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Credentialing &

Contracting

Our credentialing and contracting professionals proudly assist the physicians and the institutions to complete their enrollment and participation status with the state-based and commercial insurances and their health plans efficiently. As the healthcare revenue cycle has paramount importance related directly to the providers' in-network or participation status, we ensure and encourage the appropriate steps to embrace the enrollment process and this is leveraged with our APEdX score to ensure any gaps and loopholes in the providers' enrollment package.

AIHCON can deal with credentialing or re-credentialing expected by most payors. We can likewise deal with the office contracting, and CAQH quarterly updates as necessary allowing a quicker process to hold the supporting documentation. Are you ready to let someone else handle the paperwork on your own so that you can get back to your patients?


We make it easy for you to get enrolled with Managed Healthcare Organizations and Government Healthcare Program Payers. Complete the form at the contact us page to get started and a representative will contact you shortly.

Revenue Cycle Management

The healthcare revenue cycle process is more complex than for other industries due to the multiple parties involved in reimbursement. AIHCON aims to provide our providers with the confidence that their billing and coding practices are following best practices and also comply with quality codes.

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As the term “Revenue Cycle” implies that billing is a cyclical process, it usually starts from:

    Patient Scheduling and Registration

    Medical Coding & Billing Claims

    Insurance Claims are processed

    Claims are adjudicated with a clearing house and denials management is followed through

    Account Receivables and Patient Billings

AIHCON aims to provide our providers with the confidence that their billing and coding practices are following best practices and eliminates the risk of unknowingly committing wrong ICD 10 Codes and CPT codes to avoid errors and fraud in claim submission and being fined up to twice the damages.

Virtual Practice Assistance

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Healthcare administrations include some quite challenging processes to manage a practice effectively and could stand in a way of physicians not being able to provide the services with quality and at a minimized cost. A lot of these activities can be easily substituted with the advent of virtual or remote assistance with speed and at a much-reduced cost to a facility owner. It can make patient records, test results, and practice rules more accessible from the diagnostic room with speed and in a significantly more straightforward methodology.

It can likewise permit healthcare or medical professionals or other suppliers to talk with one another electronically to examine treatment plans or other usable strategies. Simultaneously, the Internet upholds a shift toward more persistent focused care with quality towards the patient population, and even to get care in the home.

Schedule a free consultation with our experts and find out which of these services are compatible to meet your needs.

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Our Virtual Remote Assistance services can also support numerous health-related activities beyond the direct provision of care, such as; patient eligibility check, appointment scheduling and follow-up services, missing services identification, screening and notification for the healthcare provider, enabling inventory management seamless with virtual activities,vaccination inventory is also managed virtually, checklist and daily huddle can also be done remotely, staff screening, training and recruitment are also possible.

Quality Incentive Payment

The Quality Incentive Program (QIP) addresses compensation or pay for performance to represent a value-based payment model for the physicians and clinicians in the healthcare system. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a US legislation passed in the year 2015 and acts as a healthcare network to evaluate and reward healthcare reimbursements MACRA requires to implement of an incentive program, the Quality Payment Program.

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There are 2 methods a physician or a clinician can choose to participate in, which are MIPS and APMs. Quality health care is a high priority according to the Department of Health and Human Services (HHS), and the Centers for Medicare & Medicaid Services (CMS) and AIHCON want to ensure a physician provides and promotes the best healthcare services to the medical facility on the patient treatments to address the various quality initiatives taken for the quality improvement according to a health condition. Feel free to schedule a free consultation to learn more about how we can help you with the QIP program.

HEDIS MEASURES

HEDIS allows consumers and purchasers to compare the performance of health plans to other plans as well as national or regional benchmarks. HEDIS, which includes over 70 measures of process, structure, and outcomes, addresses a wide range of care from prevention to acute to chronic care.

AIHCON can help a facility reach a satisfactory outcome with the HEDIS performance measures, reach out to us to see how we can help you more with your HEDIS quality measure performances.

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Transitional Care Management

Healthcare practices that provide TCM services to their patients can improve the patient’s self-care abilities after discharge while reducing the likelihood of exacerbations and readmissions to the hospital.

AIHCON’S healthcare professionals are available to assist private practices that are interested in building TCM services.

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HIPAA CERTIFICATION

HIPAA certification implies whether a healthcare organization has been found to meet the guidelines of the Protection, Security, and Breach Notice Rules of HIPAA. HIPAA policy development and certification guarantees that healthcare professionals understand what their lawful commitments are.

There's more to HIPAA compliance than login information and passwords. AIHCON will guide as a consulting partner with the HIPAA entity to facilitate and get certified.

One Stop Solution For Comprehensive Diabetic Care

Medical care or treatment programs coordinating data and correspondence with communication system advances have the likely potential gains to give medical facilities to further develop medical care and personalization care towards diabetes patient population. AIHCON’s one-stop comprehensive diabetic care model proposes to create a service-oriented platform based on various individual services and implement innovative care models that can be deployed in different settings to perform remote patient monitoring, distributed decision support, and clinical feedback provision

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Practice Management Solution

Our Practice Management Solution is equipped with multiple solutions and platforms making healthcare practices to streamline their administrative and important medical visit planning more accessible and aid their EMR systems with core functions to close the referral loop between providers and specialists and to manage all the information involved to run a medical facility as efficiently as possible.

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AIHCON’s tech wing is encompassed by a team full of web architects and enthusiasts built with integrity and committed to delivering outstanding and measurable results for our valued clients. Our team of web developers and strategists have a good footprint exclusively in the medical sector as our passion to develop and optimize healthcare facility or physician websites has strengthened our web experience and competitiveness.

PCMH CERTIFICATION

The Patient-Centered Medical Home (PCMH) is a patient-centred care model and is also stated as a philosophy of care based on the Agency for Healthcare Research and Quality’s (AHRQ) definition of a medical home.

PCMH meets the QIP program with MIPS guidelines for CMS reimbursement and can benefit a physician and a medical facility in increased payments from CMS and other payors from our healthcare ecosystem. AIHCON will facilitate the medical facility to transform into a patient-centred medical home to be certified by NCQA and receive quality incentives by addressing and shaping to provide better care to the patients and the clinical care teams

According to NCQA, research also shows that PCMHs improve quality and the patient experience, and increase staff satisfaction—while reducing health care costs. If your facility wants to provide continuous commitment with a patient-centred approach to care, then join AIHCON today and allow us the opportunity to provide the medical, administrative and technical assistance to help you earn the PCMH recognition from NCQA.

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