Coding Expertise

The livelihood of every health care organization rests upon correctly coded data. This is true from a basic financial tenant – coding drives reimbursement – as well as a compliance perspective. At ebix, our coders are trained to look at the physician’s coding and check to ensure the physician is not:

• Using invalid codes
• Unbundling procedure codes
• Billing of services included in global fee as a separate professional fee
• Use of an inappropriate or no modifier for accurate payment of a claims
• Monitoring billing patterns for any inappropriate combinations of procedures and diagnoses creating compliant billing environment.

Our Certified Professional Coders participate in on-going training and industry conference activities to stay current on the ever-changing medical management world. They have the expertise to serve your specialty, whether that's radiology, emergency department or more others. This level of coding provides our clients with the maximum allowable reimbursement approach.

Managed Care Consulting Services

We have the ability to provide in-depth managed care consulting services, featuring comprehensive advice on managed care contracts. This includes contract reviews, recommended language changes and inside knowledge as it relates to managed care products. This advice has greatly improved many of clients' managed care agreements and increased those clients' knowledge on how to effectively negotiate a managed care agreement. Many clients have seen significant revenue improvement as a result of this service.

Contract Monitoring

ebix will load your top payer contracts into our practice management system to monitor payments. We flag any over- and under-payment, and follow-up on it for further research. This ensures you are being paid accurately and fully, without losing any reimbursement to which you are entitled.

There is critical evidence from the Health Care Portability Act that Medicare’s audits will target providers who do not document adequately. It is estimated that for every dollar the government spends auditing providers, the return is twenty-seven dollars. In order to control rising healthcare costs, the government has allocated new funding for auditing and enforcement projects. ebix stays current with all Medicare and Medicaid policy changes and uses compliance process protocols to produce complete, accurate and compliant claims.