Eclat Health is a “one stop” solution for all your RCM needs. We are equipped with trained and certified professionals to provide a complete solution.
Eclat has expertise in providing professional services to providers in all 855 forms, PECOS (Provider Enrollment Chain and Ownership System) and CAQH’s (Council for Affordable Quality Healthcare) ProView system.
Eclat supports our clients in credentialing and re-credentialing of Medicare and commercial payers.(We also)
Add physician(s) into an existing group, changing from one practice to another.
Eclat provides ERA / EFT set-up and assistance.
Assistance for Insurance contracts, evaluation and negotiation.
Eclat’s Eligibility Team (EET) follows up with patients to help them with their schedules, helping our clients in increase cash flow and reduce ‘no shows’.
EET verifies the eligibility, co-pay, co-ins, and deductible details and sends this information to the provider’s office even before the patient’s visit.
We streamline the procedure upon receiving the copy of insurance card prior to appointment for services which require pre-certification / authorization.
Patient Demographic Entry
Eclat’s Demo Team (EDT) enters patient demographic details such as name, date of birth, SSN, address, phone #, insurance details, medical history, guarantor, as provided by the patient at the time of the visit to the doctors’ office on the PMS.
CPT and ICD-10 Coding
Our coding team works in accordance to CPT and ICD-10 Coding Compliance.
Our billers receive superbills with diagnostic notes with or without ICD and CPT codes. If codes are already provided on the superbill, they are validated by our coding team to check and prevent any ‘Upcoding’ or ‘Downcoding’ to avoid denials.
The fee schedules are generally pre-loaded into the PMS.
Our billers ensure that the fee schedule is as per the state / provider insurance contract.
Our billers ensure all patient demographics have been provided in the claim and are ready to be filed.
Our billers ensure that the claims are submitted electronically. Paper can be used as an insurance requirement within a 24 hours’ window to the clearing house or insurance.
With ECLAT you can expect all clearing house rejections to be resubmitted on the same day.
EFT/ ERA enrollment to all providers to avoid delays in the payments.
Our billers post and reconcile ERA / EOB / Denials (Based on the PMS) to the PMS on a daily basis.
Account Receivables Follow-up
We can provide a unique follow-up on a weekly, bi-weekly, and / or monthly basis, through your preferred method of communication, depending on the filing limits and buckets of aging.
After a detailed analysis on denials and partial payments, Eclat’s Account Receivable (EAR) team calls payers, patients, providers, facilities and any other participants to follow-up on denied, underpaid, pending and any other inappropriately processed claims.
Notes are posted / documented in the PMS on each account to analyze trends in payments and denials.
Once the provider authorization is completed, our team will contact appropriate patient to obtain information as required for billing such as Insurance Identity number, coordination of benefits and other requirements.
Our (EAR) experts also work on secondary / tertiary / paper claims and follow-ups.
Eclat’s Appeals Team (EAT) appeals on the denials once the correspondence is received from the payers.
For more information on our Medical Billing Services, reach us on