What We Do

Solutions to Help You Focus

• Insurance Verification and Authorization

  Insurance verification is a crucial part of the billing process. Medical claims are rejected due to insurance eligibility issues. At Madrelle, we help clients to be on the safer side! Our insurance eligibility team are experienced professionals. They verify and determined if authorization is required for claim payment processing. We have a system in place that makes it easy for providers to inform the patient about co pays and deductibles that need to be paid, prior to the patient’s visit. You are guaranteed to have an increase in self-pay collections by working with Madrelle!

  Our easy to use system facilitate the process of reviewing patient information without going through too many steps. We use the patient look up feature, to review the details of patients. The medical billing information and insurance details of the patients are viewed. The patient pivot contains the patient’s appointment and payment details. We carry out a detailed insurance eligibility check, prior to the claims creation process. This is one of the reasons, why we are the best in the industry.

• Coding and Review of Encounters

  Coding requires experienced and credentialed coders who know how to capture the billable services from your Notes/EHR. Madrelle uses a comprehensive knowledge-base of coding, compliance, and reimbursement rules, including federal record, Medicare announcements, and payer claim payment rules to help you capture charges while still in line with the rules of regulations of coding.

  We perform ICD-10 code validation, CPT/HCPCS code and modifier validation, CCI edit validation, and local national coverage decision (LCD/NCD) validation. To eliminating repetitive data entry, we make use of our macros feature which enables us to enter a group of procedure and diagnosis codes for common services quicker and in a more effective way.

• Electronic Billing

  Madrelle’s 24/7 back office team submits medical claims three times faster than most. How often have you missed the deadline for submitting a claim? If you have 9 to 5 employees working your billing process, chances are you have missed timely filling, whether you are aware of it or not. Small and mid-size practices find filing claims on time a very difficult task, due to having to multitask, or maybe you don’t have enough manpower. Madrelle have a system in place that speeds up the process of filling claims.

• Paper Billing to Secondary and Tertiary

  Most providers have no knowledge of this, but chances are your patient’s secondaries are not being filed, which can translate to thousands of dollars at the end of each year. Madrelle have a process in place that allows us to swiftly submit your secondary and tertiary claims. The system we have in place does not allow us to miss the process of printing or electronically submit to secondary and tertiary weekly with the appropriate EOB/ERA attached.

• Paper Billing for Auto Insurance and Workers Comp

  Madrelle has an exceptional billing and follow up process that have been helping providers get paid efficiently and fast for auto accident claims. We are experienced and knowledgeable regarding auto insurance and workers compensation claims. We understand the importance of timely filling, attaching documentation to the claims, as well as keeping record of proof of mailing. Madrelle is well informed concerning the process of PIP suit demands and the negotiating process of PI claims.

• Clearing House/EDI Report Review

  Madrelle preferred system provides EDI and Code scrubbing technology that validates insurance claims against the ever-changing rules and regulations of the billing industry. This Technology detects errors and allows us to correct them prior to submitting the claim. This helps Providers get paid quicker, but also save time by avoiding insurance denials and rejections of your medical claims that can take a lot of time to correct and refile to health care payers.

• Payment Posting

  Madrelle post insurance payments automatically with ERAs, as well as insurance checks from EOBs and patient payments. We understand that you need an accurate and efficient payment posting process. Our preferred software offers a powerful automated payment posting engine, an efficient manual posting process, and other features to manage your payments and collections. Our payment tools will maximize your productivity by streamlining the process.

  The process is easy, whether posting a payment during check-in or check-out, Madrelle will automatically match up any posted patient payments. Our system offers an easy to follow refund and overpayment tool.

• Create Patient Statements

  Madrelle’s customized Patient statements can also help reduce your costs and save time by billing your patients quickly and efficiently. We customize our own patient statements specifying contact information and office hours for your practice, showing the types of payment you accept, we also create custom messages that appears on the statements based on the age of the invoice. We then send these statements.

• Answer & Resolve Billing Questions from Insurers & Patients

  Our team of well trained and knowledgeable billers are very capable of handling patient and payer’s questions regarding claims.

