Claims Audit - Patient
Record Audit

A solution to reduce your claims rejection

Group of trained RCM professionals (internal or outsourced) who are involved with the patient from the start of their care to the very end when payment is made. They assign appropriate codes based on a patient's record and bill. These codes are made into Pre-approval & claims that are sent to the patient’s insurance company/TPA. Though RCM unit use professional team, still claim rejection persist, and it is mainly due to gap between patient EMR and RCM process and leads to following rejections:

Patient eligibility
Medical necessity
Coding errors

Pre-authorization errors
Billing errors
Submission errors

Cephal offers a Claims Pre-submission Tool is to identify potential reject-able claims and guide healthcare providers to rectify the gap prior to claim submission. Tool address the following errors and flag them for correction.


Our Services