Prepare Accounts Before Services Are Billed
- Insurance Verification: Review insurance information, plan benefits, network questions and service-specific coverage details.
- Eligibility: Check coverage status for the date of service and identify inactive plans or information mismatches.
- Prior Authorization: Coordinate authorization requests, required documentation, payer responses and approval details.
- Medical Credentialing: Organize provider applications, payer enrollment follow-up and updates to participation records.
These services address separate questions. Active coverage does not establish that every treatment is covered. An authorization does not replace provider enrollment. Connecting the findings helps your team prepare a more complete account before claim submission.
Build and Submit Claims With Better Information
- Medical Billing: Manage claim preparation, submission status, payment posting and billing follow-up.
- Medical Coding: Review documented diagnoses, procedures, modifiers and relevant coding requirements.
- Coding Audits: Examine a defined sample of records and claims to identify coding and documentation issues.
- EHR Integration: Assess billing data movement, workflow connections and reconciliation between compatible systems.
Claims should reflect the care documented and the setting where it occurred. Our work helps identify missing or inconsistent administrative information while directing clinical questions back to the provider responsible for the record.
Follow Up on Payer and Patient Balances
- Denial Management: Investigate denial reasons and support correction, reconsideration and appeal activity.
- AR Follow-Up: Review unpaid insurance balances and document the next action needed for each account.
- Patient Statement Processing: Prepare understandable statements after patient responsibility has been reviewed.
- Patient Collections Management: Support practice-approved patient balance communication and account resolution.
The appropriate next step depends on the account. A claim may need a missing document, a corrected submission, an enrollment review or a payment reconciliation. We focus on that distinction so routine resubmission does not replace investigation.
Connect the Full Revenue Cycle
- Revenue Cycle Management: Coordinate selected administrative stages from patient access to final account resolution.
- Reports: Review collections, aging, claim activity, denials and other agreed billing measures.
RCM gives the individual services a shared structure. Reporting then helps show whether work is progressing, which issues recur and where your practice needs to make a decision.
Select Support by Service and Specialty
The right scope depends on more than claim volume. We consider professional or institutional billing, recurring authorizations, treatment patterns, patient balances and specialty documentation. Visit our specialties directory to see how support can be shaped around your care setting.
Questions About Our Services
Can we combine several services
Yes. Discuss the functions you need together so the responsibilities and information handoffs can be included in one service plan.
Can Native RCM review older unpaid claims
Yes. An AR review can assess account age, previous actions, available records and remaining payer deadlines before the next steps are agreed.
Where should we start if we are unsure what is wrong
Begin with a discussion of your billing process and recent reports. We can help identify whether the priority is claim preparation, denials, aging, enrollment or another function.
Discuss the Services Your Practice Needs
Call (307) 454-0429 or contact Native RCM to discuss medical billing and revenue cycle services for your Wyoming organization.