Our Healthcare & Billing Process

At Suntel Global we bring together expertise, technology, and business processes to provide innovative, high-value business-critical solutions to our healthcare customers. We help our healthcare customers become very effective and efficient, enhance their innovative and competitive edge, and help them in increasing their top-line and bottom-line.

Provider Credentialing
  • One of the first steps in the insurance billing services for doctor's offices is making sure the provider has been approved by the insurance carrier.
  • Simplify the process by submitting and tracking provider credentialing applications based on insurance plan requirements.
  • Follow-up with insurance payers regularly to make sure the providers are enrolled in-network when enrollment is open.
Eligibility and Benefits Verification
  • Verifying a patient’s insurance eligibility and benefits is another way we implement insurance billing services for doctor's offices.
  • Verifying that insurance data is correct by confirming the insurance plan policy effective and term dates.
  • Obtaining prior authorization for specific services, if needed.
  • Verifying the patient’s out-of-pocket costs, such as co-pays, co-insurance and deductibles, as well as verifying co-pays for exam and medical procedures.
  • Authorizing benefits and confirming medical plan coverage for exams and medical procedures.
Charge Entry
  • Charge entry is one of the most important features of the medical billing cycle—it’s where the claims are created. We understand the importance of accurate charge entry.
  • Collect maximum reimbursements.
  • Decrease payment denials.
  • Increase profitability.
  • Improve productivity.
Medical Coding
  • Our certified coders have extensive experience in medical billing and coding. Coders are well versed in diagnosis and procedure coding, billing with code modifiers, electronic data interchange (EDI) processes, industry standards, and maintaining 100% HIPAA compliance.
  • Billing the best way possible, adhering to strict state-specific coding and audit guidelines.
  • Evaluating medical documents and physician notes to ensure claims are not under or over-coded.
  • Reviewing previous denials that may occur due to incorrect coding, to help lower your AR even more.
Claims Submission
  • We know the ins and outs of your payers best. We’ll make sure your claims are clean and free from errors before we submit them—delivering a consistent and positive cash flow for your practice.
  • Once we file claims electronically, our clients typically receive insurance payments in less than two weeks instead of the 3 to 4 weeks that top commercial payers take.
  • We submit vision insurance claims through portals.
  • For those payers who require paper submissions, we’ll take care of submitting paper claims.
Clearinghouse and Payer Rejections
  • We track all claims we submit electronically through clearinghouses and ensure that insurance payers accept the claims. If we notice a rejection, our medical billing consultants promptly fix the errors to ensure timely insurance receivables.
Payment Posting
  • When you delay posting payments, you keep your AR artificially high. By moving the balance to secondary insurance, you bill much quicker and improve cash flow.
  • We post insurance payments that come in through Electronic Remittance Advice (ERA) and standard paper Explanation of Benefits (EOB) within 24-48 hours directly into your practice management system, so you have accurate and up-to-date accounts.
Secondary Claims Filing
  • If a patient has secondary insurance, you can run into timely filing denials. Many payers require you to bill a secondary carrier within a specific period, after you receive the primary payment. We’ll keep those remits posted and process claims daily.
Denial Management
  • Researching unpaid or denied claims is a time-consuming process. We analyze all unpaid claims and EOBs and take the necessary steps to correct and reprocess rejected claims to recover the maximum payment possible.
  • Accounts Receivable (AR) Cleanup & Insurance Follow-up.
  • You have a team of experts focusing on your AR cleanup daily. Our Suntel Global billing consultants take care of:
    • Reviewing AR and aging claims to see why open balances are still outstanding.
    • Analyzing unpaid claims then take the necessary steps to recover the amount due.
    • Helping you reduce the number of hours you spend on the phone with insurance companies, so you can see more patients and increase revenue.
    • Verifying receipt of claims with insurance companies then entering them into your practice management system, making your AR cleaner.
Claims Audits
  • Avoid delays in reimbursements with claim audits. We make sure your insurance claims are clean and free from errors. We review accounts receivable aging claims daily to see why open balances are still outstanding. We believe that preventing those rejections in the first place is the best way to expedite revenue recognition.
Patient Statements
  • Having a difficult time keeping up with printing and mailing statements? We can help reduce expenses, boost your revenue, and eliminate the time-consuming task of in-house printing and mailing.
  • We print and mail patient statements for your practice through our HIPAA-compliant print and mail service partner. Statements are typically mailed within 24 hours (during normal business hours) upon receipt of insurance payments.
  • Or, we can print your patient statements to an assigned printer in your office, so you can mail the statement to the patient.
Quality and HIPAA-Compliancy Reviews
  • We take patient health information (PHI) security and privacy seriously by:
    • Continuously training and monitoring our medical billing consultants to make sure we are complying with current protected health information (PHI) and HIPAA rules.
    • Continuously training and monitoring our medical billing consultants to make sure we are complying with current protected health information (PHI) and HIPAA rules.
    • Complying with document and workstation security, email security, fax security, data security, document disposal and destruction.
Business Analytics
  • Our comprehensive reports analyze the activity and the work completed for your practice. You gain insights into business strategies that help you move your medical practice forward—growing top-line revenue for a healthier bottom line.

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