Our Services
Provider Credentialing
Our team recognizes the critical importance of provider credentialing in maintaining the integrity and quality of healthcare services. Our Provider Credentialing Services are designed to help healthcare providers navigate the complex process of verifying and maintaining their credentials, ensuring compliance with industry standards and regulatory requirements.
We handle all aspects of the credentialing process, including:
- Collecting and verifying provider information
- Submitting and tracking applications to insurance companies and hospitals
- Monitoring the status of applications and providing regular updates
Insurance Authorization
Our team handles the entire prior authorization request from start to finish, including
- Submitting authorization requests to insurance companies
- Providing necessary clinical documentation
- Following up on pending authorizations to ensure timely approvals
In case of denials, we handle the appeals process to ensure the necessary approvals:
- Reviewing denial reasons and gathering additional information
- Resubmitting authorization request with appropriate documentation
- Liaising with the insurance companies to resolve issues promptly
Claims Management
We manage the entire claims process to maximize reimbursements and minimize denials:
- Claim preparation and submission
- Denial management and appeals
- Insurance follow-up and resubmission
- Detailed reporting and analytics
Out-of-Network Negotiation
Our expertise ensures that you receive fair compensation for the care you provide, even when dealing with out-of-network payers. Our experienced negotiators work to secure the best possible reimbursement rates for out-of-network services:
- Communicating with insurance companies to negotiate fair payment rates
- Providing necessary documentation and justification for charges
- Leveraging our industry knowledge to advocate for higher reimbursements
Recovering Your Lost Revenue
Unpaid and aged accounts receivable can significantly impact the
financial health of any healthcare provider. Our expertise in handling accounts receivable up to 5 years
of age ensures that you receive the funds you are owed efficiently and in most cases with interest.
We conduct a thorough review of your aged accounts to identify recovery opportunities:
- Analyzing outstanding receivables
- Prioritizing accounts based on recoverability
- Developing customized recovery strategies
Accurate and Efficient Payment Posting
Our Payment Posting Services ensure that all payments are processed accurately, helping you manage your revenue cycle effectively and reduces discrepancies.
Insurance Payment Posting
- Reconciling Explanation of Benefits (EOB’s) with patient accounts
- Handling of payment recoupments and recovering
- Payment Reconciliation detailed reports
MAke An Appoinment
To learn more about our business processes and how we can start recovering revenue for your practice
or health system complete the information below and schedule a time to speak with us.
