The benefit of our long-standing relationships with payers is only a part of what we offer to our client facilities.
With services relevant to each stage of your revenue cycle, every aspect of your facility’s operation can become more productive in partnership with us.
- Eligibility and Verifications
Our eligibility reports are the most thorough in the industry, with breakouts for types of treatment, coverage, and levels of care. All financial elements are specified, such as co-payments, current status of patient deductible and out-of-pocket amounts, previous authorizations, and vital information on coverage restrictions. We take the time to be sure you have the kind of deep detail necessary to make the most informed admission choices, beginning with the conveniece of our online Eligibility Request Form.
- All Clinical Reviews In-House: Authorization, Utilization, Peer-to-Peer, and Appeals
Our review processes are immediate and responsive to your patient’s needs throughout their stay in treatment. Committed to holding payers to the highest standards of fair business practice, we maintain accredited behavioral and medical health professionals on staff to interpret your clinical information to payers and support medical necessity for your patients’ care. Our Intake and Utilization Review forms are right here on our website. From your data, we conduct reviews, track your patients’ progress, and notifiy you promptly when treatment days are authorized or updates are needed.
- Electronic Claim Submission and Follow-Up
You know what you have a right to expect from an experienced billing specialist: fast, accurate submission, aggressive follow-up for claims and appeals, and regular status reports. Quality billing service also means personalized management for your receivables and tenacious advocacy with payers on your behalf. While start-to-finish management of claims is our core service, we invite you to expect more from A-Fordable Billing Solution. Bring your specific needs and challenges to us, and let us evaluate how we can improve the revenue cycle of your facility or practice.
- Advanced, Up-to-Date Medical Coding
At this moment, our industry is experiencing some upheaval with the ICD-10 transition, and each year there are changes in procedural codes. The complexities of new add-on and E&M codes, and the applicability of codes to levels of qualification in medical personnel are some of the variables that affect whether a code is appropriate for a given treatment. We check every procedural code used by our new client facilities for accuracy and currency to be sure revenue is not being lost as a result of improper coding, and to avoid denials due to incorrect or outdated codes. In addition, as socially responsible billing specialists, we support the ICD-10 changeover: our client facilities were updated well before the implementation deadline. We can do the same for you.
- Profiling and Credentialing
Our Profiling and Credentialing departments bring your office or facility current with payer practices in the new marketplace. It’s another of the many ways we protect your revenue potential. We do the legwork for you: all the research, paperwork, and follow-up to establish your relationship with payers. Your profile data is completed and entered with all appropriate payer entities for your fastest, most accurate payment cycle. We manage your credentialing process, authenticating your qualifications according to payer requirements, and your contracts with payers are drafted, reviewed, negotiated, or re-negotiated as necessary, to ensure that your practice or facility is operating within its fullest range of possibility.
- Family Advocacy™
We never forget that while mental health and substance abuse treatment are business as usual for us, for the parent, spouse, or child of an individual in treatment, this can be an emotionally difficult time. In providing family members with up-to-date information about their insurance, we can alleviate some of that stress, as well as ease the workload for your facility and clinicians.