At Upside Lead LLC, we leverage our smart workflow services, which focus on doing things right the first time, every time, while identifying and eliminating the root cause of most billing errors and other mistakes.
98% First Pass Claim Acceptance
Our monthly first pass claim acceptance rate across all of our customers has consistently averaged 98% — 3% higher than the industry average!
Less than 10% Monthly Denials
Our monthly denial rate is less than 10% across all of our customers which is better than the industry average!
80% Electronic Submissions
Electronic submission helps us get our customers paid faster. This function helps in fixing claims-related issues/denials faster as compared to paper submissions.
Clean Submission – Claim Scrubbing
Our state-of-the-art claim scrubber has thousands of intelligently built rules. It automatically tries to fix most of the billing errors before submission.
Comprehensive Reporting
For staying on top of business we provide daily, weekly, monthly, quarterly & yearly practice analysis reports to our clients.
“Almost all quality improvement comes via simplification of design, manufacturing… layout, processes, and procedures.” ~TP
Fee Schedule Review / Analysis
We regularly review procedure fee plans to avoid any financial loss to our clients because of under-billing and non-payable codes.
Denial Coding Audit
Our certified coders, audit claims on a daily basis and suggests correct codes. In case of invalid coding, we notify our clients immediately.
Patient Calls
We have a dedicated team for answering patient calls.
AR Follow-Up
We have billing professionals with a specialized skill-set for AR follow-up. We make sure that the client’s AR is below MGMA standard in all buckets.
Weekly/Monthly Analysis
Our periodic reporting bundle will enable you in making more informed decisions for business improvements.
“Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives.” ~W A. F
Out-of-Network Negotiations
The key to out-of-network billing is successful negotiations with insurances. We negotiate on the client’s behalf for maximum reimbursement.
Out-of-Network Appeals
With our expert appeals team, we make sure that our clients are fully reimbursed. Our appeals framework is specially designed for out-of-network and Lab providers.
Check Forwarding Request
After claim submission, we proactively send check forwarding requests to out-of-network patients so that they may send the check to the client as soon as they receive it from insurance.
Promised Money Details
We communicate with insurance companies and keep our out-of-network clients informed about promised money details!
Out-of-Network Recoup Appeals
We send recoup appeals to recover the refund amount. We have a very high success rate.