Service List
What We Do
Our motto is to make sure all the Healthcare Practitioners/Practices be of good service, by working along with them and assisting them in managing their revenue. North Quest has experienced and certified associates who are adding measurable value to our clients with their deep functional expertise in RCM consulting, credentialing, medical coding, billing and collections, and denial management services.
Revenue Cycle Management
North Quest Solutions is one of the global leading provider partners in technology-enabled healthcare solutions, that are designed to deliver end-to-end RCM solutions. We aim to bring financial strength to our client’s business which is directly correlated to timely billing and payment collections. Our clients enjoy a stress-free work environment and focus on providing the best medical practice to their patients.
Our associates are updated on the current and upcoming development in the RCM process, HIPAA Compliances, Regulations from other Medical governing bodies, and technological enhancements.
We Make sure that your organization has the necessary tools, process structure, and skills to advance the revenue cycle performance, as it is an essential phenomenon for the business’s financial performance. To drive a better revenue cycle performance our services are cost-effective, technology-driven, and single touch point.
Our Service Insights
Patient Demographic and Validation
The first step of Revenue Cycle Management is collecting necessary information from patients during the scheduling of appointments. The demographic includes insurance information, SSN, Date of Birth, address, etc. Validation of this information enhances the payment collection process. Our expertise helps in the process of advancement.
Credentialing and Enrolment
We assist providers with the payer enrollment process for accelerated claim process and payments. Our specialists constantly monitor the enrollment process and also work closely with payers and providers to ensure the timely and successful process of applications. We work diligently to identify and resolve potential administrative issues before they impact provider reimbursements. Our specialists are well exposed to work with CAQH and Pecos portals.
Insurance Eligibility
Verification of Insurance eligibility gives us the major information on coverage, Co-pay, primary care physician, authorization required, and In/Outpatient benefits. Our team of experts works on the eligibility and the benefits of the patients to avoid payment delays, claim rejections, etc.
Prior Authorization
Our specialist frees medical practitioners or facilities for handling the documentation of insurance pre-authorization. We initiate an insurance pre-authorization request, tracking approval all the way through providing the required information to appeal a denial by using a secured and HIPPA complied portal.
Medical Coding and Evaluation
We at Northern Quest offer a highly compatible Coding service with a team of experts with CPC, CCS, CCS P, and many more. Our Coding team identifies and addresses the physician, facility, or specialty-specific coding issues. Based on the audit findings our team drives clinical documentation improvement and helps the coding teamwork with physicians to improve coding accuracy to reduce denials/rejections.
Charge Entry and Validation
We ensure the documented service is converted into billable by initiating the patient demographics, and claim submission with proper insurance selection like primary, secondary or tertiary. The charges are captured manually or with the aid of software. Charge validation helps to reveal the complications with charge entry, provider charges, failure of reporting timely charges, coding patterns, unbilled services, and other reasons for claim denials. Our specialists are experienced in the Charge creation/validation process with a minimum of 5+ years and are well exposed to multiple specialties.
Account Receivable and Denial Management
Our has proven expertise in improvised cash flow, reducing A/R aging, and exponential revenue growth. Our Account receivable team follow-up with carriers to ensure timely reimbursements by checking information and documentation requirements, payment status, and claim resubmission with necessary corrections and/or additional documentation. We daily track the denied claims and push them back to insurance within 48hrs with proper resolution. Our multi-step approach for resolving the denials that are linked with faster payments and timely payment of the claims. Our Denial Management experts, analyze the reason for denial and work toward swift claim closure.
Reporting
Our reporting systems are unique and technology-driven with 100% HIPAA compliance. Our organizational structure eases clients to reach us directly (single POC). We follow periodic based reporting frequency, for work prioritization, areas for improvements, the requirement of skill enhancement and benchmark creations. We have separate reports for key performance indicators (KPI) Management Information Systems (MIS), Cost Efficiency reports, Revenue Analysis reports, etc. for the clients to understand their financial positions. All our reports are technology driven for better visualization.
Key Benefits
Improved cash flow through faster billing and payment posting turnaround time (TAT) and eliminating aging, delays, denials, and errors.
Increased savings by enabling the practice to deploy In House RCM Staff. Our resources are certified and experienced in various domains, EHRs, and Portals.
Improved Analytical insights through detailed, real-time reports and forecasts
Decreased claim denials through greater accuracy during the claim coding and submission process for complete and accurate reimbursement
Deliverables are audited to avoid errors, rejection, denials, and delays in the claim process.
More efficient resource allocation helps the practice to focus on its core business of delivering excellence
Well Secured system, all the login credentials are protected with the password management system.
We are 100% HIPAA compliant and follow all the regulations set by HIPPA.
Specialties we are experts in
- DME/HME Billing
- Behavioral Health/Mental Health
- Physician Billing
- Hospital Billing
- Laboratory Billing
- Pediatrics
- Anesthesia
- Ambulatory Surgery
- Emergency Medicine
- Neurology
- Physical Therapy
- Chiropractic Billing
- Obstetrics and Gynaecology
- Radiology
- Urology, and Many more…
Softwares/EHRs we are experts in
