Nixxe MBS handles all aspects of hospital medical billing, increasing revenue while eliminating the need to house, manage and pay a billing department.

Insurance Eligibility Verification

Our team members will do the following as a part of the verification processes:

  • Perform entry of patient demographic information
  • Verify coverage of benefits with the patient’s primary and secondary payers
    • Coverage – whether the patient has valid coverage on the date of service
    • Benefit options – patient responsibility for copays, coinsurance, and deductibles
  • Update the hospital’s revenue cycle system or the patient’s practice management system with the details obtained from the payers

Charge Entry Services

Charge entry is the process of assigning to the patient account an appropriate $ value as per the chosen medical codes and corresponding fee schedule. The reimbursements for the healthcare provider's services are dependent on the charges entered for the medical services performed. Charge Entry must be completed without any errors, as it may increase claim denials. Reduce revenue leakage through an adequate review of medical services provided and save millions of lost revenue. We ensure effective collaboration between the coding and the charge entry teams to ensure that the charges captured are accurate, all procedures all billed for, and the codes ascribed are compliant.

We will post, review and submit all office charges, hospital visits, surgeries, and diagnostic and laboratory tests, to ensure accuracy, completeness and proper coding.

Claim Submission

We submit insurance claims electronically through our electronic clearinghouse, eliminating substantial delays in insurance claims processing

Medical and Coding Billing Errors Statistics
Medical Laboratory Billing Services

Payment Posting

We process different types of remittances received with a high degree of accuracy, improved responsiveness, and follow the procedures defined by our clients. We perform the following services:

  • Patient Payments: We receive information on the point of service payments made by patients from our clients. These payments are made via cash/check/credit cards and could be on account of co-pays, deductibles, or non-covered services. Our team reviews the information received and adjusted the same against each patient account.
  • Insurance Posting: We process Insurance Payments in the following formats
    • Electronic Remittance Advisory. We receive high-volume ERAs from payers and process them in batches by importing them into the client’s practice management system. Each batch run throws exceptions that fall out, and we correct the same along with verification of batch totals.
    • Manual Posting: Our clients often send us scanned EOBs. Each EOB batch is accessed via secure FTPs or through the EHR system and processed in line with the client’s business rules for adjustments, write-offs, and balance transfer to secondary insurance companies or the patients.
  • Denial Posting. Posting of claim denials is essential to get an accurate understanding of the customer’s A/R cycle. Denied claims are sent back by the payers in the form of ANSI codes for denials and sometimes with payer-specific medical coding guidelines. We understand the payer-specific denial codes for most payers and have expertise in understanding ANSI standard denial codes. We record each claim denial in the practice management system and take actions to re-bill to the secondary insurance company, transfer the balance to the patient, write-off the amount, or send the claim for reprocessing.