Our Silver Program
Appointment Confirmation
Appointment Scheduling initiates a number of activities that when performed sets forth a game changing approach towards a highly successful practice.
A fully utilized scheduler is the hallmark of a high revenue practice.
An appointment confirmation call is never complete when just a voicemail is left when the patient could not be contacted. A more holistic approach is when all alternate numbers have been attempted to contact the patient or his/ her next of kin. Our experience tells us that more than 90 % of patients respond when Text Messages are left if they could not be contacted over the call. We all agree that appointment confirmations work as a true reminder to patients and gives them an opportunity to reschedule in time if they are not going to be able to make it, giving the practice to make best use of the empty slot. Billing Advisors team carries out each of these responsibilities to ensure premium value is given to both the patients and the Front Desk staff at the practice office.
Eligibility & Benefits Verification
Every scheduled patient having active insurance coverage is every practice’s dream and we make just that happen. In addition to active coverage, knowing and collecting the amount of patient cost share has helped our practices see a substantial improvement in patient collections. New Insurance Card for an existing patient or a New Patient always requires caution to be setup correctly in the PMS. Most practices rely on Front Desk to carry on this task, whereas this should be best left to be handled by dedicated Insurance Experts. At Billing Advisors, we simplify this task by limiting the Front Desk responsibilities on this to just scan the new card information if available or just ask one of our Insurance Experts to take care of the Insurance Change or New Insurance information, and we carry out a methodical approach to this task.
The exercise of coverage validation for every scheduled patient begins three business days ahead of Date of Service. In addition, we also do Spot Coverage Validation for same day scheduling. A daily report is run to make sure that all additional scheduled appointments are also validated for their coverage. We get you every patient’s detailed visit-specific information regarding copay, coinsurance, deductible, plan limitations, in-network, or out-of-network benefits. We also take all pains to deal with COB issues.
Referral Management
If you are a specialist and seeing HMO patients for instance then your staff will quickly recognize the pain of getting a Referral on time before the Date of Service. We ensure zero denials due to Referrals.
The process of Referrals begins seven days in advance and up to one day before the date of appointment. The process begins with identification of the patients (like HMO Patients) at the time of Eligibility and Verification process. The dedicated Billing Advisors team collects from practice or EMR the relevant CPT, ICD then begin faxing and corresponding with the PCP’s referral departments and then follow up with the respective insurances to ensure that the referral got processed and the patient is good for the visit. Our team will follow up multiple times if required with the PCP office. Any patient for which a referral fails to get processed before the date of service, is rescheduled so that the service does not go uncompensated for the physician.
Prior Authorizations
Sooner or later practices begin to understand that the seemingly simple process of obtaining an authorization can turn into a nightmare for the practice staff with long payor turnaround time and lengthy hold time on calls. An authorization not obtained resulting in uncompensated claim can seriously jeopardize the reimbursements.
The process to obtain Authorizations begin 15 days prior to the date of scheduled appointment. Procedures requiring prior authorizations are identified and other relevant information such as diagnosis codes, service location and clinicals are collected before the authorization is processed by online, fax, and/ or over calls. For same day appointments up to appointments booked couple of days earlier, we have dedicated teams to act promptly upon them to get their authorizations processed. Billing Advisors team work with your clinical teams for cases requiring additional documents during the approval process. Urgent cases are proactively followed up to ensure a service is not rendered to the patient in the absence of an authorization. Our team will follow up umpteen times if needed to ensure authorization is in place on time. On rare occasions, when an authorization fails to get processed, the patient appointment is rescheduled so that the service is rendered by the physician in the presence of an authorization. The practice is always kept in the loop and is informed of all developments.
Miscellaneous
Experience unmatched client service with Billing Advisors! Enjoy the convenience of having a dedicated Account Manager available round-the-clock, 24/7, 7 days a week. Rest assured, your practice retains full ownership of your EMR/PMS. Plus, we ensure transparent billing for any additional third-party expenses, including clearing house charges, patient statement vendors, and more.