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What We Can Do For Your Practice

• Patient Scheduling


• Eligibility & Benefits Verification


• Patient Pre-Authorization


• Patient Demographic & Charge Entry


• Medical Coding (ICD-10)


• Claims Submission – Electronic/Paper/ Fax/Website


• Payment Posting


• Denial Analysis & Management


• Accounts Receivable Follow Up


• Patient Billing & Statements


• Insurance & Provider Credentialing


• Practice Consulting, Audits and much more….

Deciding how to handle your processing is the first step to the cycle. How big is your medical organization? If you are fairly limited in scope and have a good IT team in place as well as team members who are well versed in using dedicated software for medical billing, you may prefer to install RCM software on your own servers.

However, if you run a Mid-size or Large-size organization, the best approach might be to outsource the RCM process to third party experts. Practices with limited staff expertise in RCM will also find it beneficial to rely on outsiders for this task, so they can focus on their core capabilities in patient treatment.

The next step in RCM is the pre-authorization of each patient. Pre-authorization is defined by the U.S. government as a decision by a health insurer or plan that a prescription medication, procedure, service or equipment is medically necessary. The exception to pre-authorization would be in cases of medical emergency.

It’s important to remember that pre-authorization for a procedure or medicine does not necessarily mean that the insurer will cover its cost, though. Patients and providers have to double-check if there is any doubt about coverage.

Some of the drudgery of your front office staff has to do with checking on eligibility and benefits for patients. When done over the phone, it can be a grueling and time-consuming process that saps employee morale.

Modern medical office software will include automatic checking of patient eligibility via the Internet over secure channels, meaning that using dedicated RCM software can speed up the work involved in verifying a patient is entitled to a particular benefit.

Apart from medical office software, we also have a lot of other options to simplify the work and get accurate benefits to the patient.

Payment will not be forthcoming until your office properly submits claims for the work you do for your patients. Practice management or PM software is invaluable in this situation. You use it to submit claims automatically, including the option to do this in batches.

Human error is always a factor to contend with in submitting claims; you’ll want to deploy PM software that includes an option to detect mistakes and then explain them to you so you can fix the problem. Then you can immediately resubmit the claim.

Accelerating the flow of revenue in your organization will be easier when you gain tighter control over claims and have tools in place to weed out common errors. Do you have an Audit team on staff? Not many practices have one.

After the claim is successfully submitted and reviewed, the Insurance payment is posted and the patient's responsibility can be paid by your patient.

Not all claims are paid by Insurance. Do you have a team to track the denials which get zero payments? Is the aging being worked? Not in most practices.

Do all your patients receive a statement about their responsibility? Most practices send statements to the patients, but do they get paid? We have a simple proven formula to collect the patient’s responsibility in more than 50% of all visits without even sending Patient statements.

How often are claims denied for your facility? If your quarterly reports are showing a downturn in revenue because of too many denied claims, it’s time to investigate the matter. Properly executed denial management will boost earnings if money has been slow because of problematic claims.

Including this process of denial management in your cycle can help you recover revenue that might otherwise have remained overlooked because of insurance being filed incorrectly. You might uncover patterns, such as more denied claims when certain people are working together (or actually not working very hard when they are scheduled on the same shift) or billing problems for certain types of procedures or members of your patient population.

Do you have a solution to eradicate the denials? Nation-Wide has that solution.

A medical practice without detailed reports is a practice that can have hidden problems that may be growing worse. You need to generate a wide range of reports for your practice revenue analysis to identify and solve hidden problems.

The range of reports will also allow you to identify financial data, management information and key performance indicators to see if your team is meeting benchmarks.

Does your practice generate and review all required and necessary reports? Many practices don’t do this, Nation-Wide does.

Nation-Wide uses and adopts the latest technologies in healthcare so we can provide services in a simple and economical fashion. It’s a leading Business Process Outsourcing (BPO) company providing services exclusively for Medical Practitioners and Facilities. Our AAPC certified coders and our billers are well experienced in many specialties with good knowledge of Insurance rules and regulations.

Benefits of Working with Nation-Wide Medical Billing & Coding Services:

Nation-Wide Medical Billing & Coding Services employees are well trained on Revenue Cycle Management. They focus on fixing the process based on six sigma and Defect per million objective (DPMO) Strategies. Your staff will be comforted knowing they have a partner assisting with upcoming implementation dates.

Audits – Nation-Wide Medical Billing & Coding Services works hard to ensure compliance with Recovery Audit Contractors (RAC) services.

• Seasoned team of healthcare professionals who understand, and diligently work on the Total RCM process.


• Get paid faster — our accurate, convenient, compliant and timely review of documentation increases your revenue.


• Spend more time seeing patients, not on paperwork.


• Streamline practice workflow to see more patients.


• Customer Service 24/7 and direct contact with Account Managers.


• Paperless option.


• Claims Billed within 24 to 48 hours.


• Rejections and denials are worked on daily & weekly basis.


• Provider & Insurance Credentialing & Re-Credentialing is done on a regular and timely basis.