meraki workers compensation billing and collections

Workers Compensation Billing Services

Efficient and Effective Workers Compensation Billing and Collection Services

Meraki RCM Solutions, LLC specializes in providing comprehensive billing and recovery services for California State Workers' Compensation claims. When you choose us, you can expect outstanding financial results, backed by a highly experienced team with over 25 years of industry expertise. Our proven track record showcases our ability to achieve a remarkable 90% recovery rate within a 60-day period.

Unparalleled Expertise in the Healthcare Industry

As one of the leading performers in the healthcare industry, Meraki RCM Solutions, LLC leverages our extensive knowledge and experience to deliver exceptional results. Our success lies in collaborating closely with our clients, sharing our expertise, and ensuring optimal financial outcomes.

Specialized Services Beyond Workers Compensation

While our focus is on Workers' Compensation, we also specialize in personal injury and motor vehicle cases. We proactively communicate with all relevant parties involved, including insurance associates, to track the progress of claims settlement and payment. Our dedicated team excels in negotiating maximum settlements, ensuring our clients receive the best possible outcomes.

Streamlined Claims Resolution Process

At Meraki RCM Solutions, LLC, we possess the competence and resources to initiate and finalize the claims resolution process swiftly. Our specialized expertise in AME (Agreed Medical Evaluation) and QME (Qualified Medical Evaluation) billing ensures a 100% collection rate within 30 days of claim submission. We have established strong, long-lasting relationships with insurance associates, including adjusters, supervisors, and defense attorneys. These connections allow us to overcome obstacles and secure timely and optimal reimbursements for our clients. Additionally, we meticulously review all bills to minimize the likelihood of denials.

Efficient Workers Compensation Process at Meraki RCM Solutions, LLC

Workers Compensation Liability Verification: We proactively contact the employer or insurance carrier to verify the patient's entitled benefits, the assigned claims adjustment party, or relevant individuals. If a claim number is missing, we make every effort to obtain the correct claim number for seamless billing.

Authorization Assistance: Our team can assist medical providers in obtaining necessary authorizations for treatments or tests. We handle the complete request for authorization (RFA) process, submitting it to the insurer or employer on behalf of the medical provider. We persistently follow up until authorization is obtained. Rely on Meraki RCM Solutions for additional tests or treatments.

Efficient Electronic Claims Processing : Whether it's electronic or paper claims, you can trust us to handle the processing of all workers' compensation claims seamlessly. Our established relationships with multiple clearinghouses enable us to submit claims electronically, ensuring efficient and accurate processing.

Accurate Payment Posting and Reconciliation: Our software is designed to automate payment posting, facilitating efficient reconciliation. We carefully match and reconcile the Explanation of Benefits (EOBs) or Explanation of Reimbursement (EORs) received from insurance companies based on OMFS (Official Medical Fee Schedule) guidelines.

Thorough Second Bill Review / Independent Bill Review: We strictly adhere to the current Labor code rules and promptly appeal any underpaid cases within 72 hours of receipt from the insurance company. Our commitment to thoroughness ensures that our clients receive their rightful reimbursements.

Expert Litigation Support: When cases warrant it, we proactively litigate to collect unpaid balances in collaboration with defense/insurance adjustment parties. As an EDEX/EAMS E-filer, we handle electronic lien filing, DOR (Declaration of Readiness) filing, and Appeal for Benefits.

Hearing Representation: We provide hearing representation services throughout the Southern California region. Our skilled representatives are available at any Workers' Compensation Appeals Board (WCAB) in the area to ensure your interests are well-represented.

À-La-Carte Services

Medical Coding:

We meticulously verify and validate documents, forwarding them to branches for review to ensure completeness, quality, and readability. Our experienced team provides modifier, diagnosis, and procedure codes based on client descriptions and guidelines.

Demographic/Charge Entry:

Our highly qualified and knowledgeable billing professionals, along with advanced technology, minimize errors and expedite the claim settlement process. Trust us forcomprehensive solutions that integrate advanced technology with expert billing professionals. Our services include patient registration, timely record updating, multi-specialty charge entry by experienced billing professionals, and thorough claim review to minimize denials and underpayments.

Pre-Certification / Pre-Authorization:

Obtaining authorization from insurance carriers is crucial for timely and accurate claim reimbursement. Our team assists in verifying insurance coverage and submitting requests to payers, providing detailed information about the patient's diagnostics and treatment plan. This integral step in revenue cycle management ensures a smooth reimbursement process.

Insurance Verification:

Accurate insurance verification plays a vital role in reducing billing denials and payment delays. Our team utilizes various methods, including direct communication with the patient's insurance company and online verification, to ensure comprehensive insurance coverage. We document this information in the patient's chart to prevent billing issues in the future.

AR Follow-up and Claim Status Updates:

Our Accounts Receivable Analytics service enhances client payments by optimizing the cash-flow cycle and reducing days in accounts receivable. We leverage advanced technology and highly experienced billing professionals to streamline payment follow-up, effectively manage denials, facilitate claims resubmission, and provide in-depth reporting.

Payment Posting:

With our Cash Post Solution, we guarantee accurate posting of all client payments within one business day. Our billing professionals meticulously post payments from EOBs, charge slips, and other documentation. We support payer billing, streamline denial management, process timely write-offs and adjustments, verify all payments posted, and minimize errors for effortless reconciliation. Experience up to 40% cost savings compared to your existing processes.

Tailored Solutions for Your Practice :

Contact us for more information on how we can customize our services to meet the specific needs of your practice. At Meraki RCM Solutions, LLC, we are committed to providing efficient, effective, and personalized workers compensation billing solutions that optimize your financial outcomes.

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