The health sector in the United States is regulated and controlled by a number of government organizations and authorities. The coding and billing of medical claims filed by healthcare providers in order to get compensation from insurance companies is one such sector. The encoding and processing of all claims for various health services delivered are subject to complex rules. MedTurtle Healthcare Solutions recognizes the value of medical billing and coding in a practice's financial health. We have a staff of medical billing and coding experts who are very passionate about what they do. We assist our clients in increasing their efficiency by efficiently managing complex billing concerns. We employ only senior billers who are billing specialists in all CPT, ICD-10, HCPCS, HEDIS, and OIG codes. Our billers are able to see through the data to advise you to the fullest on your billing practices. Furthermore, we employ a variety of platforms that dynamically integrate the demands of physicians, patients, and payers in order to maximize patient care efficiency. At MedTurtle Healthcare Solutions, we optimize your revenue cycle allowing you to focus on excellent patient care.
Fast and Easy Sign-up Process
MedTurtle Healthcare Solutions has years of experience handling all types of transitions, regardless of your organization's specialization, size, location, or experience. The process of enrollment, documentation, onboarding, installation, and training will be straightforward, quick, and cost-effective.
Top Quality Customer Service
MedTurtle Healthcare Solutions has years of experience handling all types of transitions, regardless of your organization's specialization, size, location, or experience. The process of enrollment, documentation, onboarding, installation, and training will be straightforward, quick, and cost-effective.
Higher Return on Investment
Your revenue management becomes significantly more efficient as a result of our focus on avoiding errors in the claims process and achieving a high success rate of filing clean claims. We not only shorten your days in AR, but we also ensure that claim denials are kept to a minimum. Furthermore, by outsourcing the billing department to us, you will avoid the need to hire dedicated billing professionals. Overall we offer a far better return on your investment. On average our clients experience a 15-20% increase in collections in the first 90 days of working with MedTurtle. Compared to in-house billing, we have been able to deliver our clients a 30-40% increase in their collections. We are excellent at what we do, and it would be our pleasure to bring that excellence to your business.
Faster Claim Submission
Having a lot of receivables but little cash on hand isn't going to help your organization. For its coders, MedTurtle Healthcare Solutions uses a technologically advanced online medical billing and coding system. This method makes it simple to enter all of the necessary information and expedites the submission of medical claims. Furthermore, we ensure that the claims are properly followed up on when they are submitted.
First Pass Claim Acceptance
Our monthly first pass claim acceptance rate across all our customers averages 98%, which is 3% higher than the industry average!
Monthly Denials
Our monthly denial rate is less than 5% across all our customers which is better than the industry average!
Electronic Submissions
Electronic submission for rapid fulfillment of our customer’s accounts receivables. Resolves claims-related issues/denials faster than paper submissions.
Clean Submission - Claim Scrubbing
We use state-of-the-art A.I. to prepare and scrub every claim, fixing most of billing errors BEFORE submission.
Comprehensive Reporting
We provide daily, weekly, monthly, quarterly & yearly practice analysis reports to our clients, allowing you to stay on top of your business.
Fee Schedule Review / Analysis
We regularly review procedure fee plans to avoid any financial loss to our clients because of under billing and non-payable codes.
Accounts Receivable Review
We will audit your current billing workflow to find errors and correct them. We can go back into your Aging AR and recover your lost revenue. We provide this service free of charge to all of our customers as a regular part of our contract.
Denial Coding Audit
Our certified coders audit claims on a daily basis and suggest correct codes. In case of invalid coding we notify our clients immediately.
Patient Calls
We have a dedicated team for answering patient calls, offering the highest-quality customer service.
AR Follow-Up
We have billing professionals with a specialized skill-set for AR follow-up. We make sure that client's AR is below MGMA standard in all buckets.
Monthly/Annual Analysis
Our periodic reporting bundle will enable you in making more informed decisions for business improvements.
Out-of-Network Negotiations
Key to out-of-network billing is successful negotiations with insurances. We negotiate on client's behalf for maximum reimbursement.
Out-of-Network Appeals
With our expert appeals team, we make sure that our clients are fully reimbursed. Our appeals framework is specially designed for out-of-network and Lab providers.
