List of Services
- Billing and Collections– Medical Practices, Pharmacies and Laboratories, with a focus on Workers Compensations, Personal Injury and Commercial Insurances
- Team addresses daily follow ups on open claims – Especially with Workers Compensations and Personal Injury, as it is not as simple as bill the claim and you will collect on the billed claim.
- Bills resubmissions: Bills often get lost, forgotten, and as such, need to resubmitted.
- Locate Missing Payments: The payments will also go to various locations if and when they are paid.
- Shorter Wait Time on Rejections or Pending: Missing documents and claim submission clean up: RFAs, missing demographic information, LOMNs, etc.
- Team addresses daily follow ups on open claims – Especially with Workers Compensations and Personal Injury, as it is not as simple as bill the claim and you will collect on the billed claim.
- Negotiations with attorneys and payors on claims to make sure claims get paid at a reasonable and fair rate.
- Centralized Administration – Third Party Contracting and Credentialing with PBMs and Payors
- New and Ongoing with all regulating bodies
- Maintain all current documentation
- Accessible and responsive help desk
- Stay abreast and communicate updates and PBM Changes
- Audits
- Self-Conducted Internal – in constant preparation to make sure all is compliant and in line with all regulations.
- Managing External Audits with PBMs and Payors: Preparing all needed information for instances where an audit is requested.
- Inventory and Supply Management, Procurement and Ordering
- Ability to leverage vendor relationships and economies of scale to reduce costs.
- Trend analyzing and product research to ensure the most effective product mix
- Monthly Reporting and Reconciliation
- Tracking incoming payments, accounts receivable and capturing costs.
- Continuous business analysis and feedback.