We ensure that the provider receives timely and accurate payment for the services provided, while minimizing administrative burden and maintaining regulatory compliance.

Our Revenue Cycle Management service takes on the burden of financial management and insurance from start to finish, allowing mental health facilities to focus on patient care. The first step is verifying patients’ insurance coverage, including deductibles, out-of-pocket expenses, copays, and exclusions. We provide revenue estimates based on the patient’s level of care and maintain a VOB database to track policy issues. By trusting us with this crucial step, facilities can receive accurate revenue estimates and smoothly navigate the insurance landscape.

After verifying insurance coverage, we obtain authorizations and ensure ongoing compliance for patients. We work with mental health facilities to obtain initial and ongoing approvals, audit clinical documentation, provide compliance training, and participate in clinical team meetings to simplify the authorization process and maximize approved sessions. By entrusting these tasks to us, facilities can focus on patient care.

Once authorizations have been obtained, we move on to submitting claims on behalf of the facility. Our team verifies the accuracy of claim submissions and stays up-to-date with any changes in the insurance industry. Billing frequency can be customized to the facility’s preferences. We focus on clean claim submission, with medical record audits to ensure compliance with CPT HCPC codes. By entrusting us with this critical step, facilities can avoid errors and reduce delays in receiving reimbursements.

In the unfortunate event of a claim denial or rejection, our team identifies and resolves any issues that would otherwise hinder facilities from receiving reimbursement. We have extensive experience in dealing with claim denials and rejections, and we submit first and second appeals as needed. By entrusting this critical step to us, facilities can minimize their financial losses and focus on providing high-quality care to their patients.

To provide our clients with full visibility into their financial performance, we offer customized business analytics and reporting. Facilities can access their claims and authorization data anytime and anywhere, with full transparency into the status of each case. Our team provides regular updates and communicates clearly with facilities on their financial performance. By entrusting us with this step, facilities can stay informed about their financial health and make data-driven decisions to improve their revenue cycle management processes.