Check Forwarding Request
After claim submission we proactively send check forwarding request to out-of-network patients so that they may send the check to the client as soon as they receive it from insurance.
Promised Money Details
We communicate with insurance companies and keep our out-of-network clients informed about promised money details.
Out-of-Network Recoup Appeals
We send recoup appeals to recover the refund amount, with a very high success rate.
Electronic Remittance Advice (ERA)
For staying on top of business we provide daily, weekly, monthly, quarterly & yearly practice analysis reports to our clients.
Electronic Funds Transfer (EFT)
EFT is a system of transferring money from one insurances bank account directly to clients’ accounts without any paper money.
Revalidation
We will make sure that our clients never miss timely revalidation that can result in delayed payments.
Address Change
Any change in address or TIN – we will update with insurance companies.
Electronic Data Interchange (EDI) Format
EDI is the electronic interchange of claims’ information using a standardized format; a process which allows to send claims information to insurance companies electronically rather than with paper. It is very fast process to deliver the claims to payers.
Contract Rate Adjustment
As part of our basic credentialing services, we will go through the process of updating your information with your existing panels and submitting rate adjustment requests to keep your reimbursement rates at the most competitive levels.
HHS, OCR, and CMS are among the government agencies performing random but comprehensive audits to ensure HIPAA compliance.To avoid being punished, we recommend being prepared and having MedTurtle Compliance do a risk assessment for you ahead of time.Although the chances of being audited are slim, infractions of safety and risk can result in legal action or fines.The goal of these audits is to check for noncompliance with HIPAA privacy, security, and OMNIBUS requirements.Penalties for violations vary depending on the extent of negligence, ranging from $100 to $50,000 per infraction or each patient record, with a maximum penalty of $1.5 million per year.It's also possible that you'll be charged with a crime and sentenced to prison.There are two types of fines and charges: "Reasonable Cause" and "Willful Neglect."Reasonable Cause fines range from $100 to $50,000 per incident, with no jail time involved.Willful Neglect can cost anywhere from $10,000 to $50,000 per episode, and it can also lead to criminal charges.The following are the HIPAA violation categories and fines.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated that the Secretary of the United States Department of Health and Human Services (HHS) draft regulations to protect the privacy and security of specific health data. The HHS released the HIPAA Privacy Rule and the HIPAA Security Rule in order to meet this need.The Privacy Rule, also known as the Standards for Privacy of Individually Identifiable Health Information, establishes nationwide standards for the protection of certain types of health data. The Security Requirements for the Protection of Electronic Protected Health Information (the Security Rule) establishes a national set of security standards for safeguarding specific health information that is stored or transmitted electronically.The Security Rule puts the Privacy Rule into action by addressing the technical and non-technical measures that organizations known as "covered entities" must use to protect people' "Electronic Protected Health Information" (e-PHI).The Office for Civil Rights (OCR) of the Department of Health and Human Services is in charge of enforcing the Privacy and Security Rules through voluntary compliance programs and civil money penalties. Covered entities must have a detailed, documented Security Risk Analysis in place to protect Electronic Patient Health Information in order to pass an OCR audit.MedTurtle approaches this process with extreme caution, completing a security risk analysis in conjunction with providers in a timeframe that varies depending on the size of your practice.
Appointing a privacy and security officer to the service location
Creating policies and procedures in writing
Employee training for HIPAA compliance is included in the service package (uncapped)
Based on a complete module Assessment of the Risk
Plans for disaster recovery
Disposal logs for PHI
Security incident monitors and incident reporting guidelines
Technical Safeguards
Example
Access and audit controls for any software with ePHI (EHR, RCM), or access to prescriptions and other documentation containing PHI
Prevention of unauthorized destruction of PHI
Physical Safeguards
Example
Facility access control
Device and media controls
Administrative Safeguards
Example
Workforce access to PHI and security
Contingency plans
With each module covered, risk assessments are made taking into account:
Probability of possible breach
The severity of the possible breach
If you happen to receive an audit, we recommend contacting a professional.Many online tools are available that provide convenience – but also dangerous shortcuts. It's important to distinguish between having documentation and keeping good records.Auditors will be looking for quality rather than quantity, concentrating on paperwork and whether it provides the necessary information.
.png)
.png)
