Allegiant - Medical Billing
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Specialty Medical Billing
Understanding the details of your medical specialty is critical to filing clean claims, which drives maximum revenue and reduces appeals. We have that knowledge and hands on experience in medical specialties through our total years of experience in house, our attendance of annual seminars, industry contacts, and specialty publications and news updates.
Our staff has an average experience of 12+ years in the industry covering multiple specialties. That direct experience allows us to understand the terminology and medical care that you provide to your patients. We properly interpret the care provided into the medical coding required by the carriers, which ensures you are paid the full value for your services.
We attend the annual seminars and conferences that affect your specialty. While many of the changes are easily understood through mass publications, there are critical changes that are not documented clearly, or have confusing language. We find the clarifications and explanations from panel experts on specific scenarios. By attending these events, we learn the intent of the change and adjust quickly with the carriers to avoid unnecessary appeals.
We also subscribe to specialty publications and newsletters. Staying informed by the advocate groups of our clients ensures that your medical billing is consistent with your credentials, and allows us to help promote the agendas of your specialty. Consistency in medical billing across a specialty is key in maintaining healthy revenue for services, and avoiding scrutiny by review panels.
Credentialing & Contracting
The foundation of your revenue stream is determined by your current credentials and contract rates with insurance carriers. Whatever the payors have on file for your credentials and allowable determines your total revenue. With all the reimbursement and provider identification changes over the last few years are you sure what those values are anymore? Are you getting reimbursed the full amount allowed for your specialty in your geographic region? Have your contracts aged and/or self-renewed without a thorough review?
Our experience shows that most practices have out-of-date contracts and have mismatched information on file with the payors. As an additional resource available to you, we offer our services to review and update your credentialing information and current payor contracts.
We have seen practices improve revenues as much as 40% through revised contracts and updated credentials. While each practice is significantly different from another, you can easily expect significant revenue improvement if your last review is longer than 3 years ago.
Compliance
Compliant medical billing is a fundamental element at Allegiant Medical Billing. Your medical billing is coded and transmitted by us with confirmed supporting documentation per the requirements dictated by Federal and State law. The benefit to you and your practice is both assured compliance and maximized revenue.
With the ever changing requirements for medical billing today, staying on top of the new codes, rules, and documentation is truly a full time job. But the reward is capturing full reimbursement for services provided to your patients.
Back-Billing
Backbilling is the remaining aging when you transition to a new billing service, or application. We think of it as uncaptured revenue, and understand you need to get that into the bank. And we are willing to take on your backbilling while most other services will not.
It is important to note there is an inherent risk associated with backbilling. It simply takes more time to review the entire charge to ensure the integrity of the coding and documentation that was originally created by someone else. We need to be assured the backbilling performed by someone else is compliant before transmitting under Exact Billing Solutions. While each case is unique, there is always a solution to capture the backbilling in an effective manner and avoid unnecessary loses. Our solutions capture backbilling and ensure compliance.
Timeline
Now that you are ready to transition to a new medical billing service, the most asked question is how long will it take. The most common scenario includes a new billing software application, and in our case that is a web based application. While each client is unique, the common scenario involves 3 basic elements: Setup the new billing application to accept new charges, define a ‘cutover’ date from the old application to the new application, and finally migrate accounts with outstanding balances from the old application into the new application.
The key is to properly prepare for the ‘cutover’ date by immediately setting up the new billing application to accept charges. Once in place, the actual transition from old to new is a one day event. The final step is to capture the information on remaining aging in the old application and enter it into the new application.
Our properly planned transitions provide continous billing and revenues with no interuption to the front office work flow. We provide training and direct assistance to ensure a seamless transition.
