Medical Billing

Medical billing and coding involves converting clinical documentation into CPT and ICD-10 codes used by insurance companies to authorize and reimburse healthcare providers for services rendered.

Charge Entry

ANO-RCM employs certified coders and billers for charge entry. We recognize that while many EMR/EPM systems auto-generate codes, those entries require manual professional review to ensure accuracy. Our charge entry process is fully customized to each client's individual requirements.

Medical Auditing

ANO-RCM performs medical audits to verify that documented services align with the codes submitted for reimbursement. Our certified auditors identify coding discrepancies, compliance risks, and opportunities to optimize revenue capture before claims are submitted — reducing denials and protecting your practice from audit exposure.

Claims Processing

All charges are thoroughly reviewed before electronic submission through clearinghouses. Our staff continuously monitors claim status, identifies rejections, and resubmits corrected claims promptly to minimize delays in reimbursement.

Insurance Payments

ANO-RCM reconciles all payments by cross-referencing ERA and EFT data. Our dual-verification process ensures:

Accurate payment representation in your EMR/EPM system
No missed payments
Prevention of posting payments that have not been received
Correct posting dates for accurate monthly reporting

Denials Management

We review all denials and validate each one. Where appropriate, we correct and resubmit claims or file formal appeals to secure the full reimbursement your practice is owed.

Terminology

EMR/EPM: Electronic Medical Record / Electronic Practice Management — the software systems used to manage patient records and practice operations.
ERA: Electronic Remit Advice — the electronic explanation of benefits sent by insurers detailing how claims were adjudicated and payments calculated.
EFT: Electronic Funds Transfer — the direct electronic transfer of insurance payments into the provider's bank account.
Clearinghouses: Secure electronic hubs that transmit claims between providers and insurance companies while protecting patient health information (PHI).