Why should I use Cosmos Medical Management (CMM) for medical billing and management services?

Our collection from insurance companies is 100% and A/R denial is >1%. By outsourcing billing and management services to CMM, you do not have to worry about billing staff as we are responsible for hiring, training, and supervising of employees. Our services will allow you to free up your office space and eliminate the need for billing software, thus alleviating stress, and giving your staff more time to devote to patient care and day-to-day activities. Our 20 years of experience allow us to improve your collections, no matter the size or specialty of your practice. Aside from billing services, CMM also provides complete credentialing and recredentialing services with a variety of insurance companies. We can help set up new practices and obtain NPI numbers and tax IDs if needed etc. Cosmos Medical Management is your end-to-end virtual medical billing, coding, credentialing, and management solution.

How do I make billing information available to CMM?

There are several ways to do this. We can download the patient’s demographics and superbills from your office if you give CMM remote access. Alternatively, you can email or fax the information to CMM via our secure eFax service.

How are primary and secondary insurance claims filed?

All claims are initially filed electronically or on paper if the carrier does not accept electronic claims. Claims that require medical documentation are faxed, emailed, mailed, or uploaded to the insurance website. Claims billed to secondary carriers are faxed, mailed, or billed electronically with primary insurance EOB.

How do you ensure that all claims are processed and paid by the insurance company?

We run reports regularly and use several steps to make sure all claims are paid in a timely manner. We work on each claim until it has been paid or a reasonable denial for nonpayment has been given. If a claim is not paid in a timely manner, our professional staff either calls or checks its status online and follows up rigorously until its settled. If a claim is denied and we are not satisfied, then we appeal the decision and work that claim until a satisfactory decision is rendered.

How does your company get access to EOBs and payments?

Most insurance companies make EOBs available electronically, which can be downloaded in our software through our clearing house or from the insurance carrier’s website. If your office receives EOBs and checks from insurance companies and patients, the payment will be deposited by your office staff, and EOBs and copies of the payment will be faxed to CMM.

Where do payments from insurance carriers and patients go?

All payments from insurance carriers and patients are sent directly to you by mail or through Electronic Funds Transfer (EFT). You can choose whether payments and EOBs are remitted to your post office box, bank lockbox, or physical address. If you choose to use a lockbox, EOBs are mailed to your bank where all the checks are scanned and deposited and made available through the online banking system. If you use a PO box or physical address, EOBs and checks are mailed to the payment mailing address.

How does CMM handle delinquent accounts?

CMM pursues delinquent health insurance claims and patient accounts professionally and courteously. Our procedure is to send three statements to patients with follow-up phone calls. We offer several payment plans until the account is paid in full. We also provide mutually agreed upon discounts if the patient agrees to send a full payment. Payment through credit card is offered to the patient. If the patient does not respond after three statements and phone calls, then the account is sent to a collection agency upon your approval.

How can I stay in touch with CMM to make sure my billing is done to my satisfaction?

We can meet with local physicians and selected staff upon request. For long distance clients, we can arrange a phone call or Zoom meeting to discuss any questions. We provide extensive, self-explanatory reports at the beginning of every month and can create customized reports upon request. We also provide annual comparative reports for up to the past three years of charges, collections, and outstanding balances to show the trend of your practice.

How do I make sure that patient information and data is secure?

CMM is a HIPAA-compliant billing and management company. We follow secure data protection policies, and our data is securely backed up multiple times every day.

Who answers medical billing service questions that patients might have?

The staff at CMM answers all billing-related phone calls and questions. A toll-free number will be provided on all claims and patient statements.

How do you charge for your billing and management services?

CMM does not get paid unless you get paid. Our fees are percentage-based and proportional to your receipts. The percentage charged is based on many factors, including specialty, practice size, and customized services offered. There is a one-time, nonrefundable setup fee for new and established practices. Credentialing services can be provided on an hourly basis or per project. Please contact CMM for more information.

Can I revoke or cancel my agreement with you?

Your contract with CMM is nonbinding and can be cancelled with 90 days’ prior notice and a written agreement from each party.

How do I get started?

We will send you a service contract to review and sign. We can start entering your data as soon as the agreement is signed, and the appropriate information is available. For more information please submit through our contact form or schedule a free consultation.

General Surgery

Credentialing & Billing Services for General Surgeons

General surgery covers a wide range of procedures, from abdominal and digestive system operations to trauma care and soft tissue management. Because of this diversity, credentialing and billing for general surgeons can be complex and time sensitive. Proper credentialing ensures surgeons are enrolled with major insurance carriers, allowing patients to access care without delays and practices to receive timely reimbursements. On the billing side, accurate coding is essential to capture the full scope of services provided, reduce claim denials, and secure maximum payment. By managing both credentialing and billing, we help general surgeons streamline administrative tasks, maintain compliance, and focus on delivering high-quality surgical care while ensuring their practice remains financially strong.

Credentialing & Enrollment

Application Management : We prepare and submit complete applications to insurance carriers with accurate documentation, reducing errors and delays so providers move through the credentialing process smoothly.

Enrollment Tracking : Our team monitors applications closely, follows up with carriers, and keeps providers updated until approval is secured, preventing unnecessary waiting and keeping the process on track.

Contracting and Enrollment with Payers : Enrollment and credentialing process to establish contracts with insurance payers. This ensures your practice is credentialed, reimbursed correctly, and positioned for long-term financial stability.

