Medical Billing

Outsourcing medical billing is a popular option in today's highly competitive healthcare industry. Outsourcing your medical billing process to us ensures that you get high quality services in addition to cost benefits.

If you are a healthcare service provider, a medical billing company or an insurance company, MITS can provide medical billing services to you by using your existing process and software. Thus giving you prompt turnaround time on your data processing functions with assurance of a high quality service.

Like most of MITS's Services, we are looking for effective ways to implement Medical Billings solutions and reduce overall operational costs. To be a long-term MITS has had the opportunity to look to provide high quality and cost effective complete billing solutions.

MITS’s Artificial Intelligence maps directly to the clinical, financial and business rules that impact insurance companies, managed care organizations, health care community and employers.

The intelligence is our Rules-Based Engine identifies and automatically updates the edit criterion used to establish public and private sector benefit plan adjudication rules.

Our Expertise in this Field

We are trained in regulations pertinent to Medicare, Medicaid, blue products, managed care, third party liability, workers compensation, Preferred Provider organizations, indemnity insurers and have a complete understanding of CPT, HCPCS, ICD-9 coding Level I, II, III. They also have the ability to identify data as related to submitting a clean insurance claim for reimbursement by insurers.

Technically Speaking

We use secure networked Medical Billing & document routing with advanced auditing process for the dictation, correcting and training you speech files and documents are returned, formatted and ready to print or insert into your electronic medical record.

MITS's Unique Products

¤ Impact Analysis

¤ Denial Management

¤ Pre-Adjudication

¤ Practice Management

Services leverage our proprietary database, Rules Based Engine and artificial intelligence to decrease costs, increase revenues and improve the quality of service you provide.

Our unique Practice Management and Additional Services make MITS the ideal solution for large and small healthcare providers.

MITS’s dynamic Rules-Based Engine (RBE) tracks, updates and maintains a comprehensive knowledge-base specific to the health industry on both the local and national level.

The RBE applies a series of sophisticated, clinical and financial based edits analyzing the following relationships:

¤ Insurance company

¤ Coding edits

¤ Coverage issue

¤ Financial outcomes, i.e. Reimbursements

¤ Clinical policy

¤ Utilization guidelines

¤ Employer sponsored benefit plan provisions-exclusions-limitations

¤ Line-item information contained in insurance claim or remittance statement

All benefit plan provisions, including clinical and financial rules are directly aligned with the following edit criteria:

¤ Single medical bill

¤ Single patient

¤ Provider specialty

¤ Place of service

¤ Same date of service

MITS's Unique Products

MITS offer following Medical Billing Services

Patient Demographics Entry:

This would include Patient's Name, Present Address, City, State, Zip Code, Social Security Number, Employer Details, Insurance Details like Primary, Secondary and Tertiary, and guarantor information.

Charge Entry:

This would include entering details like Date of Service,Referring Physician, Ordering Physician, Place of Service, Type of Service, CPT Codes, ICD Codes, Modifiers, Authorization or Referral Details and Co-pay Details.

Payment Entry or Charge Posting:

The following details from the EOB are keyed in-

Patient Account Number / Patient Control Number, Patient Name, Date of Service, Procedure Code, Billed Amount , Allowed Amount, Adjusted Amount, Paid Amount, Deductibles and Denial Details.

Accounts Receivable and Claims Follow-up :

¤ Denials/rejections analysis, re-billing

¤ Systemic A/R projects, re-billing

¤ Insurance Follow Up

¤ Collection Agency Reporting

¤ Payment Posting and Reconciliation