Services Offered
Eligibility
Comprehensive patient eligibility verification requirements are checked. We verify all information to determine eligibility and acceptance of the claim from policy changes with the insurance, coordination of benefits with other carriers to same/similar for Medicare beneficiaries. This is a small scope of services performed during verification of benefits for patients.
Authorizations
Although we have a broad range of knowledge with authorization requirements, many times it is not known if a service will require authorization from a carrier unless a physical phone call is made. We ensure all services are authorized and certified on the service date the patient was treated. We work with several carriers, including Medicaid HMO's to ensure a service can be backdated, if necessary.
Hyaluronic acid Injections
Hyaluronic acid injections can prove to be tedious when dealing with specialty pharmacies. We will verify, triage and authorize HA injections to any specialty pharmacy. We will also work closely with patients to make sure consent and delivery's are scheduled.
Billing consultant
Although we do not submit claims to the insurance carriers or follow-up on accounts receivable we do work very closely with billing teams to ensure there are minimal issues on a billing level. We also offer an a la carte service to teach and train billing team members
financial analysis
Many physician practices are reimbursed at a much higher rate than a typical ancillary company, but not always. For that, we will work directly with your finance team and analysts to ensure the practice is profitable.
Medicare Audits
Medicare is constantly auditing braces and many practices are not sure how to overcome these audits. We will review all documentation to ensure it meets Medicare's guidelines and will work with Medicare to submit and followup on audit requests
documentation
Communication with billing departments and streamlining documentation transmission is a must to ensure the success of the practice and/or individual physician. We compile all encounter forms along with required documentation and submit the patients chart to billing.