Efficient Onboarding into Payer Systems : By finalizing both the contract and effective date, we remove uncertainty and prevent delays. This allows your practice to begin billing payers immediately, ensures uninterrupted patient care, and drives sustainable growth.

Revenue Cycle Management

Accurate Coding & Billing

Specialized CPT & ICD-10 Codes : We apply precise codes tailored to general surgery procedures, ensuring compliance with payer requirements and reducing the risk of costly errors.

Accurate Coding for Efficiency : Accurate coding minimizes mistakes that often result in claim denials or underpayments. By reducing these errors, your practice maintains a smooth and efficient revenue cycle. This ensures financial reliability and supports long- term operational stability.

Claims Submission & Tracking

Clean Claim Submission : We ensure every claim is filed promptly and with complete accuracy, reducing the risk of rejection or delays. By submitting clean claims the first time, reimbursements are processed faster, keeping your practice’s cash flow steady.

Continuous Monitoring : After submission, our team closely tracks each claim through the payer’s system until payment is finalized. This ongoing oversight ensures no claim is overlooked or lost, giving you confidence that revenue is being managed effectively.

Proactive Resolution : If a claim is flagged, delayed, or denied, we act immediately to identify the issue and resolve it. Our proactive approach minimizes interruptions in revenue and ensures your practice continues to receive payments without unnecessary delays.

Denial Management

Root Cause Analysis : We carefully review every denied claim to identify the exact reason behind the rejection, whether it’s missing documentation, coding errors, or payer-specific requirements. This thorough analysis ensures we address the issue at its source rather than just treating the symptoms.

Quick Corrections & Resubmissions : Once the problem is identified, our team promptly corrects the claim and resubmits it to the insurance carrier. This fast turnaround helps recover lost revenue quickly and minimizes the impact of denials on your cash flow.

Comprehensive Management of Claims Appeals : For complex or disputed denials, we prepare detailed appeals supported by proper documentation and evidence. Our goal is to secure rightful payment by presenting a strong case to payers, ensuring your practice is not left uncompensated.

Strategies for Minimizing Claim Denials : Beyond fixing individual claims, we analyze denial trends to uncover recurring issues. By implementing proactive solutions - such as coding improvements or process adjustments - we reduce future denials and strengthen the overall revenue cycle.

Payment Posting & Reconciliation

Accurate Payment Recording : Every payment received from insurance companies and patients is carefully logged into your system with precision. This ensures that all transactions are accounted for and no revenue is overlooked, keeping your financial records complete and reliable.

Accurate Matching of Payments to Billed Claims : Payments are systematically matched against the claims submitted, verifying that the amounts received align with what was billed. This process provides transparency and helps identify underpayments or discrepancies early.

Discrepancy Resolution : If mismatches or shortfalls are detected, our team investigates and resolves them quickly. By addressing these issues promptly, we prevent revenue leakage and ensure your practice receives the payments it is entitled to.

Comprehensive Financial Reconciliation and Transparency : Organized reconciliation creates a transparent financial picture of your practice. With accurate records, audits become simpler, and you gain confidence in the overall financial health of your operations.

Patient Billing & Collections

Clear Patient Statements : Patients receive bills that are simple, transparent, and easy to understand, clearly outlining balances after insurance payments. This reduces confusion, improves trust, and helps patients know exactly what they owe and why.

Structured Payment Solutions for Self-Pay Patients : We handle self-pay accounts with flexible payment options and structured reminders, making it easier for patients to meet their obligations. This approach encourages timely collections while reducing the risk of unpaid balances.

Guidance on Patient Financial Responsibilities : Patients are guided through their financial responsibility with clear explanations of insurance coverage and out-of-pocket costs. By educating patients, we help them understand their obligations and avoid misunderstandings or disputes.

Compassionate and Professional Collections : Collections are managed with professionalism and respect, ensuring patients feel supported rather than pressured. This compassionate approach maintains patient trust and satisfaction while securing the payments your practice depends on.

Reporting & Analytics

Easy-to-Read Reports : Financial performance is presented in clear, user-friendly dashboards that highlight the most important metrics. These reports simplify complex data, making it easy for providers and administrators to quickly understand their revenue cycle.

Revenue Tracking : We continuously monitor collections, outstanding claims, and overall revenue trends to give you a complete picture of your financial health. This tracking helps identify strengths and areas that need improvement, ensuring nothing is overlooked.

Clear Reporting to Support Financial Confidence : Consistent reporting keeps you informed about the status of your revenue cycle at all times. With timely updates, you gain confidence in your financial operations and can make proactive adjustments when needed.

Why Choose Us

Specialized Expertise : We focus on credentialing and billing for surgical practices, bringing deep knowledge of payer requirements and surgical coding.

End-to-End Support : From application management to patient collections, we handle the entire revenue cycle so you can focus on patient care.

Improved Cash Flow : Our proactive approach reduces denials, speeds up reimbursements, and ensures consistent revenue for your practice.

Transparent Communication : We provide regular updates on credentialing status, claim progress, and financial reports, keeping you fully informed.

Patient-Centered Approach : Collections and billing are managed with professionalism and respect, maintaining patient trust while securing payments.

Data-Driven Insights : Clear reporting and analytics empower smarter business decisions and long-term practice growth.