First Rate

Firstrate delivers high quality healthcare revenue cycle services by strictly adhering to industry guidelines, resulting in low denials and maximum payment. Our systematic approach to decreasing outstanding A/R, reducing bad debts and minimizing average DSO allows our clients’ practices to focus on patient care rather than finances.

• Our highly skilled and experienced professionals handle all of your revenue cycle needs.
• Firstrate software improve efficiency and productivity for each thing of your practice.
• 100% HIPAA compliant.

Credentialling Process and Enrolment Process:

We assist healthcare providers of all specialties in the payer enrolment process with federal and commercial payers. We coordinate with insurance companies to initiate and maintain accurate credentialing statuses. When applicable, we handle the process of getting your providers credentialed with new payers or plans to ensure timely and clean claim submissions.

We negotiate contracts on your behalf. Our expert team of negotiators consistently monitor all national, local, and specialty specific reimbursement rates. We periodically compare reimbursement models to make sure you get paid correctly for each claim.

We eliminate the stress of endless paperwork allowing you to focus on patient care. We complete all applications and necessary paperwork on your behalf with the chosen payer networks and government entities. We follow all payer contracts and provide executed copies of contracts and fee schedules to your practice. We can help you with adding/removing a provider, contract status research, insurance payer applications, Medicare re-validations, Medicaid re-enrolments, hospital privileges/re-appointments, address updates, bank updates & credentialing maintenance, so that you can focus on patient care.

We assist with all aspects of the credentialing process—adding or removing providers, contract status updates, payer applications, Medicare revalidation, Medicaid reenrolment, hospital privileges, bank updates and more.

Eligibility and benefits & Pre-Authorizations:

First Rate Benefits verification team manage the process of eligibility and benefits verification for each patient at least two days before to their appointment and procedure. This reduces claim denials and allows you to make informed decisions about the services you render and how much you should collect from the patient at the time of service.

we provide below information:

• Patient’s coordination of benefits, member ID, group ID and policy effective date, copay, coinsurance, and deductible amount, patient current outstanding balance and services covered under the policy.
• We obtain pre-authorizations at least ten days before to patient appointments. This ensures less denials and maximum reimbursement for the procedures you perform.

Medical Billing:

• Firstrate provides an end-to-end claims management solution. From charge entry to claims submission to payment posting and reconciliation, we ensure that accurate charges go out and appropriate payments are received.
• Completion of CMS-1500 form for each patient visit, Automated Claim Generation, Automated Electronic Submission, claim scrubbing before to claim submission, Clearinghouse integration and working if any rejections, Direct deposits from payers and reconciliation with your bank, payment posting for paper EOBS and lockbox check payments.

Payments Posting

• We ensure our clients get as many electronic payments as possible. We then approach all of your top payers and set up Electronic Fund Transfers (EFT) and Electronic Remittance Advice (ERA) utilities. This approach decreases turnaround time for posting payments and account reconciliation. For insurances which do not provide EFT, we post payments from paper EOBs as soon as possible maximum 24 hr.
• We process patient statements and collections process and posting patient’s cash, Credit card and check payments into system.

A/R Follow-Up:

Firstrate Account receivable team will take care of all the unpaid claims such as denied and pending claims, contacting all the payers for finding accurate reason for unpaid claims and take appropriate action for faster payment.

Medical Coding:

Firstrate offers professional medical coding solutions through AAPC, AHIMA-certified, specialty-specific coders to ensure quality, compliance, and maximum reimbursement.

We conduct chart audits to confirm you are coding to the appropriate level for the level of service we are providing. We handle inpatient, outpatient and Mult speciality coding for providers and facilities alike.

Our team of AAPC (American Academy of Professional Coders) certified medical coding specialists strictly adhere to all payer and government rules, regulations and coding guidelines.

Medical transcription:

Firstrate provide accurate and reliable HIPAA compliant medical transcription services for physicians, laboratories, hospitals, clinics and other healthcare organizations.

We use industry-leading speech recognition technology, which enables us to reduce human error and shorten turnaround time from days to hours. Our skilled medical transcriptionists then review and edit ensuring even greater accuracy. We provide detailed tracking information and monthly status reports on turnaround time, quality, and open items.

Your patient data is safe with us. We are fully compliant with HIPAA and other legislation and offer cutting-edge data security, encryption, and redundancy so that you always have access to your data.

Denial Management:

Our denials team closely working to identifying denials, we categorizing denials by based on common reasons such as coding errors, additional documentation request, eligibility issues, medical necessity and Non-Covered services taking appropriate action against for faster payment for each claim.

We Analyse denial trends is essential for understanding the root causes of denials. By performing root cause analysis, we can identify patterns and systemic issues contributing to denials. This analysis helps in developing targeted strategies and process improvements to prevent similar denials in the future.

Submitting Appeals:

Resolving denials and submitting accurate appeals by our denial management team. Our team work closely with coding and billing teams to gather necessary information, such as additional documentation or coding clarifications. Timely and accurately submitting appeals within payer guidelines for maximum reimbursement.

QA Team Process:

Firstrate QA team working for decreasing denials rate.QA team working for improvement in our daily work process collaborating with other departments, such as coding, billing, clinical documentation improvement, Payment posting, denial management and AR follow-ups, for addressing systemic issues and enhancing communication to preventing denials.

HIPPA Compliant:

As per HIPPA, your patient data is safe with us. We are fully compliant with HIPAA and other legislation and offer cutting-edge data security, encryption, and redundancy so that you always have access to your data.

Contact Us:

First rate will always have a dedicated team at your service. Feel free to contact us anytime by phone, chat, or email for a no-cost consultation- we will be happy to help you!

Our Other Services

1. Medical Terminology
2. Anatomy and Physiology
3. Medical Coding
4. ICD-9 CM Coding
5. CPT Coding
6. HCPCS Coding
7. Medical Billing
8. CMS -1500
9. Clearing House
10. Revenue Cycle
11. Denial management
12. AR Work (Working on Denials and Rejections)
13. Medicare, Medicaid, TRICARE21
14. BCBS and Other Commercial Players
15. Workers Compensation
16. NPI, CLIA 24 Certificate
17. HIPAA Privacy and Security/HITECH Law Management
18. Application of Six Sigma in Medical Coding and Billing/Revenue Cycle Management/PQRI
19. EMR Advantages and about EMR in Detail
20. Sample file for Coding and Billing (Job Oriented)
21. 3 sample National Certification Exams Papers
22. Anatomy and Physiology Animated charts for easy learning
23. Medical Billing in Practice (sample claim Processing)

Our other Services:

• Patient’s Billing or Statements Process
• Patient’s Collections Process
• Clinical coding or clinical investigation Process
• Financial Reporting and Analytics
• Compliance and Audit Services
• Revenue Cycle Management and Training
• Medical Billing and Medical Coding Training
• ICD-10 CM Training
• Provider’s Credentialling
• HIPAA Privacy and PHI Security Law Management
• Application of Six Sigma in Medical Coding and Billing/Revenue Cycle Management/PQRI
• Sample file for Coding and Billing (Job Oriented)
• Anatomy and Physiology Animated charts for easy learning for Medical Terminology
• Medical Billing in Practice (sample claim Processing)
• NPI and CLIA 24 Certification process