BILLING SERVICES:

  • Ancillary 
  • DME
  • Physician 
  • Wellness Clinic, Inpatient and Outpatient Services
  • Physical, Occupational and Speech Therapy

Claims are electronically transmitted to the Primary Insurance Carrier to insure rapid reimbursement. Secondary claims are submitted for any claims that are not automatically crossed over by the Primary Insurance carrier. Medicare reimbursement commonly occurs within 14-15 days from claim receipt, via Electronic Funds Transfer (EFT). 

 

ADMINISTRATIVE SERVICES

  • Support Activities for Multiple Supervisors
  • Data Entry
  • Creating Accounts
  • Online Customer Service
  • Document Preparation

 

 

Insurance Paneling: Our 5-Step Process

To provide the most transparent, consistent, and efficient service to our clients, we’ve developed a simple 5-step credentialing (i.e., provider enrollment, getting in insurance panels) process.

how it works

We provide ongoing Credentialing services to all doctors, hospitals & group practices (including new ones). We check the contract and verify their credentials from time to time. This process ensures a good rapport & helps to deal with payment delays from the Payers in an effective way.

Your medical practice is incomplete without a license & a medium to get paid by the Payers.

For that, it is imperative to have a meticulous credentialing process done. Also known as Provider Enrollment / Insurance Credentialing, the result of a proper credentialing process is recognition by the insurance companies that certifies your authenticity, specialty expertise, cross check with the medical school you have graduated from, claims of having completed internships successfully, your medical license, etc. only after a thorough registration & verification process.

For that, it is imperative to have a meticulous credentialing process done. Also known as Provider Enrollment / Insurance Credentialing, the result of a proper credentialing process is recognition by the insurance companies that certifies your authenticity, specialty expertise, cross check with the medical school you have graduated from, claims of having completed internships successfully, your medical license, etc. only after a thorough registration & verification process.

         *     Data Collection – Our credentialing services ensure you don’t lag behind in collecting patient data & utilize it in many ways to improve your practice management & revenue strategies.

·         Patient Quality Reporting System (PQRS) – Save your practice from negative reporting penalties & smoothly conform to all the compliance standards & regulations for the government’s reporting system & get attractive incentives along with getting paid accurately and more importantly, on time.

·         Council for Affordable Quality Healthcare (CAQH) – Collaborate with the popular & most recognized non-profit insurers & have the privilege of streamlining your revenue cycle.

·         Trail through Transition – With amendments in the Affordable Care Act (ACA), the recent years are going to be a major period of overhauling health care facilities to maximum number of citizens. Make the transition hiccup-free with us.

 

Step 1: Selection

Select the insurance companies you want to be contracted with.

Samples:

§  Aetna

§  Anthem

§  Blue Cross / Blue Shield

§  Cigna

§  Compsych

§  Highmark

§  Humana

§  IEHP

§  Magellan

§  Medicaid

§  Medicare

§  Molina

§  Tricare

§  United Healthcare

§  and many others to choose from.

If you’re not sure what panels you’re interested in, my support team can help you decide.
Send in necessary documentation (resume, degree info, etc).

Step 2: Application

We retrieve all up-to-date insurance applications and complete them on your behalf.
We create and/or update your CAQH profile as necessary

Step 3: Follow Up

We first follow up to make sure all applications have are received
Then, we follow up regularly to ensure the enrollment process moves from the “credentialing and approval” phase to the “contracting” phase.

We navigate any issues that come up along the way

Step 4: Contracting

We receive contracts from insurance companies, review them for accuracy, and send them to you to be approved and signed.
We will negotiate any rates or terms based on your feedback.

Step 5: Confirmation

We submit signed contracts on your behalf.
We track, and follow up as necessary, to ensure you receive written confirmation of your enrollment.
You’re now ready to see clients and bill their insurance!