Claims Processing
Guidant MSO offers a wide range of claims processing services to streamline the administrative functions of healthcare providers. These services are designed to ensure timely, accurate reimbursement and smooth operational workflows.
What We Offer
Claims Submissions
Guidant MSO manages the process of submitting claims to insurance companies or other payers. This includes both electronic and paper submissions, ensuring that claims are formatted correctly and include all necessary information, such as patient data, diagnosis codes, and procedure codes.
Status Monitoring
Our team tracks the status of submitted claims, ensuring they are processed in a timely manner. Guidant MSO keeps healthcare providers informed of any updates, rejections, or denials, and help resolve any issues related to claim processing, such as missing or incorrect information.
Payment Posting
We receive payments from payers and post them to the correct patient accounts. Guidant MSO reconciles payments with the claims submitted, ensuring that healthcare providers are paid the correct amount. This service includes identifying underpayments, overpayments, or discrepancies that may need to be addressed.
Claims Submissions
Guidant MSO manages the process of submitting claims to insurance companies or other payers. This includes both electronic and paper submissions, ensuring that claims are formatted correctly and include all necessary information, such as patient data, diagnosis codes, and procedure codes.
Appeals Management
In case a claim is denied, Guidant MSO manages the appeal process by submitting revised claims or providing additional documentation. We work to ensure that the healthcare provider's claims are reconsidered and reimbursed, often through resubmission or negotiation with payers.
Claims Adjudication
We are experts at reviewing submitted claims to determine their validity and accuracy. Guidant MSO verifies that the claims meet the payer's requirements and follow appropriate billing codes, ensuring that all necessary documentation (such as pre-authorization or medical necessity) is in place.
Eligibility Verification
Guidant MSO handles the verification of patient eligibility with insurance providers before services are rendered. This service ensures that patients' insurance plans are active, and the required benefits are available for the services being provided, reducing the risk of claim denials.
Valued Clients
