and financial assistance. Follow-up efforts include phone calls, emails, or letters to encourage payment.
Payment
Reconciliation and
Reporting
Healthcare organizations reconcile received payments with expected reimbursements and generate financial reports to track revenue performance, accounts receivable aging, and key performance indicators (KPIs).
Who we are
At Gold Consulting, we are leaders in billing and revenue cycle management for healthcare providers.
With a commitment to excellence and innovation, we specialize in streamlining medical billing processes and optimizing revenue cycles.
Our Services
Gold Consulting provides comprehensive revenue cycle management for medical billing. Our services cover every stage of the revenue cycle, from initial coding, chart entry to prompt payment posting, diligent accounts receivable (AR) follow-up, strategic appeals management, and comprehensive financial analysis and reporting. Our expertise helps healthcare providers optimize revenue, minimize denials, and improve financial performance and patient satisfaction.
Our team of professional negotiators is equipped with proven processes, proprietary data, and years of negotiation experience to ensure you receive the maximum reimbursement possible. We simplify the challenges of negotiating with third-party payers hired by insurance companies, who often seek to minimize payouts. We directly handle negotiations with third parties, guaranteeing that your out-of-network claims are paid directly to you. By entrusting us with your negotiations, you can be confident that we are dedicated to securing your full reimbursement.
Benefits of Outsourcing Revenue Cycle Management
Cost savings on staff training and management.
Streamlined workflow and organization.
Accelerated cash flow and quicker claims payment.
Continuous monitoring of the revenue cycle’s every aspect.
Access to specialized expertise without hiring.
Reduction in billing errors and claim denials.
Improved patient satisfaction through faster billing resolution.
Compliance assurance with evolving regulations.
Enhanced focus on core clinical activities.
