Billing Solutions

Eligibility Verification

We do provide eligibility verification services to clients to get higher chances of confirmed payment of the services given by the provider. We do check eligibility of each patients to make sure their coverage are active for the dates.
We also do a detailed eligibility in cases as required by the provider to support them with the all the details required by them. Such as copays, deductibles, In / OON benefit coverage's etc.
We also provide authorization services to providers if they are performing such procedures or injections which may need authorizations.
We do have a good follow up system on these so that provider can be updated for any suggestion / changes required. So we can avoid denials for eligibility and authorizations.

We have a well organized process for Denial Management and insurance follow-up.
We do have a RA process to reduce AR. In this when any denial is posted it will fall in our RA cycle and our Denial Management team will find the reason and try to fix it at very first level.
Now AR process comes in picture when any claim is not sent but not paid till 30 days. The Denial Management team will reach out to insurance and find out reason why the claim is denied and try to get it paid by providing solution to that denial.

We provide complimentary MIPS (Merit-based Incentive Payment System) reporting services to ensure your practice meets all CMS quality reporting requirements. Our experts handle the entire process — from data collection to submission — so you can focus on patient care instead of paperwork.
Our team tracks and reports key performance metrics, including quality measures, improvement activities, and promoting interoperability. This helps your practice stay compliant, maintain eligibility, and enhance overall performance scores.
By offering MIPS reporting at no extra cost, we help you avoid potential penalties and maximize incentive payments. With our support, your reporting is accurate, timely, and stress-free.

Zenexa do provide charge posting and Medical coding process.
We do have billing and coding protocols in which we do check cpt and diagnosis combinations that if those are valid, required any modifier etc. If we do have some concerned findings then we make provider aware with the suggestions.
We have experience of handling different specialty billing / charge posting for different kinds of specialty like Internal medicine, Pain Management, Radiology, Cardiology etc.
We do tackle different kinds of billing like in office billing, Nursing home, Hospital billing, UDS, RPM, DME billing etc.

We have a well organized process for Denial Management and insurance follow-up.
We do have a RA process to reduce AR. In this when any denial is posted it will fall in our RA cycle and our Denial Management team will find the reason and try to fix it at very first level.
Now AR process comes in picture when any claim is not sent but not paid till 30 days. The Denial Management team will reach out to insurance and find out reason why the claim is denied and try to get it paid by providing solution to that denial.

Our credentialing and enrollment services ensure your providers are properly registered with insurance payers and networks. We take care of application submissions, documentation, and follow-ups to make the process smooth and efficient.
We manage both new enrollments and revalidations, helping your practice stay up to date with all major commercial and government payers. This minimizes claim denials and prevents interruptions in payments.
By partnering with us, you save time and avoid administrative hassles. Our experienced team ensures accurate, timely credentialing so your providers can focus on patient care.