Eligibility and Benefit
Verification Services

Being a fundamental part of the billing process, insurance eligibility and benefit verification require thorough care and attention. Research shows that most claim denials or payment delays happen due to an incorrect understanding of insurance plan features.

Our experienced professionals who are fluent in the particulars of the healthcare industry, such verification tasks are performed in a precise and prompt manner.

    HIPPA Compliant

    Spectrum Healthcare Inc. provides all billing services under the compliance of HIPPA.

    Quick Turnaround

    Visible Turnaround of your practice within 24 Hours.

    Expert Certified Staff

    Each and every team member of Spectrum Healthcare Inc. is certified and well versed with all Dental Billing Practices.

    Lowest Denials

    Spectrum Healthcare Inc.’s Denial Rate has been Consistently less than 2% in the last 5 years for all clients across the United States.

    Advantages

    Advantages of Our Eligibility and Benefit Verification Services:

    • We maintain a consistent and accurate verification process to ensure there are no surprises.
    • The patient’s eligibility and benefits are subject to change. We keep the system routinely updated for the same.
    • We handle the follow-ups and information retrieval from the payor. This prevents claim denials and loss of revenue.
    • Up-to-date patient information in the system smoothens the treatment planning and promotes a better patient experience.
    • We keep a tab on procedure-specific coverage as well, to make the patient aware of any out-of-pocket costs if to be incurred.
    Working with Spectrum Healthcare Inc., you can be assured of an error-free insurance verification process. Witness increased patient satisfaction and revenue while minimizing any chances of claim rejections.

    Our Services

    Services we offer in complete Medical RCM

    Do you want to outsource your Medical RCM Services? Collaborate with Spectrum Healthcare Inc., a leading provider of MEdical RCM Services in the United States.

    Accounts Receivable and Accounts Payable (AR/AP) Process
    Medical Accounts Receivables Services

    Being a medical practice, you need a positive ledger to take a long leap. Spectrum Healthcare Inc. helps you in meeting cash flow goals by effectively taking care of Account Receivables when it comes to insurance claims. Our Account Receivables services assure you of the payments from the patient’s insurance in a shorter time.

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    Reason to outsource Credential Services - Astronehs
    Credentialing & Re-credentialing Services

    Credentialing & re-credentialing services are integral components of practice management. They review programs that verify and assure the current competence of the practitioner. This verification and validation of the skills as well as the license of the provider requires a lot of paperwork and can be quite confusing. Having dedicated in-house staff for this can be quite expensive and may hamper your productivity in the process. Spectrum Healthcare Inc. provides trustworthy, timely, and precise credentialing and re-credentialing services for providers.

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    Outsource Best Medical billing and Coding services - Astron EHS
    Medical Coding Services

    Enhance the percentage of clean claims, as well as reimbursement and data reporting. Speak with One of Our Professionals Now! Coding services that guarantee precision and the desired results. Join our community and you may start making savings right away!

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    What is Revenue Cycle Management
    Medical Revenue Cycle Management Services

    Smoother the administration, better the patient experience and revenue generation. Revenue Cycle is an end-to-end financial process that comprises multiple and complex tasks right from patient registration to payment posting. It is undoubtedly a critical operation that requires constant attention, industry expertise, and due diligence. If you fall short of trained individuals in your team or find it difficult to handle the mammoth paperwork and tasks, it is best to outsource to a leading and reputed revenue cycle management company – Spectrum Healthcare Inc.

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    What is Medical Fes Schedule Maintenance
    Medical Fee Schedule Maintenance Service

    A Fee Schedule Maintenance service is the list of negotiated amounts that the payor will pay to the providers for the rendered service. There are many types of fee schedules such as; Medicare, Medicaid, Commercial PPO, HMO, Employer Fee, Specialty Fee, etc. The structure and codes differ for each type. It is also no surprise that payers keep changing their allowable amounts many times during the year. It is tiresome to stay on top of these changes while focusing on the most important part of healthcare – the treatment.

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    Outsource Payment Posting Services for Dental Billing
    Medical Payment Posting Services

    One of the final and key processes in RCM service is Payment Posting Services and it is a service that optimizes the entire revenue cycle. The accuracy in payment posting services techniques makes sure any denials and delays can be handled swiftly. Once the claim is finalized it will be paid or denied along with an EOB. The EOB will have all necessary explanations for the payment or denial. Opting for Spectrum Healthcare Inc.’ payment posting services is the ideal solution to manage the time-sensitive and time-consuming task of payment posting services.

