Majority of practice support inquiries come from referrals across all 50-states. Our humble growth from a single doctor / clinic to today’s nationwide support.
In some instances, not all clients inquiries for help is immediately accepted. Principal reason, is where the practice is not readied to make hard changes which is needed to right the wrongs which is having adverse affect on revenue.
Unlike our colleagues within our healthcare space; we are hands on every part of the billing – collection to process and practice management issues. Our success is measured by our client’s success.
Our team members background range from Federal Claims auditors with commercial payors as; Cigna, United Healthcare, Aetna and Blue Cross & Blue Shield.
Followed by Practice Administrators who have helped many solo doctors and their clinics to Ambulatory Surgery Centers (ASC) get either off the ground or restructure their internal processes and systems.
Then, there’s the area of pre auth and insurance verification of patient benefits. One of the most important process in order for a practice to get paid. We have successfully mastered this area, which relieves the clinic of this burden.
Our billing – collection services utilize your current EMR:
- Athena
- eClinical Works
- Aprima
- AdvancedMD
- AllScripts
- ChartLogic
- Dentrix
- EagleSoft
- eMDS
There’s many more systems including all the clearinghouse’s to keep abreast of claim denials.
Clinical Trials Services
Incorporating clinical trials in the practice setting has several advantages both for the clinic and patients.
The patient / volunteers benefits by being part of cutting edge study to be later approved by the FDA. In most cases, once the study is approved, patients / volunteers can benefit years onward.
The clinic benefits from community exposure to attract new patients. And be a clinical test site – which was involved in FDA study.
Today, we are please to report to be working closely with one of OKC’s largest pain management clinic implementing clinical trial module.
In FY-2022, we project to have our 1st trial underway. This client can handle approximately 3 – 5 trials in the 1st year.
Contact one of our Medical Advisors if your practice can be a candidate as a Clinical Trial Site: 800-297-5729
Our skills covers all aspects of dental care:
- Pre Authorization
- Insurance Verification
- Insurance Billing – Charge Entry
- Collections to Patient Statements
- Bookkeeping and payroll services
- Dental credentialing to Practice Admin services
ASC and Cath Lab Developments
We work closely with seasoned talents whose knowledge in ASC and Cath Lab facilities will significantly reduce development cost.
Including credentialing the facility – provider and subspecialties before the facility is readied for 1st patients.
Pre Auths for Surgery & Meds
When Prior Authorization are Delayed, Patients Suffer
We Handle Medical Authorizations to Save You Time and Drive Outcomes. Pre-authorizations Are Mandatory. Waiting On Hold Is Optional. Let Us Take It On For You. Network-Enabled Services. Services for Hospitals. 24/7 Support
Insurance Verification
Patient insurances are changing monthly. And in most cases; patients do not have an idea what their plan covers, much less how much is out of pocket available per their deductible. We handle this for many practices across the country.
Next, this process takes up valuable staff time. We customize our process to each clinic needs. The information captured is entered in the clients own EMR.
Credentialing Services
Credentialing is one of the most important aspect of keeping the clinic and providers current with payors contracts. Facilities – Doctors – NP-C -CRNA and many more.
We work the whole process from CAQH, to Availity and setting up EFT payments directly to the provider’s bank account.
Facility & Provider Fee Schedules
A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis.
Cigna, Humana, Aetna and others issue the following year fees schedules for all disciplines in healthcare. CMS, also issues their fee schedule. All of which needs to be uploaded in your EMR.
A new enhanced benefit feature is now available: Procedure Code Look-up For Health Care Providers June 2021
UNITED HEALTHCARE WILL DENY OR LIMIT COVERAGE FOR ED COMMERCIAL CLAIMS IT CONSIDERS NON-EMERGENT
So, my husband owns several Bariatric Clinics in New York & New Jersey; we invited Gabriella, to audit our Billing process. Her findings were very effective. And since have made internal changes to bring the money.
Hired Chris, as BOM for our new ASC here in Kingwood. Within 6-months Chris got us on all of the major commercial plans. Highly recommend to anyone who needs amazing help! Now, we can see commercial payors patients. BCBS, Aetna, Cigna, Superior Health, United Healthcare, and Humana.
Gabriella is always responsive to my late text pertaining to surgeries and coding. "She's a machine," no other way to explain how effective and quick she is. Routinely, I have called upon her still, for a question or two. Happy to have gotten to know her. We use Athena & pMD, she remotes in drops the claim correctly, without telling her. A surgeons dream to have her on your billing team.
I have worked with Chris when he was at Oklahoma Eye Surgeons as Practice Administrator. He's very organized and easy to work with. Excellent with patients and fellow team members. Goes way out of his way to keep business running smoothly. I noticed major improvements within the 1st month.
Medical Billing Software and Clearinghouse Partners
