- Billing Claims are submitted at least once weekly, often more frequently. 95% of our claims (excluding EAP) are submitted electronically.
- Benefit verification & reports for each new patient and each patient who changes insurance plans How do you know how much to charge your patient at the first session? We take care of this by verifying the benefits with the insurance company. We ask about deductible/status, co-pay, coinsurance, # visits allowed, authorization requirements, pre-existing limitations, allowable CPT codes, network status, and any other special condition of the policy.
- Pre-certification Why should you have to make a special call to get authorization? We will do it at the time of benefit verification, if allowed by the insurance carrier. No more sitting on hold! Use those precious minutes between sessions to do your notes or make clinically-related calls instead.
- Authorization reports Every time your billing is done, you will be emailed or faxed an authorization report. The report lists patient name, authorization number, company name, # visits used, # visits authorized, start date, end date, and notes (usually populated with the # visits allowed per year or benefit period). The report includes not only patients with authorizations, but also EAP patients and patients with a limited # visits per year but no authorization required. There is no need to EVER lose money again because you went over on your authorization or a patient maxed their benefit.
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- Claims follow-up / investigation No, we don’t just submit once and hope you get paid! That is what some billing services do. We look at aging reports every week and follow up on what’s outstanding. You don’t even have to keep track of what we need to follow up on…we take care of it all.
- Patient statements We generate and mail patient statements periodically and/or upon patient request if your patients need statements for legal, health savings, housing, or other circumstances. We can bill attorneys, churches, trust funds, or other guarantors of patient accounts, as needed. Patients are free to call our toll-free number to ask questions about their account or their insurance coverage. You receive either copies of all statements or else a summary report showing patient balances - your choice. We make it as easy as possible for you to minimize your patient accounts receivable. Statements are run weekly with the first cycle beginning as soon as there is a balance - no waiting until the first of the month for the statement to run! The next cycle will be 4 weeks later. So, at least some statements are going out each week - this helps to keep practice revenue consistent.
To see a sample of how our statements look, click here.
send you the following reports on a weekly basis:
Patient statements sent with balances owed
|On a monthly basis, you get:
Total income list
Revenue summary broken down by payer category
Patient balances for all patients
|On a yearly basis, you get:
Yearly charges statistics
Yearly adjustment statistics
are many more reports available that we are happy to send you upon request
at no extra charge.
Some of those are:
- Pending claims (the list of claims outstanding at insurance
companies, along with date of service, date filed/re-filed, and total
- Days in accounts receivable by primary payer
- Accounts receivable aging by date of service
- Top reimbursements by CPT
- ICD diagnosis usage
- Delinquent accounts
- Charges, payment, adjustment statistics on a rolling 12 month basis
- Patient/visit counts
- 12 Month Rolling Account Status
- Annual revenue recovery report
- and many more!
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Select from the following to view detailed explanation:
We also offer a variety of optional services which you can use as needed. No retainer fees--pay only for what you use!
- Managing Authorizations Need help with end date extensions? Following up on submitted treatment reports? Calling to request re-certification? We can do it. A licensed clinical social worker is available to speak with
care managers, if needed.
- Treatment Record Forms Development / Documentation Having trouble organizing your files? We can help by creating forms and templates designed to make your life easier and minimize your documentation burden, while at the same time meeting industry standards for effective documentation.
- Credentialing/Panel Applications Why slog through the same re-credentialing applications every 2 years when nothing has changed? We can keep your information on file and help with submissions, either on paper, via CAQH, or at a payer’s website. Want to join a new managed care panel? We can do that paperwork as well.
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- Insurance/Managed Care Contract Consulting Concerned about signing that contract? Want to know what it is you are signing? We’ve read literally hundreds of contracts and are familiar with their terms. We can review your contract and provide you with a written description in English of just what it is that you are agreeing to, as well as the pros/cons from our experience. We are much cheaper than lawyers!
- Rates/Contract Negotiation Want to try to negotiate? Believe it or not, some companies DO allow negotiation. We can consult with you regarding what is and is not likely to be negotiable, and identify the correct person at the insurance company to approach. We can also conduct the negotiations on your behalf, if you choose.
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- Practice Marketing Consulting Are you not getting the business you think you should? We’ve helped practices identify and market their strengths, increasing their volume of new patients and developing new referral sources. Sometimes it just takes an experienced, objective opinion.
- Audit Consulting For a solo provider to be audited by Medicare or a third-party payor is rare, but it does happen from time to time. Have you been audited? DON’T PANIC! We can consult with you about the audit process and help you make the best possible impression.
- Appeals Consulting Sometimes appeals do actually work. It all depends on how you approach the appeal, how you frame your arguments, and what evidence your can marshal to bolster your case. We can consult with you as to the feasibility of the appeal and how to present your case.
- Electronic Remittance Advice Would you like to get paid faster? How about fewer trips to the bank? Fewer
envelopes to open, fewer paper EOBs to scan/fax? We can help. Electronic
remittances are available from the major payers. It's easy - you get the
money deposited faster, with no trips to the bank. We get the Remittance
Advice from our clearinghouse - and because it is electronic, it is usually
posted up to a week faster than a traditional paper, faxed EOB. That means,
if the patient owes money, they will get a statement up to one week earlier!
Your electronic EOBs/remittances are all stored securely online, viewable by
you at any time. We send you email notifications of the deposit, for easy
reconciling with your daily deposits.
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