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Appointment Confirmation
- Confirm appointment one business day in advance.
- Conducted during normal business hours.
- Contact patient via phone and /or SMS.
- Update EMR/ PMS when patients reply.
- Reschedule appointment when necessary.
- Send personalized text messages as may be requested by practices.
Eligibility & Benefits Verification
Coverage Validation
- Advise reception of the actual amount to be collected from the patient at time of check-in. (i.e., past due balances plus any co-pays and deductibles.)
- Communicate to practice via EMR / scheduler notes.
- Update billing software.
- Update EMR/ PMS with new insurance carrier information, policy, or both.
- Obtain new or replacement insurance carrier from patient.
- Confirm eligibility and benefits three business days in advance.
Patient Demographic Validation
- Benefits Validation.
- Determine copays.
- Determine deductible (met or unmet).
- Determine coinsurance.
Referral Management
- Identify patients requiring a referral.
- FAX patient’s PCP for Referral Request providing all requisite details.
- Advise PCP that a referral is required.
- Follow up online to obtain referral and download and update EMR.
- Follow up with the PCP referral department in case a referral is not obtained to ensure referral is in place before DOS.
- Collect procedure, Dx codes and location details from Practice via EMR.
- Follow up with the PCP referral department in case a referral is not obtained to ensure referral is in place before DOS.
Prior Authorizations
- Collect procedure, Dx codes and location details from Practice via EMR.
- Follow up online to obtain referral and download and update EMR.
- Advise PCP that a referral is required.
- Identify patients requiring a prior authorization.
- FAX patient’s PCP for Referral Request providing all requisite details.
Miscellaneous
- Physician has access to a dedicated Account Manager at Billing Advisors (By Phone) 24 hours & 7 days a week.
- All additional third-party payments to be billed as per actual, such as clearing house charges, patient statement vendor, etc.
- EMR/ PMS ownership lies with the Practice.
Pricing
The Fee for Service is based on an hourly rate, for the number of assigned staff, for a full 8 hour day, for the days your practice has scheduled patients. The rate charged is determined by totaling all the appointments for which our service was provided and dividing by the number of days that patients were scheduled.
The invoice is issued on the first of each month for services render for the previous month and payable upon receipt.
