The client came to us to help with credentialing because they needed to pull staff to help with the COVID-19 billing. Once we began talking to the client, we quickly identified that we would be able to help, and the volume was something that we had handled in the past. The client didn’t consider outsourcing the COVID-19 billing initially because of the volume, COVID billing being novel, and just trying to keep their heads above water.

We stepped into the clients’ shoes. The client was in distress and was not sure how they could manage the operations of a large COVID-19 testing center for the entire state while managing cash flow. As mentioned, moreover, the client was preparing for mass vaccinations. We were able to clear that backlog by using technology to completely automate charge pass-through from their LIS/EMR to transpose thousands of claims at a time from excel format into 837 files or electronic claims, our offshore team working 24 hours a day, 5 days a week, a dedicated onshore onboarding team, as well as, a focused onshore revenue cycle team with certified professional coders that specialize in coding and billing for COVID Vaccines, Testing and Telehealth Visits.

We uploaded, scrubbed, and submitted all claims to the HRSA Uninsured Program, government and commercial payers and began seeing payments within 1 week of going live. We quickly set up electronic fund transfers and electronic remittance advice for all insurance payments. We also provided coding and billing guidance to help capture additional revenue, performed e/m level audits on the telehealth visits, and provided the necessary bandwidth with staffing to turn a very stressful situation into a positive one.

Due to the COVID-19 guidelines, the volume and understanding of what had been completed in the past versus outstanding were critical components of our onboarding and implementation process for this client. We met with their team to fully grasp every drive-through clinic, telehealth option, and on-site testing. We completed various audits on previous billed claims and reviewed POS guidelines for telehealth visits. We provided our expertise on the previous billed claims as well as how to bill the outstanding claims correctly. Our team leveraged technology and systems to handle the backlog of 250,000+ and growing COVID-19 testing and telehealth claims. Onboarding and implementation along with our partnership and process mapping was the key to success for this client and allowed us to see payment within 1 week of going live.

You may think this took 2-3 months to onboard and complete, but with our team, we had everything live within 2 weeks of signing our contracts.