Our Services

Revenue Cycle Management

We support healthcare providers with efficient revenue cycle operations designed to improve financial performance and reduce administrative burden.

Medical Coding & Billing Audits

Unlock your practice's full financial potential while ensuring total compliance. Our specialized auditing services are designed to identify missed reimbursement opportunities, rectify coding inaccuracies, and mitigate audit risks before they impact your bottom line

Our services include:

• Medical coding, billing and claims submission

• Payment posting and reconciliation

• Accounts receivable (A/R) follow-up

• Denial management and appeals

• Insurance verification and claim correction

• Monthly Financial & Analytics Reporting

We assist with:

• RAT-STATS Statistical Sampling

• E/M Documentation Reviews

• Revenue Leakage Detection

• Compliance & Risk Mitigation

• Pre-billing & Retrospective Audits

• Payer Recoupment Prevention

Our services include:

• NPI (NPPES) Registry Updates & Maintenance

• SICRO (OCS) Profile Management

• Medicare & Medicaid (Vital) Enrollment & Revalidation

• Health plan enrollment applications

• Demographic & Directory Accuracy Audits

• Follow-up with payer credentialing departments

• Monitoring of contracting status

• Expiration Tracking & Renewal Alerts and more

Provider Credentialing Management & Health Plan Contracting

Through our specialized division, Certum Provider Solutions, we ensure your organization establishes and maintains optimal participation with all major insurance networks