ALTS is one of the leading Business Process Management & Revenue Cycle Outsourcing Company, having our presence in Florida and multiple delivery centres in India. Founded in 2011, offering a wide range of services to healthcare industry. ALTS understands, medical billing is a payment practice within the United States health system. The process involves a healthcare provider submitting, and following up on, claims with health insurance companies in order to receive payment for services rendered; such as treatments and investigations.
Our rich US healthcare industry knowledge and deep payer & provider knowledge allow us to do the work in a fraction of the time.
At ALTS, we provide the most unique and advanced Smart Sourcing Remote Experts (SSRE) to optimize your coding, billing and accounts receivable functions—all with a smooth transition. We have a dedicated team and assigned account managers to work with physician and hospital billing services for hospitals, healthcare systems, specialty clinics, and related areas of patient care to increase cash flow and improve financial performance.
ALTS Value Proposition
Committed to the delivery of highly-customized, value-focused revenue cycle outsourcing services
ALTS assignees task to each medical billers and medical coders to respective hospitals, clinics, and healthcare organizations. These assigned tasks may be performed by a single person with extensive knowledge of both fields, or there may be different people handling the various stages of documentation, research, and billing.
ALTS Billing specialists:
Our medical billing specialists focus on collecting payments from the insurance companies to ensure healthcare providers are compensated for their services. These professionals possess a strong working knowledge of insurance plans. They determine the amount a patient should pay and what amount should be billed to the insurance company.
ALTS Coding specialists:
Our medical coding specialists, on the other hand, understand the ICD and CPT codes that apply to all medical procedures and diagnostics. They are responsible for coding patients’ bills accurately so they can be processed correctly
- See an increase in your productivity and efficiency
- Get your work completed ahead of schedule
- Maximum profit margin at a minimal cost
- Better business performance
- Make huge savings on your capital expenditure
- Access reports from anywhere at anytime
Hospital and other related healthcare affiliates can now concentrate on patient care and leave out the worries regarding managing of healthcare staff and compliance with HIPAA.
ALTS– as a preferred strategic partner by outsourcing the daily non-core activities such as: medical billing, coding, claims adjudication or AR follow-ups Hospital, medical centres, clinics or physician network can now rely on us.
1. RCM Services to Providers:
End to End Revenue cycle management services starts with:
1.1 Insurance verification:
The patient list, a copy of the insurance card and demographic details are sent to us via email/fax or secure FTP. Our medical billing specialists call up the insurance company prior to the appointment. Pre-certification is done for specific lab tests, diagnostic tests and surgeries. The details are sent to the hospital/clinic in the prescribed format.
1.2 Patient Demographic entry:
The medical billing specialists enter patient demographic details such as name, date of birth, address, insurance details, medical history, guarantor etc. as provided by the patients at the time of the visit. For established patients, we validate these details and necessary changes, if any, are done to the patient records on the practice management system.
1.3 CPT – ICD10 coding:
Our coding team works in accordance to CPT codes and ICD-10 Coding compliance, and consists of AAPC certified coders with over 2 years of multi-specialty coding experience. You may send us superbills with diagnostic notes with or without ICD and CPT codes. If codes are already provided on the superbill, they are validated by our coding team compulsorily to prevent any ‘up-coding’ or ‘down-coding’ and therefore, any denials.
1.4 Change Entry:
The fee schedules are pre- loaded into the practice management system. CPT and ICD-10 codes are entered into the system. The billing specialists ensure that all details have been provided in the claim and ready to be filed.
1.5 Claims Submission:
Claims are submitted electronically via the practice management system. However, we can process paper claims also. At this stage, a thorough quality check is done by a senior billing specialist and then submitted. The rejection report received from the clearing house, if any, is analyzed and the necessary changes are done. These claims are then resubmitted.
1.6 Payment Posting:
Scanned EOBs and checks are sent to our team for Payment Posting. All payments are entered into the system. The amounts from EOBs/checks and amounts posted in the system are reconciled on a daily basis. A daily log is updated with these data.
1.7 Account Receivables – Follow-up:
All claims in the system are examined and priorities are set. First the claims close to their filing limits, and then work down from the age of the claim. Periodic follow-ups over phone, email and/or online is done to get the status of each claim submitted to the insurance company.
1.8 Denial Management:
Denials Management including analysis of denials and partial payments is done by our senior medical billing specialists. Payors, patients, providers, facilities and any other participants are called to follow-up on denied, underpaid, pending and any other improperly processed claims and the action is documented in the system. We will call patients, if authorized by the provider, to obtain information from the patient needed for billing such as ID# and to update the COB (Coordination of benefits) with their insurance companies. Secondary paper claims are processed and sent to the client office for submission.
2. Payer Services
2.1 Claims processing
2.2 Claims adjudication
2.4 Eligibility verification
2.5 Provider data management (Credential and Sanctioning)
2.6 Bill reviews