Services

Verification of Benefits & Eligibility

Acquiring a detailed, accurate verification of insurance benefits for an individual, requires knowledgeable and experienced professionals that understand and stay current with the array of insurance payers.

Elements included in a VOB:

  • Eligibility

  • Covered benefits

  • Deductibles

  • Out-of-Pocket Amounts

  • Coinsurance

  • Copays

  • Limitations

  • Restrictions and provisions

  • Pre-Authorization requirements and contact information

 

Authorizations

Illuminate Billing Advocates can help treatment providers, establish a system that improves authorization approvals for medically necessary treatment. When pre-authorization is obtained it begins the treatment process and starts the wheels in motion for the Utilization Reviews (UR) which will follow.  Every pre-authorization generates an NDA, Illuminate provides a Number of Days Authorized (NDA) report, indicating the authorization outcome with any limitations, requirements, instructions and other detailed information.  We pride ourselves on effective communication with our partners.

 

  • Pre-Authorizations

  • Utilizatoin Reviews

  • Number of Days Authorized

 

Utilization Management

Medical necessity, effective level of care and length of stay are our high priorities at Illuminate Billing Advocates.  Our collaborative approach will maximize insurance benefits as we advocate for client care through:

 

  • Experience and expert knowledge of admissions and utilization requirements

  • Effective collaboration with treatment providers, Illuminate and insurance providers

  • Detailed documentation to support any appeals processing

  • Established relationships with care managers

  • HIPAA compliant with regular risk management assessments

  • Strong focus on eligibility and verification


 

Reports

Service is what sets Illuminate apart from the rest.  We don’t stop with the latest technological advancements in software and analytics.  We offer more with single point contact that improves customer service and satisfaction.  We continue to look for improved communication formats for sharing data with our treatment providers instilling confidence in Illuminate’s work ethic and dedication to our providers.

  • Accelerated generation of individual claims, professionally prepared, accurately coded and electronically submitted medical information.

  • Consistent tracking and reporting of all claims.

  • Customized monthly reporting of business activity and productivity.

 

Billing

It is vital that the billing and claims process are tracked and reported.  Illuminate Billing Advocates will provide detailed information every step of the way with:

 

  • Cutting edge submission and tracking of claims

  • Improved communication results in faster and more efficient payments

  • Multi-level claims scrubbing to assure clean claims

  • UB04 and CM-1500 formats with accurate and up to date coding

  • Consistent and aggressive follow-up and denial process

  • Payment tracking and customized reporting

  • One-on-one, personalized customer contacts


 

Consulting Services

We can help our provider partners with many important documentation and tracking processes like:

 

  • Clinical records, best practice

  • Admissions process and assessment protocol

  • Documentation templates, tracking and reporting

  • Level of care guidelines and criteria

  • Communication and reporting processes

  • Analysis and best practice consultations

Contact Us
Illuminate Billing Advocates

720 North 530 East

Orem, UT 84057

T: 801-990-1777
F: 888-855-2850

 

contact@illuminatebilling.com

© 2015 Illuminate Billing Advocates