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    What is Revenue Cycle Management
    Dental Revenue Cycle Management Services

    Smoother the administration, better the patient experience and revenue generation. Revenue Cycle is an end-to-end financial process that comprises multiple and complex tasks right from patient registration to payment posting. It is undoubtedly a critical operation that requires constant attention, industry expertise, and due diligence. If you fall short of trained individuals in your team or find it difficult to handle the mammoth paperwork and tasks, it is best to outsource to a leading and reputed revenue cycle management company – Spectrum Healthcare Inc.

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    Medical Billing Denial management Services - Astron EHS
    Medical Denial Analysis Services

    By outsourcing medical billing denial analysis to Spectrum Healthcare Inc., businesses can effectively file insurance claims and obtain compensation. Our denial analysts understand healthcare denial management concerns and help organisations benefit from denial analysis.

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    21.00%

    Positive feedback

    From Doctors

    2+

    Experienced Clinics

    High Qualified

    321+

    Questions & Answers

    Your Questions

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    Our Document Indexing Services Include:

    • Patient Records.
    • Medical Charts.
    • Clinical History.
    • Various Reports.
    • ERA / ROB.
    • Insurance ID cards.
    • Provider Notes.
    • Insurance Bills and related information.
    With qualified staff managing such complex medical billing tasks, we assure you accuracy and timely delivery of results. Your patient document Indexing and data are in safe hands with our dedicated team working to ensure high standards of quality and service.

    Best Medical Payment Posting Solutions

    At Spectrum Healthcare Inc., one of the crucial activities that receives the utmost attention from our Operations management is payment posting in Medical billing. In order to reconcile the claim, the payments in lieu of claims that are received from the Payer and Patients are posted in the client’s dental billing system. To ensure that no payment is overlooked, e-care additionally performs electronic payment posting into the dental billing software and manually manages the exceptions (fallouts). The billing system or a document management system (DMS) both store the posted ERAs for further use.

    Revenue from production is slipping between the cracks

    Insurance Payment Posting: In order to pay a claim, all payers either provide an EOB (explanation of benefits) or an ERA (electronic remittance advice). In order to reconcile them, the Medical billing team posts these payments right away into the relevant patient accounts. Client-specific rules that specify the cut-off levels for adjustments, write-offs, refund rules, etc. are applied to the payment posting process.

    Benefits:

    Our Medical billing includes all aspects of submitting finished treatment to an insurance carrier for reimbursement in accordance with the patient’s insurance plan. This process begins with ensuring that the correct CDT codes are included on the claim and finishes with reimbursement from the insurance carrier.

    Users Question & Answer :

    Before a patient visits, a healthcare provider needs to confirm that the patient is eligible for the benefits they are receiving and that the patient meets the requirements for receiving those benefits.

    Make phone calls to insurance companies and use their official online insurance portals to double-check if you’re covered as a patient.

    Through the process of eligibility verification, medical practitioners are able to determine the status of a patient’s medical insurance coverage prior to the scheduled visit and appropriately report demographic information on insurance claims. A further advantage of giving priority to eligibility is that it encourages proactive patient collecting efforts and eliminates delays in payment.

    A simple mistake can cause a claim to be rejected or denied, so you need to make sure it is done right. A health insurance verification specialist, also called an insurance verifier, is a very important part of the health insurance system.

    The medical billing services provided by Spectrum Healthcare Inc. are excellent. Spectrum Healthcare Inc. medical billing services have been a fantastic fit for my little part-time private practise. Spectrum Healthcare Inc.’s medical billing service offered experienced advice and help in a very personal and timely manner.

    – Dr. Kelly S. Oggero ( Clutch )

    Mark, you’ve been a pleasure to work with. Thank you incredibly much. You “the team” have been a pleasure to work with; we overcame obstacles in the beginning, and the results are impressive. Everyone gives each other high fives.

    – Dr. Miller ( Goodfirms )

    Spectrum Healthcare Inc. stood out among the other dental billing insurances because there would be accountability. We had one point of contact for all claims and follow-ups, and we knew that person would handle everything for us.

    – Dr. Savio ( Google )

    Every day, they’re there, allowing our front desk and front management to do what they do best. And Spectrum Healthcare Inc. excels at what it does.

    – Dr. Scott Dudley ( Clutch )

    Spectrum Healthcare Inc. is a well-known group of medical billing and medical coding. Any project you work on with the Spectrum Healthcare Inc. Team results in elegant code and unmatched support, turning you into a true partner.

    – Dr. Watson ( Clutch )