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Healthcare Services

Healthcare Payer Services

Our highly experienced Team is equipped with the required knowledge and resources to handle these transactions efficiently while maintaining the expected Accuracy levels within defined Turn Around time.

Medicare & Medicaid Member Enrolment
Medicare & Medicaid Member Enrolment

Data entry of Medicare and Medicaid enrolment applications within the expected turn-around time while ensuring the expected accuracy is met. Flexible staff to handle high volumes during the AEP & OEP

Member Data Maintenance
Member Data Maintenance

Handling various member data maintenance requests such as Address Change, Power of Attorney, Authorized representative with utmost accuracy

Member Disenrollment & Cancellations
Member Disenrollment & Cancellations

Team of experts managing the OOSA disenrollment or member disenrollment requests due to various reasons and cancellation of enrolments, considering the CMS guidelines

Provider Configuration & Maintenance
Provider Configuration & Maintenance

Demographic and Financial data entry of Provider details post credentialing. Creating Provider ID and working on various Provider data maintenance requests within the defined TAT and Accuracy SLA

Provider Credentialing
Provider Credentialing

Verification and Validation of providers qualification and resume. Rigorous check on malpractices before the Provider is contracted with utmost accuracy

Claims Adjudication
Claims Adjudication

Manual Adjudication on multiple claims hold codes that fall out post auto adjudication of claims. Flexible staff to handle high complexity transactions while maintaining the accuracy Service levels

Claims Adjustments
Claims Adjustments

Manual Adjudication on multiple claims hold codes that fall out post auto adjudication of claims. Flexible staff to handle high complexity transactions while maintaining the accuracy Service levels

Overpayment Recovery
Overpayment Recovery

Recovery of any overpaid claims amount post thorough research, collecting required information and documentation from the payer and provider

Revenue Cycle Management

Front-End, Mid-Cycle, and Back-End Revenue Cycle Support:

Get the balance and skill necessary for a dynamic healthcare environment. Whether you need a temporary assistance or you are seeking revenue cycle outsourcing, our highly experienced team of experts are driven to surpass your financial health goals. Our Medical RCM Services are tailor-made to meet specific provider requirements.

Robust Reporting and Continual Improvement would be provided as value added services with the aforementioned services.

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Our services are tailor made to meet specific provider requirements.

  • Patient Appointment Scheduling
  • Insurance/Eligibility Verification
  • Prior Authorization
  • Medical Coding
  • Charge Capture/Entry
  • Payment Posting
  • Accounts Receivables Follow Up

Medical Coding

We take care of all these services as you provide exceptional patient care while focusing on your practice.

At MediClerx, we understand that medical coding is one of the most important process in healthcare revenue cycle management. Our Medical Coding Services staff has comprehensive medical coding experience across all medical specialties while adhering to ICD-10-CM (International Classification Of Diseases, Tenth Revision, Clinical Modification) guidelines.

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  • Accurate Medical Coding
  • Reduce Denials
  • Generate More Collection
  • No More Code Compliance Issues
  • Specialty Based Customized Services
  • Optimize Your Revenue Cycle

Our medical coding resources are experts in below billing and coding software

  • OfficeAlly
  • CureMD
  • AdvancedMD
  • Dr Chrono
  • NextGen
  • Waystar
  • NueMD
  • PracticeSuite
  • Kareo
  • Athena
  • MediTouch
  • SimplePractice
  • Brightree
  • Medisoft
  • CareCloud
  • Lytec
  • AdvancedBilling
  • TotalMD

Medical Billing

We provide end-to-end Medical Billing Services and act as a mediator between insurance companies and healthcare providers. Healthcare providers are facing challenges with the possibility of losing large quantities of money every year due to underpricing, coding errors, non-reimbursed claims and missed charges. We can eliminate the occurrence of these losses through our vast industry experience.

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Our End-to-end medical billing services include:

  • Pre-certification & Insurance Verification
  • Patient Demographic Entry
  • CPT and ICD-10 Coding
  • Charge Entry
  • Claims Submission
  • Payment Posting
  • Account Receivables Follow-up
  • Denial Management

Data Solutions:

  • Hassle free migration from one billing software to another
  • Manual conversion of data
  • End-to-end billing and coding solutions
  • Recover every dollar you are entitled to

HCC Coding Services

We provide most reliable and cost-effective way to ensure consistent and accurate HCC Coding Services performance. This helps ease some of the administrative burden on physicians, allowing them to focus more time and attention on caring for their patients.

Our concurrent approach helps in minimizing rework, duplication of efforts, and the need for alternate submission forms to adjust initial claims.

Our vast industry experience helps us implement the best practices used by top-performing medical organizations to To improve your HCC coding performance

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  • Uncompromised coding accuracy
  • Transparent best-in-class audit framework
  • Dedicated audit teams for each project
  • Adherence to client & regulatory guidelines
  • Dedicated & Experienced Resources
  • Strong governance through regular reports and reviews


Practice Performance Audit And Analysis

We perform a comprehensive audit and provide detailed analysis of the current health of your practice. Our team of experts generate several reports which outline the areas where the physician needs to focus to make sure the reimbursements are appropriate.

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  1. Revenue cycle management
  2. Optimization of costs
  3. Expert guidance on choosing appropriate EMR/EHR, Practice management software
  4. Migration of practice management software
  5. Strategic analysis on maintaining AR below 90 days aging

Our wide range of services are created to ensure medical practices receive an optimal Return On Investment. Whether you have an in-house medical billing team or you are looking for help with a specific area of your practice, we are here to help!