• Customized RCM Reports

  Physicians need special reports that are precise, organized, and insightful. That’s why we provide specific customizable reports that can be viewed on screen in Microsoft Excel or Adobe PDF file formats or printed. Reports gives you flexibility, control, and access your Practice financial performance. Madrelle preferred technology software offers a variety of reports for your practices. Madrelle uses accounts receivable reports to monitor the revenue, encounters and charge reports to monitor your billings. Payments and adjustments reports are used to analyze your collections. Denial reports are used to detect errors and more collection opportunities. Patient scheduling reports are used to monitor the stream of patients through your practice.

• Claim Follow-up and Insurer Denials

  Madrelle’s accounts receivable reportie lets us pin point patient and insurance list reports to thorough reports with a specific list of claims. We can then run your accounts receivable aging by service date, post date, first billed date, and last billed date, or by balance range and sort accounts by balance providing an efficient accounts receivable reporting solution. Madrelle also run distinct reports for primary, secondary, and tertiary payer and patient payment report.

   

• Efficient collection on Receivables

  Insurance and Patient collections can be overwhelming to providers especially having a substantial amount of overdue accounts. Whether you have a large group, or you are a single practice, your cash flow will be negatively affected by slow-paying patients and unresolved insurance claims. Our preferred collection agents are specifically trained in communicating with patient and insurance companies and are extremely effective, we will ensure your collections increase for both insurances and patients. Madrelle’s preferred experienced collection specialist team will take care of it all and get your medical office’s bottom line back on track quickly.

• Recommendations for Maximized Reimbursement

  Madrelle’s coding audit team will review your notes/EHR to determine if all services rendered are being billed properly. Madrelle assist with setting a fee schedule specific to providers location to help increase your collections. We also manage your payer contracts to verify you’re getting paid properly from insurance companies.  Once we have determined what is causing your practice to bleed financially. We will put together a presentation and make our recommendations.

• Reporting MIPS & MACRA

  MACRA stands for the Medicare Access and CHIP Reauthorization. MACRA was signed into law in early 2015. This act makes tremendous changes to the government’s healthcare payment system. MACRA was put in place to reward providers for better, lower-cost patient-driven care. The Center for Medicare Services promotes the shift away from fee-for-service payments to adopt payment models such as (APMs) to hit industry goals of having 50% of Medicare payments made through APMs and having 90% of remaining fee-for-service payments tied to quality and value by the end of 2018.

  The first performance year started on January 1, 2017 and will impact payments adjustments in 2019. MACRA, and the Quality Payment Programs that comes out of it, will impact most providers across the country. Adjustments will start in 2019 based on your 2017 performance, and by 2022, they are expected to increase to up to 9%. This means that if you bill $1,000,000 per year in Medicare, your MIPS performance can make up to a $180,000 difference in your income starting in 2024. That adds up fast. For more information go to the CMS website to see if you must participate: qpp.cms.gov or for more details on MACRA & MIPS click here.

  When you partner with Madrelle, we take away the stress of understanding and attesting to the MACRA & MIPS program. Madrelle understands how time-consuming and how frustrating it can be when trying to keep track of all the complex aspects of reporting. We work diligently to stay up-to-date with changes. Madrelle has the solutions you need to success with MACRA & MIPS. Our preferred modernized system utilizes organized health-system-generated and patient-generated information, that will help accuracy, modernize workflows and give you valuable perceptions that will allow you to succeed.

• Credentialing

  Medical credentialing is a process used to evaluate the qualifications and practice history of medical professional. This process includes a review of a medical professionals completed education, training, residency and licenses.

  Madrelle provides efficient provider enrollment, and credentialing service for health care specialists. Our Credentialing medical professionals are experienced in the industry. Credentialing is a time-consuming process. Mardelle’s seasoned and professional provider enrollment credentialing specialist will help take the stress of having to complete credentialing contracts.

• EHR & PM System

  Madrelle preferred Electronic Health Record (EHR) software application that is designed to save physicians time as they collect patient information, record the diagnosis, order tests and prescriptions and prepare billing information. This modern intelligence with a deep knowledge of medicine that automates your medical documentation and adapts to your style of practice. A good EHR system should help facilitate documentation, which allows you to focus on your patients care. Instead of typing at a computer, you can face your patients when using an iPad-based system.

  How to transition from paper to EHR: You can use Madrelle’s preferred system to do your clinicals moving forward and refer to the paper records as needed, or you can have the paper records scanned and attach the patient records. Most physicians choose the first alternative and gradually phase over to electronic record as time pass, but we allow you to choose.