Claims & Billing Services

Efficient claim submission and billing management that accelerates payments.

Streamlined Claims Processing for Faster Payments

Our comprehensive claims and billing services ensure timely, accurate submission of all claim types to maximize your revenue cycle efficiency.

We handle electronic and paper claims for Medicare, Medicaid, commercial insurance, workers compensation, and liability cases with precision and compliance.

With our proactive approach to claim management, you can reduce days in accounts receivable and accelerate your cash flow.

Our Approach

We combine advanced claim scrubbing technology with expert human review to ensure maximum clean claim rates and minimal rejections.

Quality Assurance

Every claim undergoes automated validation and human review before submission to ensure compliance and accuracy.

WHAT'S INCLUDED

Complete Claims Management

Every aspect of claim submission and billing covered for maximum efficiency.

Electronic claim submission to all major payers

Paper claim processing for workers compensation

Real-time eligibility verification

Claim status monitoring and follow-up

Payer portal management

Remittance advice processing

Secondary claim submission

Coordination of benefits processing

Workers compensation billing

Medicare and Medicaid claims

Commercial insurance claims

Liability and no-fault billing

OUR PROCESS

Claims Workflow

Eight-step process ensuring timely submission and optimal reimbursement.

1

Charge entry and claim scrubbing

2

Eligibility verification

3

Claim generation and validation

4

Electronic submission to payers

5

Claim status monitoring

6

Denial identification and response

7

Secondary claim submission

8

Payer communication and appeals

PERFORMANCE METRICS

Claims Excellence

Measurable results that drive your revenue cycle success.

>95%

Clean Claim Rate

>85%

First Pass Resolution

<48 hours

Submission Timeliness

100%

Payer Contract Compliance

CHALLENGES WE SOLVE

Claims Complexity Made Simple

We handle the complexities so you don't have to.

Challenge 1

Complex payer contract requirements

Challenge 2

Frequent claim rejection patterns

Challenge 3

Payer-specific submission formats

Challenge 4

Timely filing deadlines

Challenge 5

Coordination of benefits complexity

Challenge 6

Workers compensation regulations

Challenge 7

Medicare and Medicaid billing rules

FAQ

Frequently Asked Questions

Answers to common questions about our claims and billing services.

How quickly do you submit claims?

We submit clean claims within 48 hours of receipt. Urgent cases can be expedited for same-day submission when clinically necessary.

Which clearinghouses do you use?

We partner with leading clearinghouses including Change Healthcare, Availity, and NaviHealth to ensure broad payer connectivity and optimal claim routing.

How do you handle claim denials?

Our denial management team identifies denial patterns, responds within 72 hours, and implements preventive measures to reduce future denials. We track denial reasons and work with providers to address root causes.

What reporting do you provide on claims?

We provide real-time claim status updates through our provider portal, plus weekly denial reports, monthly submission summaries, and quarterly performance analytics.

How do you ensure compliance with payer contracts?

We maintain detailed profiles for each payer with specific requirements, fee schedules, and submission guidelines. Our compliance team regularly audits our processes to ensure adherence.

Ready to Accelerate Your Claims Process?

Schedule a free consultation to see how Aethera can reduce your denials and speed up payments.

RELATED SERVICES

Complete Revenue Cycle Management

Additional services that complement our claims and billing expertise.

Medical Coding

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Denial Management

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Payment Posting

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