Our name says it.
Our expertise backs it up.
There’s a reason we’re called Billing Solutions.
The solutions we provide are vast and offer wide-spread benefits for your business – whether you’re a large facility or a single practitioner. We focus on your profits, efficiencies, and solutions so you and your staff can focus on the reason you’re in business – your clients.
Growth in Profits
Helping increase profits is what we do. But we won’t stop there. We want to become your partner and forge a long-lasting relationship founded on integrity, advocacy, and a long-term outlook of your business that only comes from the practical, hands-on experience we have.
We will diagnose your current billing practices to uncover reasons for aged accounts, discover where efficiencies can be made in verification, utilization and reviews, and claims and collections. We’ll work hard to become an extension of your facility – providing insight, innovative thinking, and expert consultation that leads to increased productivity, profitability, and time for your staff to concentrate on your clients.
Our verification of benefits service standardizes admission processes to improve patient flow. As your authoritative source, we will navigate through the misinformation that is often provided by carriers and guide you through the proper documentation for a thorough utilization review.
Keep up with a changing industry
Insurance eligibility verification is the first and most important step in the medical billing process. The verification of benefits has evolved well beyond deductibles and co-pays. It’s no longer a simple eligibility check. It requires an experienced staff who will work with you directly, and who understands payer benefit systems to eliminate the risk of inaccurate, incomplete, or out-of-date information.
As the behavioral healthcare industry grows, insurance carriers are decreasing the number of claims they are paying. For many, this makes verifying benefits challenging. With carriers adding layers of criteria to individual benefit plans, it’s difficult to avoid administrative and financial errors without the help of a verification specialist.
Our verification specialists provide:
- Patient policy deductible and out-of-pocket responsibility
- Co-insurance and co-payments
- Benefit limits
- Reimbursement estimates
- Pre-authorization and clinical requirements for admissions
Reduce errors for faster turnaround time
Verification and eligibility of benefits must be timely and accurate in order to increase your admissions and to maintain a competitive edge. Billing Solutions has years of clinical experience, allowing us to apply our expertise to create a verification of benefits process that differs from other billing companies.
We provide each client with an insurance verification form, specifically tailored to ensure we obtain all necessary information, eliminate the occurrence of errors and aid in a seamless admission process. After providing us with patient and insurance information, you’ll submit the information to our verification team. Our verification specialists confirm the benefits, via online portals and by phone to improve accuracy. Billing Solutions typically returns your completed verification in as little as one hour.
Manage ongoing clinical reviews
It’s imperative that all benefit information be verified before offering advisement. However, confirming that there are no changes to a client’s benefits during their stay is just as crucial as when they first arrive at your facility.
Therefore, we offer ongoing clinical reviews of your clients’ insurance carriers while they are with you. Conducting clinical reviews guarantees the information you received initially remains accurate and up-to-date, and avoids the high risk of error. We help you plan to re-verify and determine what may have changed with each patient’s benefits. This process solidifies your verification process so you can provide the highest-level of service and extend the length of client stays, all while we keep the insurance provider accountable.
Receive guidance from our utilization review professionals
Through the process of initial payer approval, concurrent service reviews, appeals, and post service reviews, our aim is to obtain insurance coverage for the entirety of your client’s treatment episode at the clinically indicated level of care designated by your treatment team. Our utilization review professionals handle all communication with payers regarding authorizations, allowing your clinical staff to focus on treating your clients without the distraction of managed care.
When you join Billing Solutions, you receive a dedicated utilization review professional who functions as an extension of your clinical team. This model provides continuity of care through a client’s case. Having a designated utilization review professional who truly knows your facility and your treatment vision helps us accurately reflect the type of care your client is receiving and avoids any chances of reporting incorrect information.
In addition to obtaining authorizations, your dedicated utilization review professional is also available to provide insight and assistance in navigating the managed care landscape of private insurance. Our process is well tested and enhances the amount of approved services through third party payers. We do not just advocate, we guide.
Understand payer compliance and best practices for documentation
With an ever-changing private insurance landscape, it is imperative that facilities remain aware of payer expectations. In addition to obtaining coverage for your clients, our utilization review department also provides:
- One of our primary objectives is to keep you informed of industry standards to promote your long-term success
- Charting to medical necessity
- Clinical documentation
- Individualized treatment planning
- Intensity of service requirements
- Level of care guidelines
- Licensing requirements
- Education regarding program structure
Avoid error and delays
After we have obtained initial authorization for your client, our staff wastes no time in notifying you of the payer’s determination. As part of our commitment to provide a personalized utilization review for each of your clients, your dedicated professional will also notify you of what information is needed for the client’s next review for continued stay. Upon receipt of the requested clinical information, your dedicated professional will continue to make the case for medical necessity. The process will be repeated at regular intervals until the client is discharged from your program.
Let us be your advocate
Our utilization review team is interdisciplinary, educated, experienced, and passionate. With more than 95 years of experience combined in covering many specialties in the medical and behavioral health fields, we possess a breadth and depth of understanding that allows us to effectively advocate for a client’s treatment—regardless of their clinical presentation. With backgrounds in long-term care, hospital-based psychiatric units, residential treatment, acute detox, halfway house settings, and working in both the private and public sectors, our team not only understands your clients, but also your clinical staff.
Having worked in the field, we understand the need for ailing individuals to receive quality treatment. Our passion to participate in the healing process translates into diligence in obtaining coverage for your clients. We work with you to materialize your vision.
Discover a new approach to billing
Increase your practice’s productivity. Predict your future revenue more accurately. Manage your facility’s growth. Collect more of your well-earned fees. Once you achieve these objectives, you are able to focus on your core competency—patient care.
Our cutting-edge software and our staff’s commitment to excellence is what differentiates our billing and collections process from the rest. Through constant communication and the ability to customize our processes, we work hard to tailor our services to your unique needs.
Our most popular billing and collections services include:
- Electronic claims processing
- Aging reports
- Monthly statements
Collect revenue faster and easier
Our electronic claims processing is designed to speed up your reimbursements by maximizing throughput of our billing process. This helps you avoid disruptions to your cash flow, which ultimately helps you collect revenue faster with fewer complications.
When we handle your claims processing electronically, we’re simplifying the revenue cycle. We’re able to direct your claims to multiple payers. And by making sure your billing is correct the first time, we reduce the common complications on the back end and alleviate your stress of dealing with insurance companies.
Project your revenue
Aging reports accurately align your expectations with your company’s financial future. Based on collected analytics, aging reports are helpful in projecting your revenue and managing your facility’s growth. The reports reflect gaps in a facility’s processes such as billing errors or claims not being submitted appropriately. We relay these issues to you immediately along with our proposed solution.
With our monthly aging reports, you’ll be able to confidently care for your patients. Knowing your financial outlook gives you the confidence to plan for the future of your facility.
Receive statements, reports, and updates regularly
As a part of our billing and collections services, we provide your company with monthly statements, reports, and updates. These monthly updates allow us to remain on the same page, which is something that is crucial when dealing with your company’s finances.
If you feel that your company needs more guidance, we’ll customize our service to you. Whether you need bi-weekly aging reports or weekly electronic claims, we’ll tailor our expertise and services to meet your needs.