Eligibility verification.

Many practices require patients to proactively research eligibility and benefits. We will do this for you. To provide a comprehensive overview of benefits, eligibility, deductible, and co-pays directly to you and your clients:

• We verify eligibility and detailed mental health benefits before submitting claims through our HIPPA-compliant portal

• We review for missing information to complete the patient file, and will report errors in a daily email summary

• We communicate information about insurance benefits directly to you or your clients

• When insurance changes, we re-verify eligibility

Claims processing.

Our program interface allows insurance information to be captured accurately to ensure a 95% first-pass acceptance rate. The clearinghouse facilitates a smooth re-submission process:

• Pre-billing

• Verifying patient demographics and insurance information

• Confirming that authorizations are on file

• Submitting claims electronically

• Follow up on Denied claims

  • We will quickly and efficiently following-up on denied claims to alleviate unnecessary stress. We will navigate the appeals process and get your funds into your account as quickly as possible.

    • Calling insurance companies to check on status of unpaid claims

    • Resubmitting unpaid claims as needed 

    • Filing appeals

Invoicing.

Requesting co-pays can be difficult to manage. Let’s take this task off your plate. We will send out statement charges and follow-up with your patients for unpaid balances:

• Emailing out patient/client statements

• Responding to account inquires

• Following up on past due invoices

• Sending you a lump sum with out-of-pocket payments

Posting of EOBs.

All insurance payments and insurance contract adjustments are posted to the patient ledgers within 2 business days after the Explanation of Benefit (EOB) is posted. Our team of billing managers will communicate daily with your office manager via email or phone to resolve any issues.

Submission of primary and secondary claims.

All insurance billing claims for primary and secondary claims are sent electronically. Pre-authorizations will be sent to insurance companies when requested. We work with any current electronic claims system you are using.

If you are currently sending paper claims, we will assist you in setting up electronic claims at no additional cost to you. Every claim is audited before it is sent to an insurance company to ensure that the claim will not be denied over a clerical error.

Monthly Reports

The Insurance Report is processed and analyzed each month to minimize outstanding insurance balances. You will receive monthly summaries that track how many overdue claims were appealed, how much money was collected, and what your current account receivable balances are.