Optimize Your Revenue Cycle with Expert Medical Billing and A/R Management
Elevate your healthcare facility’s revenue cycle with Ledger Logic Health Solutions’ comprehensive medical billing and A/R management solutions. Designed for hospitals, physician offices, Independent Practice Associations, and other healthcare providers, our services aim to reduce errors, accelerate collections, and enhance cash flow.
Our Solutions
At Ledger Logic, we offer all-inclusive Revenue Cycle Management solutions tailored to your facility’s needs. From Provider Enrollment and Credentialing to Denial Management and Patient Collections, our experts handle every aspect of the revenue cycle with precision and efficiency. Our goal is to empower you to focus on delivering exceptional patient care while we optimize your financial operations.
Key Features
Experienced Billing Experts
Our billing experts boast a minimum of 10 years of experience and maintain compliance with HIPAA, HITECH, CMS, In-Network, and Out-of-Network regulations.
Customized Solutions
Unlike one-size-fits-all models, Ledger Logic customizes medical billing and A/R management solutions to meet your facility's unique requirements.
Error Investigation
We go beyond mere claims processing by investigating the root cause of any billing errors and implementing corrective measures to enhance your billing processes.
Specialties Covered
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Get Started
Ready to optimize your coding accuracy and revenue potential? Contact Ledger Logic today to schedule your consultation.
Comprehensive End-to-End Revenue Cycle Management
Provider Enrollment and Credentialing
Provider Enrollment and Credentialing
- Ledger Logic delivers a comprehensive suite of services to meet all your Revenue Cycle Management (RCM) needs.
- Our team of certified professionals specializes in various administrative processes, including handling 855 forms, PECOS, and CAQH’s ProView system.
- We provide support for credentialing and re-credentialing with Medicare and commercial payers, ensuring compliance and seamless transitions.
- Ledger Logic offers assistance with ERA/EFT set-up, insurance contracts evaluation, and negotiation, optimizing your financial operations.
- Partner with Ledger Logic to streamline your administrative tasks and focus on delivering exceptional patient care. Contact us today to learn more.
Pre-certification (Authorization) & Insurance Eligibility Verification
Pre-certification (Authorization) & Insurance Eligibility Verification
- Upon receiving a copy of the insurance card before the appointment for services requiring pre-certification or authorization, we simplify the process.
Patient Demographic Entry
Patient Demographic Entry
- Ledger Logic's Demo Team (LLDT) inputs patient demographic information, including name, date of birth, SSN, address, phone number, insurance details, medical history, and guarantor, as provided by the patient during their visit to the doctor's office in the PMS.
- Collaborate with our auditing experts to identify Social Determinants of Health data embedded in demographic information, mitigating risks and avoiding revenue losses.
Medical Coding
Medical Coding
- Our coding team adheres to Coding Compliance standards.
- Our billing team receives superbills containing diagnostic notes, with or without corresponding codes. If codes are included on the superbill, our coding team validates them to prevent any instances of 'Upcoding' or 'Downcoding', ensuring denial avoidance.
Charge Entry
Charge Entry
- The fee schedules are typically pre-loaded into the PMS.
- Our billers verify that the fee schedule aligns with the state/provider insurance contract.
- Our billers confirm that all patient demographics are included in the claim and are prepared for filing.
Claims Submission
Claims Submission
- Our billers ensure that claims are submitted electronically. Paper submission is only utilized if required by insurance, within a 24-hour timeframe to the clearinghouse or insurance.
- With Ledger Logic, expect all clearinghouse rejections to be promptly resubmitted on the same day.
Payment Posting
Payment Posting
- We enroll all providers in EFT/ERA to prevent payment delays.
- Our billers diligently post and reconcile ERA/EOB/Denials (based on the PMS) to the PMS every day.
Account Receivables Follow-up
Account Receivables Follow-up
- We offer personalized follow-up schedules tailored to your preferences, whether weekly, bi-weekly, or monthly, and communicate through your preferred channels. This approach is based on filing limits and aging buckets to ensure effective communication and resolution.
Denial Management
Denial Management
- Following a thorough analysis of denials and partial payments, our Account Receivable (AR) team at Ledger Logic reaches out to payers, patients, providers, facilities, and other relevant parties to address denied, underpaid, pending, or inaccurately processed claims. Detailed notes are meticulously documented in our Practice Management System (PMS) for trend analysis regarding payments and denials.
- Upon completion of provider authorization, our team contacts patients to gather necessary billing information such as insurance identity numbers, coordination of benefits details, and any other required data. Additionally, our AR experts handle secondary, tertiary, and paper claims, along with corresponding follow-ups.
- Ledger Logic's Appeals Team (AT) initiates appeals for denials once responses are received from payers, ensuring comprehensive resolution of claim disputes.
Patient Collections
Patient Collections
- Ledger Logic's team will proactively reach out to overdue accounts to facilitate balance collection, offering tailored payment plans for balances surpassing client-established thresholds. We meticulously review patient demographics, ensuring accuracy across mailing addresses, email addresses, alternate phone numbers, and more.
- In cases where an invoice was missed or not received, our team implements diverse delivery methods to ensure prompt invoice receipt by the patient, including directing them to the patient portal for convenient payment options. We meticulously verify patient balances against EOB/ERA postings for accuracy.
- For patient inquiries following collection efforts, Ledger Logic provides a toll-free callback number, ensuring accessible support. Our Billing and AR team diligently notify clients of any posting issues or pending patient payments. We facilitate flexible payment options, accepting various forms of payment such as debit/credit cards and auto-pay, with confirmation receipts for all transactions.
- Throughout the collections process, our team prioritizes maintaining a positive patient experience. Additionally, Ledger Logic provides a comprehensive monthly AR Status Report alongside each monthly invoice, ensuring transparent communication and clarity regarding account statuses.
