Services
Our service model covers the full claim lifecycle, from front-end intake controls to denial recovery and credentialing support.
We validate demographics, policy details, and active coverage before service date. This reduces eligibility denials, supports accurate patient responsibility estimates, and improves first-pass claim acceptance.
Our coding team reviews documentation for diagnosis and procedure alignment, modifier usage, and payer-specific requirements. The result is cleaner claims and stronger compliance discipline.
We capture and post charges promptly with reconciliation checks against encounter data. Accurate charge entry prevents missed revenue and reduces downstream correction cycles.
Claims are prepared, scrubbed, and transmitted electronically with rejection monitoring. We correct front-end edits quickly to avoid filing delays.
We post ERA/EOB payments with contractual adjustment logic and variance checks. This provides reliable reconciliation and clearer visibility into underpayments.
Our AR specialists prioritize aged balances by payer behavior, claim value, and denial reason. Focused follow-up accelerates collections and reduces avoidable write-offs.
We classify denials by root cause, coordinate corrected claims, and submit appeals with supporting documentation. Monthly trend reviews help prevent repeat denials.
We support provider enrollment, revalidation, payer roster updates, and tracking of effective dates. Proper credentialing workflows help protect reimbursement continuity.
Nexiqor workflows are designed to align with common PM/EHR ecosystems and clearinghouse integrations. During onboarding, we map data handoffs and reporting requirements to your operational setup.
Contact Us| Workflow Stage | Primary KPI | Monitoring Frequency |
|---|---|---|
| Registration & Eligibility | Eligibility-related denial rate | Daily |
| Coding & Charge Entry | Charge lag and coding variance | Daily |
| Claims Submission | First-pass acceptance rate | Weekly |
| AR Follow-up | AR days and aged balances | Weekly |
Client Reporting
Net collections, underpayment tracking, payer turnaround performance, and contractual variance highlights.
Denials grouped by front-end, coding, authorization, and payer processing categories with targeted fixes.
A practical issue log with accountable owners, due dates, and expected revenue impact by corrective action.