Loveland is a focused group of professionals interested generating maximum revenue for our provider clients in the minimum duration of processing possible.

This is as important to us as high levels of patient satisfaction. We work to ensure patients have a smooth hospital experience from the first consultation through admission to discharge through to completing all payment transactions.

Back End Services Include:

Medical coding

Charge entry

Denial management

Account receivable management

Payment posting and adjustment

Medical coding services:

Once records are sent to us, at the backend, this is the first step. We have certified coders who have a comprehensive list of standardized codes for services provided by providers. The team will enter correct codes for the services rendered and the audit team will verify that codes are correctly entered for the given services. Our team is updated regularly with the latest changes in codes and related legal changes. By making sure we enter correct codes for the services we can expect to generate maximum revenue without much hassles.

Charge entry:

Charge entry is the process of entering correct charges for the code(s) entered. Under billing is when the entered charge is lower for a certain code. Overbilling is when the entered charge is more than the one for the code. We regularly audit our software and services to ensure we don't make such errors which may lead to difficulty in receiving payments for provider services from the insurers. A load of hassles can be avoided by ensuring that correct charges are entered for the codes. With our team members' vast experience we take pride in the fact that we have had minimal errors in charge entry over the years. We have perfected this task over years of experience.

Denial management:

Usually, with proper documentation and ensuring correct steps are accurately performed, claims won’t be denied. When a claim is denied or part of it is denied, it’s usually because of wrong codes or wrong charges assigned or not getting proper prior authorization or any related documentation errors. When we receive a denial, the insurer usually sends a code for such denial. We usually are highly successful by sending error-free, clean claims. We can avoid a lot of hassle and extra time and effort consumed, by following standard procedures step by side accurately and send all documentation and get all needed authorization beforehand. However, in cases where a claim is denied or part thereof, we analyze it microscopically and correct any code or change entry errors, etc., to ensure denials are kept at a minimum and revenues maintained at the maximum levels.

Accounts receivables management:

Tracking the status of claims using regular communication such as email or phone calls etc., to check for AR bucket outstanding payments is a critical step in ensuring claims are reimbursed within reasonable or shortest time spans. We strive to keep AR ageing buckets to a minimum. The main focus is to generate maximum reimbursement within the minimum of timespan. AR team works with the Denial team to chart out ways and modes of ensuring denials are kept at a minimum and payments are obtained within the minimum of timespan. The analysis team works with other teams to train them on how to minimize denials and to obtain reimbursements within the shortest timespan.

Payment posting and adjustment:

The team will study all paper or electronic statements sent by the insurer to check for any claimed payments that remain unpaid or denied so as to correct any errors in our bills and documents sent to them to ensure full reimbursement.

The payments and adjustments presented in the EOB (Explanation of Benefits) sent by the insurer will be reviewed by us. We will get the most updated financial statement about a particular case. The payment posting team will send it to the denial management team who will further send it to the code entry team or the charge entry team to correct any errors that might have led to any denials.

If the statement lays out that nothing is denied and all billed services are correctly paid up, it will serve as a way to understand how to best complete formalities to ensure such complete reimbursements.