Clean Ratio
1 st Submission Page Rate
Revenue Increase
Our billing specialist begin by accurately capturing and verifying all patient demographics and insurance information during the intake process. This includes name, date of birth, address, policy numbers, and payer details. A solid foundation during registration helps prevent delays, claim denials, and eligibility issues later in the billing cycle of your practice.
Before services are rendered, our team verifies patient insurance coverage, eligibility, co-pays, and deductibles by contacting payers directly or using secure verification portals. This critical step helps reduce surprises for both the provider and patient, ensuring that all services rendered are billable and reimbursable in Illinois.
Once services are provided, we accurately translate your clinical documentation into billable charges using proper CPT, ICD-10, and HCPCS codes. Our trained coders review each record to ensure compliance with payer guidelines, minimizing the risk of underbilling or overbilling.
We compile all relevant data into clean, structured claims that are fully compliant with HIPAA and payer requirements. This includes attaching the correct modifiers, rendering provider information, and location codes to ensure the claim meets all submission standards.
Before any claim is submitted, our system runs it through an advanced scrubbing process to catch coding errors, missing information, or inconsistencies. This proactive step significantly lowers the chances of claim rejection or denial by addressing issues early in the cycle.
Cleaned and verified claims are submitted by our certified billing experts electronically to insurance companies through secure clearinghouses. Electronic submission allows faster processing, reduces mailing delays, and ensures that claims reach payers quickly, accelerating your reimbursement timeline.
Once payments are received, we match them against submitted claims and post them to your practice management system. We carefully analyze Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to ensure accuracy and proper reconciliation of payments, adjustments, or write-offs.
Our dedicated AR team continuously monitors outstanding claims and follows up with payers on denials or delayed payments. We appeal denials when necessary, correct rejected claims, and make sure your revenue doesn’t fall through the cracks, keeping your cash flow steady and strong.
Credentialing is important for getting reimbursed by insurance companies. We handle the entire process, from initial application to recredentialing, by submitting necessary documentation, tracking status updates, and ensuring timely renewals. With Stars Pro managing your credentialing, you can start seeing patients and receiving payments without unnecessary delays.