Benefits Verification: How does this work?
Benefits are verified for the service performed based on information provided by the patient. It is confirmed through the respective company and given as a summary to the practice.
If you are a general practitioner, a member of your team will be available to give benefits in the event of an uncommon service. The benefit of knowing a patients benefits PRIOR to the service allows the clinician to correctly prepare for the patient responsibility. This decreases after care patient invoicing, write off, and collections accounts.
Benefits Verification: Patient Responsibility Calculations?
When a patient has a co-insurance versus a co-pay, knowing the amounts due when the service is rendered is vital to the profitability of a practice. It allows for immediate collection of the patient portion which increases daily cash flow and receipts, making the wait for the remainder less painful.
How does this work?
Depending on insurance panel affiliation. Best Practice Management is able to load all the practice contracted rates in our system. We can reference this data quickly and accurately allowing precise calculations of the patient invoice amount.
If the provider is out of network with the insurance panel, we utilize standard average rates for an approximation. This gives a basic amount due with the minimal remainder invoiced.
Authorizations: How does this work?
Authorizations, for most specialty practices, are the difference between payment and denial. Merely obtaining an authorization is not always the key to successful reimbursement. The authorization process requires an understanding not only of the process but the procedures being requested.
Best Practice Management’s background in insurance utilization management and authorizations makes us uniquely successful in achieving the proper pre-determinations, pre-certifications, and authorizations. We specialize in obtaining authorizations for out of network, single case agreements, gap exceptions, and coordination of care.
Authorizations: How much does it cost?
The fee schedule for this services varies and can be bundled into the billing rates. For more information, please contact us.
Healthcare claims submission is a partnership and one that relies on the commitment of all parties. Best Practice Management works with you to find a complementary data flow, making the submission process more reliable and efficient.
