Medical Billing and Coding

Mapping out ICD and CPT

SwiftStax, a leading medical coding company, employs certified coders experienced in mapping CPT and ICD codes along with modifiers. Utilizing industry-standard resources and ongoing training, SwiftStax coders ensure accurate assignment of codes to medical procedures and diagnoses. With a commitment to efficiency and compliance, SwiftStax provides comprehensive coding solutions to healthcare providers, facilitating proper reimbursement and adherence to coding regulations.

Daily Monitoring Rejections & Denials

SwiftStax offers daily monitoring services for rejection and denials, ensuring swift resolution by resubmitting rejections within a 24-hour time cycle. Our dedicated team diligently tracks and analyzes rejected claims, promptly identifying the reasons for denial and taking corrective action. Leveraging efficient processes and advanced technologies, we streamline the resubmission process, maximizing reimbursement for our clients while minimizing revenue loss. With SwiftStax, healthcare providers can trust in proactive monitoring and rapid resolution of claim rejections and denials, optimizing their revenue cycle management.

Insurance Eligibility & Benefits Verification

SwiftStax implements a streamlined insurance eligibility and benefits verification process, seamlessly reflecting eligibility status and missing information directly to the front office. Through our efficient systems and trained personnel, we verify patient insurance coverage in real-time, promptly identifying any discrepancies or missing details. This information is then communicated directly to the front office staff, enabling them to address any issues proactively before patient appointments. With SwiftStax, healthcare providers can ensure smooth patient experiences, minimize billing errors, and optimize reimbursement by staying informed about insurance eligibility and benefits upfront.

Patient Registration & Demographic Entry

SwiftStax revolutionizes patient registration and demographic entry by integrating eligibility verification directly into the process, ensuring accurate data updates aligned with payer files to minimize rejections before submission. Our advanced systems seamlessly cross-reference patient information with payer databases during registration, automatically updating demographics based on real-time eligibility verification. By proactively addressing discrepancies or missing data upfront, SwiftStax significantly reduces the likelihood of rejections reaching the payer, streamlining revenue cycle management and enhancing reimbursement outcomes for healthcare providers.

Charge Entry

SwiftStax enhances charge entry processes by conducting thorough audits of each line item with certified coders. Our experienced coding professionals meticulously review all charges to ensure accuracy and compliance with coding guidelines and payer requirements. By leveraging their expertise, SwiftStax identifies and rectifies any discrepancies or potential coding errors before submission, minimizing the risk of claim denials and rejections. With our commitment to precision and quality assurance, healthcare providers can trust SwiftStax to optimize revenue capture and streamline their billing operations.

Electronic Claim Submission

SwiftStax facilitates electronic claim submission through various channels, including EDI batch submission, paper submission, and fax. Leveraging EDI technology, we streamline the process by electronically transmitting batches of claims directly to payers, ensuring efficiency and accuracy. Additionally, for providers preferring traditional methods, we offer seamless paper submission services, meticulously preparing and mailing claims on their behalf. Furthermore, SwiftStax accommodates fax submissions, promptly sending claim documents via fax for quick processing. Our versatile approach to electronic claim submission caters to the diverse needs and preferences of healthcare providers, optimizing reimbursement and reducing administrative burdens.

Clearing House Rejection Management

SwiftStax provides comprehensive clearinghouse rejection management services, meticulously monitoring each claim through the clearinghouse rejection report. Our dedicated team systematically reviews rejection reports to identify and address issues promptly. By analyzing rejection reasons and patterns, we implement corrective actions to resolve issues efficiently, such as correcting errors in claim data or addressing missing information. SwiftStax ensures that all rejected claims are resubmitted accurately and timely, minimizing revenue loss and optimizing reimbursement for healthcare providers. With our proactive approach to rejection management, clients can trust SwiftStax to streamline their revenue cycle and improve overall financial performance.

Payment Posting-Patient and Insurance

SwiftStax ensures meticulous payment posting for both patient and insurance payments, with a dedicated team of experienced cash posters monitoring each line item. Leveraging their expertise, our cash posters meticulously reconcile payments received from patients and insurance companies with corresponding claims and invoices. They accurately allocate payments to the appropriate accounts and verify that all payments are posted correctly in the billing system. By closely monitoring each line item, SwiftStax minimizes errors and discrepancies, optimizing revenue recognition and financial accuracy for healthcare providers. Our commitment to excellence in payment posting enables clients to maintain transparent financial records and effectively manage their revenue cycle.

