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.
Partner with us to take your patient care and revenue cycle to a next level with high-end healthcare solutions.
Increase the chances for your efficient billing and achieve faster reimbursements hassle-free.
Medical Billing Companies
Expand the possibilities of catering to medical billing requirements and streamline the new client acquisition with excellent team back up.
Accelerate your product development processes and sales, while our expert-led teams maximize the potential of your client’s RCM services.
What do we do if you choose us:
We provide end-to-end RCM services, which means you don’t have to go to different doors for different solutions; we provide all under one roof. We extend our professional services and trained teams to achieve a competitive advantage in your RCM journey.
Pre-Registration and Registration:
- Insurance verification: Patients' eligibility is determined by verifying insurance details with set procedures and standards of the insurance company and verifying the authenticity of their claims. The eligibility verification process will verify the information relative to the patient's screening process.
- Demographic verification: The main prerequisite for pre-registration is demographic verification. It involves checking the social security number and other demographic information like name, age, and sex. It is crucial to validate this data since it validates that the patient's information is accurate and identical to what is already on file. Correct implementation of this helps in hospitals' compliance with their legal obligations.
- Clinical documentation: Patient’s accurate details and documentation is a vital step to establish the authenticity of the claims to be submitted. It must be ensured that records are updated and compliant with ICD and CMS guidelines which will aid in better claim processing.
- Charge entry: Charge entry helps assign the actual charge to the medical procedures as per the appropriate fee schedule. This is a crucial area in the Medical Billing process, as it determines proper and adequate reimbursement for the claims billed to the insurance. It captures the DOS, provider information, POS, facility information, diagnosis codes, CPT Codes, units, modifiers, prior authorization number, admission date, injury date, and referring provider information.
- Coding: Coding in accordance with ICD and CMS has to be done for effective billing. Our coding experts encompass inpatient, outpatient, emergency, multi-specialty, and other domains. We deliver accurate coding outputs with a keen focus on minimizing backlogs, thus saving from the disruptive workflow.
- Claim submission and payment posting: Once the charge entry and coding procedures have been completed, claims are scrubbed and submitted to the insurance providers. To track incoming payments, payment posting plays a role, and also, when part payments are involved, patients are required to co-pay the costs. Practices of all sizes can recognize problems and take proactive measures to redress them when they are effectively organized and streamlined.
- Credit balance and refund processing: Credit balances occur due to overpayment by the patients or the payers as the extra charges are rendered for the medical services provided. Certain compliance risks are emerging due to credit balances that can land the healthcare provider in significant difficulty, indirectly leading to reduced patient flow and team productivity, among other significant effects on financial publicity.
- AR follow-up and denial management: A/R holds a significant position in a healthy revenue cycle of an organization as often hospitals, doctors, and medical practices frequently find themselves in sticky situations. The reasons were a lack of staff to follow up, ineffective write-off policies, ineffective closures, etc., resulting in a backlog of insurance claims amounting to millions of dollars. We follow a robust process to reduce the quantity of aging A/R buckets with our specialist teams. On the other hand, to carry out effective denial management practices, our excellent teams perform root cause analysis of the denials, identify the backlogs and take measures to prevent the denial problems from re-occurrence.
- Patient Collections and Reporting: If the services not covered under the insurance cover are availed, the administrative staff has to send a separate bill for the services to the patient. A regular follow-up has to be done until the collections are realized. Customized reports with data-driven strategies to be followed are sent to the client enlisting the services rendered with highlighted objectives that are achieved and the subsequent course of action to be followed.
Why Choose QWay Healthcare?
- We work with Quality, Quantity, and Quick processes, our three standards that are imperative for a billing company to function.
- Our trained and certified staff makes tackling ever-changing procedures and rules easier.
- We rely on scalability, productivity, and efficiency to deliver optimized RCM solutions according to your needs.
- We bank on our strength of giving quick turnaround time with our prompt processes and swift responses.
- We depend on quality assurance, and every process strictly undergoes quality audits for the accurate deliverable.
Got a question?
Talk to us to optimize your revenue cycle!
Dial our numbers and get an instant response to your queries, our sales support agents are available Mon-Fri, 8:00 AM to 5:00 PM EST.