ClaimCare
Tech-infused Back-end Medical Billing Operations

In recent years, the healthcare landscape has witnessed the emergence of new modalities, such as telemedicine and remote patient monitoring, revolutionizing patient care and accessibility while addressing cost concerns.

However, the rapid integration of these technologies has left medical billing operations struggling to keep pace. Reimbursement models now prioritize value and outcomes, with fee-for-service overshadowing alternative approaches like bundled payments and accountable care organizations.

The evolving landscape, influenced by the Affordable Care Act and subsequent updates, also introduces compliance requirements and billing regulations. This dynamic environment demands adaptability from medical billing professionals, leading to increased workloads, potential errors, and delays. Adequate training and support are essential for maintaining accuracy and efficiency in billing processes, enabling companies to capture the value of healthcare services accurately.

ClaimCare, an innovative medical billing company, has stepped forward to alleviate these challenges by streamlining medical billing processes and ensuring claims get paid on time. Its comprehensive offering in revenue cycle management encompasses every aspect of claim submission and follow-up—from the moment a patient is seen to the point where funds are deposited in the bank.

ClaimCare’s mission is to collect the maximum revenue for healthcare professionals as quickly as possible while helping their clients reduce costs and hassle for their organizations. ClaimCare delivers on this vision through a combination of proprietary automation technology, a billing process engineered to deliver accurate, replicable results, outstanding feedback and analytics, and a 100% US-based, highly motivated, well-trained, and experienced billing team. This toolkit has placed ClaimCare on the top 10 medical billing companies list for several years in a row.

The comprehensiveness of ClaimCare’s solution is epitomized by the organization’s credentialing services, which help clients see solid billing results by putting a strong foundation in place. This service includes negotiating payer contracts and enrolling new providers. Another example of the extensive nature of ClaimCare’s solution is the company’s pre-authorization services, assisting those who need help retaining staff to handle billing tasks independently.

Additionally, it uses analytics to provide clients insights into their revenue trends, areas for improvement, and operational efficiency. The company also offers consulting, particularly for new companies navigating the complexities of revenue cycle management. This aligns with its emphasis on credentialing, compliance, and proactive consulting to ensure clients adhere to industry standards even before commencing billing activities. ClaimCare’s focus on compliance extends throughout its partnership, guiding clients to adopt best practices and navigate the intricacies of the revenue cycle management landscape. Whether assisting with initial steps or ongoing compliance, the goal is to support clients in conducting their operations in a compliant manner.

“Most clients see their collections grow by 10-25 percent with our consultation and also cut down their waiting time for payments to under 45 days,” says Carl Mays II, president and CEO of ClaimCare.

A case in point is a sizable orthopedic practice that initially sought ClaimCare’s consulting services and later entrusted it with managing their billing operations. In the first year, the medical billing company elevated their collections per encounter by approximately 12 percent, followed by an additional 6 to 7 percent increase in the second year. This culminated in an impressive total rise of 16-17 percent in collections per encounter. ClaimCare has also guided numerous clients, some starting from zero revenue, to achieve multimillion-dollar revenue figures over the past three years. After each consulting service, it meticulously follows up, takes proactive measures to ensure timely claims submission, and strategically implements automation. This enhances efficiency and minimizes human error, guaranteeing every necessary step is taken for each claim.

With our consultation, most clients see their collections grow by 10-25 percent and also cut down their waiting time for payments to under 45 days

ClaimCare’s competence in delivering reliable back-end medical billing operations lies in its in-house, proprietary technology and its unique blend of extensive experience spanning 30 years. Its best-in-class technology empowers it to create a fair and balanced landscape by employing advanced claim scrubbers, a robust analytical reporting engine, unique monthly client report cards, and a dynamic feedback process. This means the company’s technology evolves and learns from payers’ tactics, ensuring swift adaptation to new strategies aimed at delaying clients’ payments. To align with current technological trends, ClaimCare charges forward with determination—continually refining its proprietary technology. This adaptability ensures that the company maintains a positive impact on the dynamic healthcare landscape and ensures sustained relevance.