About Us
Our Goal

Medical Billing Services

Caliber RCM with its offices in TX and Bangalore, India, caters outsourcing services to healthcare providers in the US. Timely billing of all accounts is a key to any effective revenue cycle management and ensuring that all bills are submitted clean with the correct information is an underlying goal of Caliber RCM department. You can benefit from our expertise in any specialties. Our rates are extremely competitive, our service is second to none and we are committed to maximizing your income while simultaneously treating your accounts with utmost cautiousness and compassion.

We can help you significantly reduce payroll costs, accelerate revenue cycles, assure processing accuracy and regulatory compliance, and enhance your satisfaction and delight. Our highly efficient trained team, our use of technology and the ability of quick ramp-up, and rigid compliance processes will free you from the regular hassles of claims submission and help you concentrate on your core business-building capabilities which results in increased customer satisfaction.

Medical Biling Services:

Demographic and Charges Entry
Clearing House Rejection Handling
Correspondence and Denials Handling
Generating Patient Statements and
A/R Follow Up
Patients Follow up
Payment Posting

Our Goal

Patient Demographics Entry

The patient demographic entry is an important & key process as we need to capture the patient details accurately. Our experienced team of professionals can work from scanned images & process the demographic details of each patient.

The account number is generated for new patients, if the system doesn't generate it automatically. Then patient demographics, Insurance, Employment and sponsor details are entered.

Our Goal

Charge Entry

Charge Entry is the crucial part of Medical Billing process. After receiving the super bills from the Doctor's office, it gets passed through the coding & pre-coding department, and then comes to the charge-entry department. It is only here in this department; the claim/bill is actually created.

Our Charge Entry team looks-up the codes entered in the claim, and assign the relevant charges for those codes. This is also one of the key functions in Medical Billing as there should not be any up billing done by assigning an incorrect charge for the codes. Likewise, we enter all the relevant information needed, such as place of service, date of service, type of service, modifiers, units, value, referral, prior authorization, on bill comments etc. and create a claim ready for auditing, and then transmit to the insurance company.

Our Goal

Payment Posting

We carefully scrutinize each Explanation of Benefits (EOBs) from the insurance companies and adjust each account accordingly. We post all payments, calculate insurance write offs, coinsurance and deductibles.

Our expert patient and insurance payment posting team enters payments on a daily basis. We review each Explanation of Benefits very carefully to ensure each claim was processed properly, the insurance name, check number, total check value is cross verified with the check and EOB copies. Claims are frequently under paid by insurance companies and we are trained to evaluate payments for maximum reimbursement. Write offs, coinsurance and deductibles are calculated and allocated appropriately, and we bill patients immediately upon EOB posting. Once EOBs are posted, your claims are immediately turned over to our follow up team for pursuit.

Our Goal

Accounts Receivables

Accounts Receivables is the nerve center of any practice. Without efficient and effective means of AR working methodologies the collection for any practice becomes unstable. Analysis of denials and partial payments is done by our senior medical billing specialists. Payers, patients, providers, facilities and any other participants are called to follow-up on denied, underpaid, pending and any other improperly processed claims and the action is documented in the system. We call patients, if authorized by the provider, to obtain information needed for billing such as identification number and to update the Coordination of Benefits (COB) with their insurance companies. Secondary paper claims are processed and sent to the client office for submission.

All claims in the system are examined and priorities are set. First the claims which are close to their filing limits are processed and subsequently based on the age of the claim. Periodic follow-ups over phone, email, and/or online are done to get the status of each claim submitted to the insurance company.

We track the healthcare updates through Monthly Bulletins, Notices, Circulars, Denial EOB, EOB with Deductible and Co-insurance information, Billing Rule Modification, Procedure Changes, Diagnosis Changes, modifier changes, New Policies, Check Copies, etc. Based on the updates we implement the changes for billing and collection purposes.

Our Goal

Patient Eligibility And Benefits Verification Services

Caliber RCM provides patient eligibility verification and helps customers to improve collections, reduce denials and reduce AR days. The work flow includes:

Verifying all Primary and Secondary insurance coverage. (Insurance type, plan, member ID, Group number, coverage period, co pay, deductibles, authorization requirement, payer ID, other benefit details etc.)

Updating the billing system with eligibility and verification details.

If found patient not eligible inform physician office/hospital.

Our Goal

Old Accounts Receivables Services

Many healthcare service providers have accumulated or unresolved accounts receivables either due to lack of follow up or they do not want to follow up on low pay EOB's because they end up spending lot of money without much returns on the claims. At Caliber RCM, we analyze accounts receivables report provided by the client and determine the strategies to work & secure maximum reimbursement possible.