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Services We Offer

Credentialing

  • Complete all application forms, materials, and submissions for the insurance company

  • Handle all communication and correspondence with insurance representatives and network management teams

  • Set up EFT, EDI/ERA enrollments (if applicable)

  • Submit network appeals in the event of network participation denials

Benefits Verification

  • Call the insurance companies to verify mental health benefits and eligibility before the client's first appointment

  • We will confirm the amount of co-payment, deductible, maximum visits allowed per year, any authorization requirements and claims mailing address

Claims Processing

  • Entering patient demographics and insurance information

  • Checking that authorizations are on file

  • Submitting claims electronically when possible

  • Filing secondary claims or coordinating automatic cross-overs

EAP Claims Processing

  • Call for authorization

  • Verify number of sessions

  • Navigate billing rules and procedures

  • Submit claims

Payment Posting

  • Enter payments and adjustments from insurance EOB's

  • Post patient copays

Follow-Up and Appeals

  • Call insurance companies to verify status of unpaid claims

  • Refiles unpaid claims as needed

  • File appeals

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