Your Dedicated Hospital Billing Partner
Hospital Billing
Improve accuracy and efficiency in your hospital billing operations with our trusted solutions.
Streamlined Solutions for Hospital Billing
At Med Karma, we understand that managing a hospital’s financial life cycle is a highly complex and overwhelming task. From emergency services and inpatient admissions to outpatient surgeries and specialty clinics, each service rendered requires proper handling to secure timely reimbursement.
That’s where we step in. Our automation-enhanced Hospital Billing and Revenue Cycle Management (RCM) services are built to help hospitals optimize every phase of their revenue cycle. This includes reducing denials, accelerating cash flow, and minimizing administrative burden through the power of intelligent automation paired with deep healthcare expertise.
Why Hospital Billing Is So Complex
Hospital billing must manage:
- Complex DRG (Diagnosis-Related Group) and APC (Ambulatory Payment Classification) assignments
- Professional and facility charge separation and reconciliation
- Prior authorizations for procedures, admissions, and high-cost drugs
- Modifier and multiple service rules
- Medicare and Medicaid billing regulations
- Commercial insurance variances
- Frequent audits and compliance risks
- Lengthy A/R cycles and multi-step denial management processes
Without an efficient, automation-supported revenue cycle system in place, hospitals risk significant revenue loss, claim rejections, and costly delays.
How Our Automation-Powered Hospital RCM Works
At Med Karma, we integrate cutting-edge automation tools at every stage of the hospital revenue cycle – reducing manual work, improving data accuracy, and accelerating revenue collection, while maintaining full compliance with payer and regulatory guidelines.
Automated Patient Registration, Eligibility & Benefit Verification
From emergency room arrivals to elective procedures, our system automates the capture of patient demographics, insurance information, and benefit details in real time. It verifies eligibility, benefit limits, and prior authorization requirements, ensuring financial clearance before care is provided whenever possible.
Key Benefits:
- Real-time eligibility and benefits verification for all inpatient and outpatient services
- Automated prior authorization status checks and follow-ups
- Integrated financial clearance workflows with point-of-service staff
- Reduction in eligibility-related claim denials
AI-Driven Medical Coding & Charge Capture
Hospital coding requires accurate DRG, ICD-10, CPT, HCPCS, and revenue code assignments for a wide range of services – including inpatient, outpatient, surgical, ancillary, and professional services. Our certified coding specialists work alongside AI-powered coding tools that automatically analyze clinical documentation, suggest codes, and identify missing or non-compliant elements before claims are created.
Features Include:
- AI-assisted DRG and APC assignment
- Automated CPT/HCPCS coding suggestions for outpatient encounters
- Modifier management and NCCI edit validations
- Integration with CDI (Clinical Documentation Improvement) programs
Automated Claim Scrubbing, Submission & Real-Time Tracking
Before submission, our intelligent claim scrubber reviews every claim for errors, coding conflicts, missing data, and payer-specific billing rules. Clean claims are submitted electronically to government and commercial payers, with real-time tracking and rejection alerts to minimize revenue delays.
What You’ll Gain:
- Automated claim validation against payer guidelines and compliance rules
- Instant notification and auto-correction for claim rejections
- Seamless electronic submission to Medicare, Medicaid, and all commercial insurers
- Live dashboards for claim status, aging, and financial forecasting
AI-Powered A/R Management & Denial Resolutions
Hospital accounts receivable is notoriously complex, with varied payer timelines, high claim values, and intricate denial reasons. Our AI-based A/R management platform automatically prioritizes outstanding claims by age, balance, and denial reason, generating follow-up task lists and automated appeal letters to expedite resolution and prevent revenue loss.
Key Highlights
- AI-driven A/R worklist prioritization
- Automated appeals for underpayments, coding denials, and medical necessity rejections
- Real-time denial analytics by department, service line, and payer
- Lien tracking for Workers’ Compensation and accident-related claims
Automated Patient Billing, Payment Plans & Digital Collections
Today’s patients are responsible for a growing share of their hospital bills – billing transparency, accuracy, and convenience are essential. Our system automatically generates clear, patient-friendly statements, sends reminders via email or text, and offers secure online payment portals and recurring payment options for large balances.
What Patients Appreciate:
- Automated billing statements and text/email reminders
- Mobile-friendly payment links and secure portals
- Recurring payment plan setup for high-dollar balances
- Instant digital receipts and account updates
Med Karma Benefits
- Faster patient eligibility checks and fewer eligibility-related denials
- Accurate, AI-assisted coding for DRG/APC and professional services
- Significantly reduced claim denials and rejections
- Real-time claim status monitoring and revenue forecasting
- Automated, data-driven denial management and appeals
- Shortened A/R cycles and improved cash flow
- HIPAA-compliant, secure data and documentation management
At Med Karma, we don’t just process hospital claims – we automate, optimize, and protect your hospital’s financial health so you can stay focused on what matters most: saving lives.
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