At QUAD Healthcare Solutions, we understand that a submitted claim is only as good as its accuracy. Our medical billing experts focus on a "clean claim" rate of 98% or higher, ensuring that your practice gets paid on the first pass without the frustrating delays of rejections and denials.
Accurate Medical Coding & Charge Entry
Our certified coders meticulously review encounter forms and clinical documentation to ensure that all CPT, ICD-10, and HCPCS codes are accurately assigned. We stay up-to-date with the latest NCCI edits and payer-specific coding guidelines to maximize legitimate reimbursement and prevent compliance risks.
Electronic Clearinghouse Integration
We utilize advanced electronic data interchange (EDI) clearinghouses to submit your claims within 24 to 48 hours of charge entry. Electronic submission not only speeds up the payer's adjudication process but also provides immediate feedback on frontend rejections so they can be corrected and resent on the exact same day.
Secondary & Tertiary Claim Processing
Coordinating benefits across multiple payers can be tedious. Once the primary insurance processes a claim, our team automatically attaches the Explanation of Benefits (EOB) and generates the secondary (and tertiary, if applicable) claims. We ensure that patient balances are correctly calculated only after all insurance avenues have been fully exhausted.
Claim Scrubbing & Quality Assurance
Before any claim leaves our system, it passes through a rigorous, multi-tiered scrubbing process. Our software checks for missing modifiers, mismatched diagnoses, and demographic errors, while our billing specialists perform manual quality assurance checks on complex claims.
Specialty Coding Expertise
We code for the full range of outpatient specialties including family medicine, internal medicine, pediatrics, OB/GYN, behavioral health, physical therapy, chiropractic, DME, home health, and ambulatory surgery. Our coders hold active CPC, CCS, and specialty certifications.