Reconciliation of accounts – between what was billed by the provider and paid by payers following all submission and resubmission steps – is a key step in closing the revenue cycle. Our experienced finance team, supported by our team of professional medical and insurance reviewers, is tasked with auditing and financially reconciling all records to be presented to the payer for final closure of accounts.
The reconciliation process entails:
- Performing claims audit by analysing reason/s for rejection;
- Verification, validation and assessment of claims eligibility for re-consideration post resubmission;
- Communicating with payers on findings, justification and other relevant required documents;
- Negotiating on rejected claims for re-consideration post resubmission;
- Supporting the ultimate objective of achieving and maintaining the lowest rejection rate; and
- Signing off for account closure as per agreed contractual terms (quarterly, semi-annually and annually).