FAQs

Medical billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a healthcare provider.

AguileraRCM offers comprehensive medical billing services, including claim submission, denial management, payment posting, and patient billing...

Yes, AguileraRCM is fully HIPAA compliant and takes the privacy and security of our clients' information very seriously.

Our billing service offers straightforward and cost-effective pricing, prioritizing your profit. We charge a percentage of the revenue acquired, ranging from 2.99% to 5.99%, while ensuring a minimum saving of 35% on your billing costs. Additionally, we can provide a per-hour rate that may be advantageous for our clients.

AguileraRCM wants to provide you with maximum benefit from the services. If you opt to choose software that we suggest and outsource Billing functions to us, we can take care of the software fees.

Once the contract has been signed we inform our clients about a tentative live date. We try to suggest a live date keeping the current scenario and the requirement of software or credentialing.

Yes, we are. Our billing specialists are trained and certified. Our medical coders are AAPC certified and are experts in multiple specialties.

Great question. We would think 99% of our clients have software and we work as an extension to their practice by remotely working on their system. This keeps transparency. We do have our own web-based software as well that we can use in case you do not have your own software.

Our staff are constantly trained and attend classes to keep themselves informed of the changes. We are also working with several insurance companies and constantly check the portals for changes and updates.

The idea is to reduce denied claims by doing everything you can upfront correctly. Our process for handling denied claims involves a systematic review of the denial reason, followed by immediate action to rectify any errors or discrepancies. We prioritize swift appeals for valid denials, leveraging our expertise in coding and documentation to optimize success rates. Currently, our claim resolution success rate stands at approximately 95%.

Healthcare practices need these services to streamline their billing and collection processes, ensuring that the claims are processed efficiently and payments are collected promptly. This ultimately improves the practice’s financial health and allows you to focus on patient care.

Yes, the services provided by our AR management company can be tailored to your practice’s unique requirements. Providers typically offer customizable solutions to address the specific challenges and goals of your healthcare organization.

By ensuring smooth financial operations and reducing billing errors, these services indirectly contribute to better patient care and satisfaction, as healthcare providers can focus more on medical services and less on administrative tasks.

Not with our services. We leverage advanced technologies and streamlined processes to ensure a swift and efficient insurance verification process, saving your staff valuable time.

Absolutely. Our services include analytics and reporting features, allowing you to track the performance of the insurance verification process and make informed decisions for your practice.

Yes. We understand that every practice is unique. Our Services are customizable to accommodate the specific requirements and workflows of your specific specialty.

No disruptions here. We work to seamlessly integrate our services into your existing workflow, ensuring a smooth transition with minimal impact on your day-to-day operations.

Here are the reasons that make AguileraRCM stand out from other medical coding companies:

• Expert medical billing and coding specialists
• HIPAA-compliant services
• No long-term contracts
• 30% to 40% cost savings
• Dedicated billing managers
• No start-up fees

Medical coding is an essential part of healthcare, supporting accurate and timely payment for healthcare services, ensuring compliance with regulations, improving patient care and safety, and supporting research and public health initiatives.

Generally, surgeries and treatment procedures that are costly or considered non-emergent may require prior authorization. These could include surgeries, diagnostic tests, hospital admissions, and certain prescription medications.

Our services streamline the authorization process, saving time and reducing administrative burdens. We also increase the chances of timely approvals, thereby enhancing practice revenue and improving the overall patient experience.

Authorization approval times can vary depending on the procedure, insurance company, and specific circumstances. Generally, it can take anywhere from a few days to several weeks. Our services aim to expedite this process.

Yes, by partnering with us, your practice can stay up-to-date with insurance regulations and guidelines. We ensure that authorization requests comply with all necessary requirements.

Patients need to provide accurate insurance information and be prepared to cover any co-pays or deductibles as specified in their insurance policy.

Yes, our team is experienced in working with various insurance providers, including commercial and government payers like Medicare and Medicaid.