Denial Management

SwiftStax excels in denial management by diligently monitoring every denial and implementing proactive measures to filter them out before submission, utilizing our billing rules to prevent future claim rejections. Our expert team meticulously analyzes denial reasons, identifying patterns and root causes to develop customized strategies for prevention. By leveraging advanced analytics and industry expertise, we refine billing processes and adjust claim submissions to align with payer requirements, minimizing the risk of denials. SwiftStax’s proactive approach to denial management ensures optimized revenue cycle performance for healthcare providers, reducing financial losses and improving reimbursement outcomes.

A/R Analysis

SwiftStax conducts thorough A/R (Accounts Receivable) analysis by monitoring daily denials with our experienced AR analysts. Our skilled analysts meticulously review denials, identifying trends, patterns, and underlying issues impacting revenue flow. By leveraging their expertise, they develop actionable insights and recommendations to address root causes of denials, improve billing processes, and optimize revenue cycle management. With SwiftStax’s proactive A/R analysis, healthcare providers can enhance cash flow, reduce aging A/R, and maximize financial performance.

A/R Follow Ups

SwiftStax ensures effective AR (Accounts Receivable) follow-ups by meticulously monitoring each and every line item with regular follow-ups. Our dedicated team conducts systematic reviews of outstanding accounts, identifying overdue payments and discrepancies. Leveraging our expertise, we implement strategic follow-up protocols tailored to each account, including phone calls, emails, and written correspondence, to expedite payment collection. By maintaining consistent communication with payers and patients, SwiftStax accelerates cash flow, reduces aging A/R, and maximizes revenue recovery for healthcare providers. Our proactive AR follow-up approach enhances financial stability and operational efficiency, allowing clients to focus on delivering quality patient care.

Paper Claims-Mail and Electronically

SwiftStax offers flexible options for submitting paper claims, utilizing both traditional mail and fax services. Our streamlined process ensures efficient handling of paper claims, whether they are mailed via postal services or transmitted electronically through fax machines. With SwiftStax, healthcare providers can choose the method that best suits their preferences and operational needs, ensuring timely submission and processing of claims. Our commitment to providing comprehensive billing solutions extends to accommodating various submission methods, optimizing reimbursement and minimizing administrative burdens for our clients.

Appeals and Grievances

SwiftStax takes full responsibility for managing appeals and grievances, ensuring thorough handling of every appeal and paper claim. Our dedicated team meticulously reviews each case, identifying grounds for appeal and crafting compelling arguments to support our clients’ claims. Leveraging our expertise in payer regulations and coding guidelines, we develop comprehensive appeal packages, including all necessary documentation and evidence, to maximize chances of success. SwiftStax manages the entire appeals process, from initial submission to follow-up communication, alleviating the administrative burden on healthcare providers and maximizing reimbursement outcomes. With our commitment to excellence in appeals management, clients can trust SwiftStax to advocate effectively on their behalf and achieve favorable resolutions.

Accounts Reconciliation

SwiftStax provides comprehensive accounts reconciliation services, offering end-of-day (EOD) billing and posting reconciliation reports for healthcare providers. These reports are readily available, enabling clients to track the volume of accounts posted accurately throughout the day. Our meticulous reconciliation process ensures that all billing and posting activities are accurately recorded and aligned with financial records. By offering transparent and detailed reconciliation reports, SwiftStax empowers healthcare providers to maintain accurate financial data, identify discrepancies, and ensure compliance with billing standards. With SwiftStax’s accounts reconciliation services, clients can trust in the integrity of their financial records and make informed decisions to optimize revenue cycle management.

Credentialing-Providers-EDI

SwiftStax takes responsibility for credentialing providers for EDI (Electronic Data Interchange) and ensures thorough follow-up throughout the credentialing process. Our dedicated team manages the entire credentialing process, from initial application submission to ongoing follow-up with payers and credentialing bodies. We meticulously track the progress of each credentialing application, proactively addressing any issues or delays that may arise. By managing credentialing follow-up effectively, SwiftStax helps healthcare providers ensure timely access to electronic billing and data exchange capabilities, streamlining administrative processes and optimizing revenue cycle management. With our expertise in credentialing and commitment to excellent service, clients can trust SwiftStax to facilitate seamless integration into EDI networks and maximize operational efficiency.