Answered by Olga Khabinskay, Credentialing Manager and Director

Answered by Olga Khabinskay, Credentialing Manager and Director of Operations at WCH Service Bureau:
Any rendering service provider that is seeing patients in your practice must:
1. Complete medical charts for the encounter within 24 hours after the visit, demonstrating a strong medical necessity for performed services2. Review and sign all charts and supporting laboratory and imaging test results3. Indicate procedures and diagnosis codes on a superbill4. Cosign the charts for the providers that are being supervised6. Communicate with referring physiciansFront desk staff must:1. Check the insurance eligibility of your patients on a regular basis2. Enter patients into your EMR with insurance details and scan necessary documents including patient IDs, financial information, and consent forms3. Take copay and note in the ledger4. Schedule follow-ups for the patient automatically after they are done with the visit5. Make referrals or help with referrals paperwork6. Collect outstanding balance from patients (deductibles, coinsurance)7. Sort mail8. Schedule appointments9. Alert patients to return to the office for lab or imaging results10. Respond to eRequests sent by WCH
According to the contractual provisions, WCH specialists must:
1. Create and submit claims to insurance carriers based on your superbills2. Follow up on the status of submitted claims3. Work on claim denials, rejections, and underpayments. This includes but is not limited to claim resubmission, calling insurance companies’ customer service, submitting online reconsideration requests, insurance appeals, Department of Finance appeals5. Brief you on the general state of affairs of your revenue cycle management, as well as on the most significant insurance policy updates7. Perform a bonus chart review of five medical records per month9. Provide you with access to all claims and payment reports10. Ensure secure and HIPAA-compliant storage of PHI of your patients.