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At Venus Health Synergy, we provide intelligent, secure, and accurate solutions that transform the way healthcare organizations manage financial and legal operations. Backed by AI, compliance-driven practices, and a client-first approach, our services are built to improve efficiency, reduce denials, and accelerate reimbursements.
With Venus Health Synergy, you don’t just get automation —
you get a hybrid model of process precision + intelligent automation, built to scale with your practice.
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Our core processes are backed by years of operational excellence, and every service is designed with a clear goal: to help you focus on patient care while we handle the revenue cycle with unmatched accuracy and accountability.
Eligibility & benefits verification
Prior authorization management
Real-time demographic & insurance validation
Expert-led medical coding (ICD-10, CPT, HCPCS)
AI-assisted coding for speed & accuracy
Compliance review with human quality checks
Clean claim creation with smart scrubbing
Auto-correction of common errors
Multi-payer EDI claims submission
ERA/835 processing
Manual & electronic reconciliation
AI-powered variance analysis with audit trails
Predictive denial analytics for proactive follow-ups
AI-enhanced root cause analysis
Automated A/R recovery strategies
Custom dashboards with real-time KPIs
AI-driven revenue leakage detection
Goal: Prevent denials by verifying details before services are provided.
Patient Scheduling – Phone, online, or referral bookings with initial demographics.
Patient Registration – Full details including insurance information.
Eligibility & Benefits Verification – Confirm coverage, copays, deductibles, and out-of-pocket costs.
Prior Authorization – Secure approvals for required procedures with full documentation.
Financial Counseling – Provide cost estimates and flexible payment options.
Goal: Capture accurate information at the point of care.
Verify ID & insurance details.
Collect copay upfront.
Document diagnoses and treatments in EHR.
Goal: Convert medical services into billable, compliant codes.
Capture all billable charges from provider notes.
Assign CPT/HCPCS and ICD-10 codes.
Ensure codes match medical necessity.
Goal: Send clean claims for faster approval.
Run claims through scrubbing tools to detect errors.
Submit electronically via clearinghouse or directly to payers.
Goal: Ensure claims are adjudicated correctly.
Payer reviews for coverage and coding accuracy.
Receive Explanation of Benefits (EOB) or Electronic Remittance Advice (ERA).
Goal: Record payments accurately and promptly.
Post insurance and patient payments.
Apply adjustments based on contractual agreements.
Goal: Recover revenue and reduce future denials.
Identify root causes of denials.
Correct and resubmit claims or file appeals.
Monitor denial trends to prevent recurrence.
Goal: Collect outstanding balances quickly and clearly.
Send easy-to-read patient statements.
Follow up via calls, emails, or texts.
Offer multiple payment methods and plans.
Goal: Recover unpaid balances ethically.
Internal collection efforts with reminders and hardship discussions.
External collections only when necessary.
Goal: Optimize cash flow and reduce leakage.
Track KPIs such as Days in A/R, First-Pass Claim Rate, and Denial Rate.
Implement process improvements, automation, and AI-based denial prevention.
