W.C. Billing & Collection
Sammy Health Care Solutions specializes in California State Workers Compensation claim billing and recovery. Our average recovery rate is 85-90% of the amount that is recoverable within 60 days of the bills submission.
Sammy Healthcare Solutions is one of the industry's top performers, delivering you outstanding financial results, fully utilizing the knowledge, experience and success of our 10+ years of experience people on board!
Workers Compensation Process at Sammy Healthcare Solutions
1. Workers Compensation Liability Verification: We call the employer/insurance carrier to verify the patient's benefits and the assigned Claims Adjusters. All attempts will be made to obtain the proper claim number for billing purposes, if the claim number is not on file.
2. Authorization: Sammy Healthcare Solutions can assist you by obtaining authorization for treatment or testing. We can complete the request for authorization (RFA) on behalf of our medical providers and submit it to insurance/employers, and we will make every effort to obtain authorization from/for the physician and follow up until it is obtained. Sammy Healthcare Solutions will obtain authorization for additional tests or treatments requested.
3. Payment Posting/Payment Reconciling: We match all the EOBs/EORS received from insurance company and reconcile the payment as per the OMFS, as well our software has the capability to store and automate the payment posting.
4. Second Bill Review / Independent Bill Review: As per current Labor Code rules, we follow strict Second Bill Review guidelines and appeal each and all the EOB for underpaid cases within 72 hours of receipt from insurance.
5. Litigation: We Litigate cases based on the merit and aggressively work with the defense/Insurance adjuster to collect the outstanding balances. We are an EDEX/EAMS E-filer and electronically do Lien Filing, DOR Filing, Petitions for Benefits.
6. Hearing Representation: We serve each and every WC board , we also do PI and Medicare in California region and have hearing reps available for representation at any Workers' Compensation Appeals Board (WCAB) in the area.
Offer Services
➤ Medical Coding:
⇒ Our teams verify and validate the documents, split them into batches and review them for completeness, quality and readability.
⇒ Diagnosis, Procedure Codes and modifiers are assigned as per client descriptions and guidelines. Modification of certain codes may be made as per carrier requirement (e.g. certain insurance carriers require ASA code).
➤ Demographic/Charge Entry: Our experienced billing professionals can get the claims sent to payers faster, with fewer errors and at lower costs. A completely seamless solution that minimizes data-entry while utilizing their guidelines and billing software.. Through the creative combination of advanced technology with qualified and knowledgeable billing professionals.
⇒ Patient Registration
⇒ Multi-specialty charge entry by our experienced billing professionals
⇒ Scrubbing of all claims before submission for fewer denials and underpayments
⇒ Save up to 40% as compared to your existing costs
⇒ Complete HIPAA Compliant process and remote access solution keeps data in your control
⇒ Rapid and seamless transition to MERAKI RCM SOLUTIONS's Operations Centers in 30 days or less
➤ Pre-Certification / Pre-Authorization: Sammy Healthcare Solutions offers a much needed service for insurance authorization.
⇒ Submit Authorization Requests for All Insurance Carriers
⇒ Assigned On-Demand Specialist
➤ Insurance Verification: We can contact carrier and verify your patients' Insurance coverage and benefits before the patient actually visits the Doctor's office.
➤ AR Follow up, Claim Status Updates: Sammy Healthcare Solutions's Accounts Receivable Analytics is a follow-up service that gets our clients paid more, faster, and at a lower cost, through the creative combination of advanced technology qualified and experienced billing professionals, we can improve cash-flow and reduce days in A/R ensuring that our clients get paid more, faster and at a much lower cost to you.
Key Highlights
⇒ Receivable Analysis
⇒ Low per claim processing fee
⇒ Payer Follow-up
⇒ Denials Management
⇒ Re submission of Claims / Secondary Claims Submission
➤ Payment Posting: Our Cash Post Solution ensures that all our client payments are posted accurately usually within 24 hour . .
⇒ Experienced billing experts post payments from EOBs, Charge Slips and other documentation
⇒ Secondary payer billing
⇒ Management and posting of denials
⇒ Processing write-offs and adjustments
⇒ Correspondence processing
⇒ Verification of all payments posted to reduce errors and ease reconciliation
⇒ Save up to 40% as compared to your existing costs.
Reach out to us for more information on how we can tailor the solution for your practice
Our Solutions
The answer is to outsource your medical billing to the workers’ comp billing experts:
⇒ Our expert teams, one for each segment of the process, will increase your income and reduce time to payment
⇒ Our dedicated legal team has years of expertise and experience with workers’ compensation cases and keeps up to date on the frequent changes in workers’ comp legislation.
⇒ We are a billing company who does collections, not a collections company that does billing. Our focus is on coding accuracy and timely prevention.
⇒ Our internal processes are under constant review and improvement. Our goal? Excellence and continued market leadership in the medical billing and collections space.
Unlike our competitors, Sammy healthcare provides medical billing ,coding, transcription paired with collections (Specialize in WC LIEN COLLECTIONS) in the most complete Revenue Cycle Management solution available to health care providers of various sizes and specialties. This is what makes us the leading workers’ compensation billing and collection company in JAIPUR (INDIA). Call us at (562) 452-3234 or use our contact form to change the medical billing equation in your favor.
We offer customized services at cost-effective rates as per our client's requirements. Our services span a variety of industry verticals and include value propositions for -
⇒ Non-core Business Process Support: From Receivable services to general accounting, denials, data entry, reporting etc., we provide exceptional services which take care of all your non-core work, thereby reducing business workload and increasing employee productivity
⇒ Core Business Process Support: Our professionals with their relevant experience and core competencies help to improve your processes - be it in Healthcare
Why Sammy Healthcare ?
We value your time & have the expertise, diligence and devotion you need in a medical Billing & Collections service!
All healthcare providers and practitioners desire to receive the best for their patients while ensuring that their service remains profitable and their bottom-line grows. A serious obstacle to this goal is an inefficient revenue cycle management system that leads to missed, inaccurate and deleted payments, hurting revenue growth. Sammy Healthcare enables healthcare organizations and companies to streamline and enhance their RCM efficiency through effective management of their billing and collections functions.
Various hospital billing departments, private medical practitioners and organizations who have partnered with Sammy Healthcare have always gained by availing the advantages of a Healthcare BPO Company with unparalleled experience and expertise in the health care industry.
We possess the highest standard of ethics that you would probably see in a medical billing company with absolute focus on the individual needs of each and every client, irrespective of specialty or size of the business. By combining an extremely qualified and professional team, state-of-the-art technology and commendable and vast experience we created Altos. We have consistently satisfied clients in California with our modernized clinical documentation methodologies.
We offering;
⇒ A professional yet considerate attitude
⇒ New and innovative ideas that meet the latest industry demands
⇒ Fully equipped with all the necessary guidelines, current industry laws and regulations pertaining to insurance coverage, recovery of debts from patients etc
⇒ Prevent costly delays & boost financial performance with dramatic improvement in business
⇒ Use of advanced coding and billing software, analysis tools and Internet tools
⇒ 100% security and protection of confidential information
⇒ US Presence, including the ability to deliver patient services from a US location
⇒ US based Transition team
⇒ Affordable rates and willing to work on a success fee model. Our Prices linked to productivity
⇒ Ongoing support & 24/7 customer care