SERVICES
VERIFICATION OF BENEFITS
We know that many patients seeking assistance with substance abuse or mental health issues might need immediate assistance -- there's often no time to delay. We also understand taking on a patient without verifying their benefits is a big risk to your practice. Because we understand these issues, we do our best to complete verification of benefits within 30 minutes, which allows you to act quickly and get help for your patients faster.
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. We're here to help.
Elements of a verification of benefits include:
Eligibility
Covered benefits
Deductibles
Out-of-Pocket Amounts
Coinsurance
Copays
Limitations
Restrictions and provisions
Pre-Authorization requirements and contact information
PRE-AUTHORIZATIONS
We work with you to establish a system that improves authorization approvals and minimize surprises when you intake a patient. Every pre-authorization generates a Number of Days Authorized (NDA) indicating the authorization outcome with any limitations, requirements, instructions and other detailed information. We pride ourselves on effective communication with our partners.
UTILIZATION MANAGEMENT
Medical necessity, effective level of care and length of stay are priorities at Illuminate Billing. 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 compliance with regular risk management assessments; and
Strong focus on eligibility and verification.
CLAIMS MANAGEMENT
It is vital that the billing and claims processes are tracked and proactively managed. We track each claim throughout every step of the claims cycle through:
Cutting-edge technology to submit and track claims;
High levels of communication with insurance providers which results in faster, more efficient payments;
Multi-level claims scrubbing to assure clean claims prior to claims submission;
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; and
One-on-one, personalized customer contacts.
REPORTING & CONSULTATION
We share custom, highly effective reports with our clients to help them quickly and easily understand their prospective cash flows, revenue, and assist them in perform essential business planning.
We take the time to work with your in-house staff to understand and implement best practices that will help ease the heavily-administrative burdens associated with insurance billing, speed cash collections, and maximize reimbursements. We are truly partners with our clients and will work together, sharing best practices with one another.
COLLECTIONS & APPEALS
Medical billing companies often focus only on claims that are relatively easy to collect. Illuminate Billing specializes in chasing and collecting difficult, outstanding claims. We recognize that 1) avoiding collecting difficult claims sets a precedent with the insurance company and likely leads to lower future reimbursements; and 2) every penny counts for your practice. Frankly, our efforts to collect these claims are not very profitable for us, but we understand our efforts may lead to a 10%+ increase in revenue for you....so that makes it worth it for us to get you paid!