Frequently Asked Questions

Revenue cycle management encompasses the entire financial process from patient registration through final payment, while medical billing focuses specifically on claim submission and payment collection. RCM includes insurance verification, denial management, A/R follow-up, credentialing, and analytics. At EBilling Medical, we manage the complete cycle to maximize reimbursements and improve cash flow for providers.

Real-time eligibility checks confirm patient coverage and benefits before appointments, preventing claims from being denied due to inactive policies or lack of authorization. This proactive step also provides accurate patient responsibility estimates upfront. At EBilling Medical, we verify eligibility prior to every visit to reduce front-end denials and improve financial transparency.

Most denials stem from eligibility issues, missing or incorrect patient information, lack of prior authorization, and coding errors. Timely filing limits and coordination of benefits mistakes also contribute significantly. Through root cause analysis and error detection before submission, EBilling Medical helps practices prevent recurring denials and recover lost revenue through appeals.

Industry benchmarks suggest A/R days should ideally stay below 40 days, with anything over 50 indicating collection inefficiencies or claim bottlenecks. Aging balances beyond 90 days become significantly harder to recover. At EBilling Medical, we use aggressive follow-up and detailed aging reports to reduce A/R days and accelerate reimbursements for Georgia practices.

Credentialing should begin at least 90 to 120 days before a provider plans to see patients, as insurance panels and CAQH registration can take several months to complete. Delays in credentialing directly impact reimbursement timelines. EBilling Medical tracks application status and manages re-credentialing to keep provider profiles current and reimbursement channels open.

A revenue cycle audit reviews billing accuracy, coding compliance, documentation quality, and claim submission workflows to identify risks and revenue leaks. It includes denial trend analysis, payer performance evaluation, and regulatory alignment checks. At EBilling Medical, we conduct internal audits with corrective action plans to improve compliance and prevent fraud or abuse issues.

Denial management involves analyzing why claims were rejected, correcting errors, and resubmitting or appealing within payer deadlines. Timely appeals and clear communication with insurers often result in overturned denials and payment recovery. EBilling Medical tracks denial trends and implements prevention strategies to reduce recurring issues and maximize reimbursement for independent offices.

Yes, outsourcing reduces claim submission errors, accelerates reimbursement timelines, and provides dedicated A/R follow-up that many in-house teams lack bandwidth to handle. Faster clean claim rates and proactive denial management directly improve cash flow. With over 20 years of experience, EBilling Medical streamlines the billing lifecycle so providers in Covington and surrounding Georgia areas can focus on patient care.

Key performance indicators include collection rate, claim denial rate, days in accounts receivable, and net collection percentage. Payer performance and clean claim rates also reveal operational efficiency. At EBilling Medical, we provide custom dashboards and monthly reports that help practices monitor these metrics and make data-driven decisions for sustainable growth.

Eligibility should be verified before every patient appointment, as coverage can change monthly due to policy updates, job changes, or plan terminations. Real-time checks ensure current information and reduce claim rejections. EBilling Medical performs verification prior to appointments to provide accurate patient estimates and reduce front-end denials for healthcare providers.

The biggest mistake is waiting too long to follow up on unpaid or aging claims, allowing balances to exceed 90 or 120 days when recovery becomes much harder. Lack of systematic tracking and prioritization also leads to revenue loss. EBilling Medical uses proactive follow-up strategies and detailed analytics to minimize aging balances and recover outstanding payments efficiently.

Yes, clear and professional patient statements improve payment rates and reduce confusion that leads to delayed or missed payments. Offering flexible online payment options also increases collections and patient satisfaction. At EBilling Medical, we design transparent statements and coordinate secondary claims to improve communication and overall financial performance for medical providers.