Our Customers
We serve the leaders in healthcare industry with strategy driven RCM solutions.
QWay Healthcare is a leading revenue cycle service provider that serves over 50 states in USA and has been the industry player from last 12 years since its inception in 2007. We are driven by strategic framework and provide value added solutions for streamlining the revenue blockages in your workflow.
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Guidance and Support for Emerging HealthTech Ventures
Our services cater to the unique needs of HealthTech companies and startups. We support organizations that are just getting started or navigating the healthcare industry for the first time. Whether you’re building from the ground up or seeking guidance through unfamiliar territory, we help establish operational workflows, ensure compliance, and coordinate revenue processes to get your organization up and running smoothly.
Our Commitment to You
We are a one stop RCM service provider. Our comprehensive services cover all touchpoints, eliminating the need to seek out multiple vendors for different solutions. Our team of experienced professionals integrates with your practice, acting as an extension of your operations to streamline your revenue cycle and elevate your overall experience.
Front-end services
- Insurance verification: Our team is well-versed in the protocols, requirements, and nuances of all major insurers and payers. We ensure accurate and timely verification of eligibility, coverage, and authorization, guaranteeing that your practice is positioned to get paid promptly and correctly.
- Demographic verification: We manage the full scope of your front-end demographic checks, meticulously verifying critical demographic details such as Social Security number, name, age, and gender. Ensuring the details aligned with existing records to ensure consistency and accuracy across systems.
Mid-Cycle services
- Clinical documentation: Accurate and complete documentation is the foundation of claim authenticity. Our team actively follows up to ensure all records are up to date and fully compliant with ICD and CMS guidelines, setting the stage for faster, smoother claim approvals.
- Charge entry: Assigning the correct charges based on the appropriate fee schedule is essential to ensure your practice receives the full reimbursement it deserves. Our team carefully captures all necessary information including date of service, provider and facility details, diagnosis and CPT codes, modifiers, units, and any required authorizations to support clean claims and prompt payments.
- Coding: We deliver accurate, guideline-compliant coding across inpatient, outpatient, emergency, and multi-specialty settings. Our certified coders work efficiently to minimize backlogs and ensure high-quality output, protecting your revenue while supporting a smooth billing workflow.
Back-end services
- Claim submission and payment posting: Each claim is coded with accurate charges and procedures, then undergoes an additional round of validation through claim scrubbing before submission to the insurance providers. We track and report all incoming payments and assign account receivable follow ups for claims requiring patient co pay in case of partial denials.
- Credit balance and refund processing: Credit balances occur when duplicate charges are generated due to overpayments by patients or payers for medical services. These overpayments can create compliance risks and expose providers to financial scrutiny. Our team carefully tracks and reimburses any duplicate payments to the appropriate party, ensuring accuracy and peace of mind.
- AR follow-up and denial management: Hospitals, physicians, and practices often face challenges such as staff shortages, ineffective write off policies, and unresolved claims, leading to millions of dollars stuck in aging receivables. Our specialist teams use a proven process to reduce aging accounts and recover outstanding balances. For denial management, we conduct in depth root cause analysis, identify recurring issues, and implement proactive measures to prevent future denials.
- Patient Collections and Reporting:
When patients receive services not covered by insurance, our administrative team initiates timely follow ups and ensures consistent communication until the balance is collected. We also deliver customized reports with data driven insights, outlining services provided, goals achieved, and clear recommendations to guide next steps.
Why Choose QWay Healthcare?
At QWay Healthcare, we are guided by three core principles: quality, quantity, and speed.
- Our trained and certified staff simplify the complexities of ever-evolving regulations and payer requirements.
- We emphasize scalability, productivity, and efficiency to deliver revenue cycle solutions tailored to your needs.
- Our strength lies in delivering fast turnaround times through streamlined processes and responsive support.
- Every step in our workflow undergoes strict quality audits to ensure accuracy and compliance at every level.
Talk to us to optimize your revenue cycle
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Technology Platforms
We have the expertise on the below systems and can work on any inhouse software that you use
