Our Services

Complete revenue cycle solutions

Comprehensive billing services for inpatient and outpatient, adult and adolescent behavioral health programs.

Verification of Benefits

Preliminary VOBs for fast admission decisions
Full VOBs detailing deductible, OOP, copays, and parity rules
Visit limits and authorization requirement analysis

Claims Processing & Denials

Billing for inpatient/outpatient, adult/adolescent services
Weekly claims submission through CollaborateMD
Rigorous follow-up to minimize AR aging
Appeals drafting, corrected claims, root-cause analysis

Credentialing & Contracting

Out-of-network provider credentialing
In-network payer applications and contract negotiation
Reimbursement assessment and implementation support

Claims Pricing & Recovery

Out-of-network pricing (Multiplan, PBS, GCS, Data iSight)
Underpayment identification and recovery
Contract rate validation and discrepancy resolution

Utilization Management

Prior authorizations for DTX, RTC, PHP, IOP, and outpatient
Initial, concurrent, peer, and retrospective reviews
ASAM 4th edition, LOCUS, and CALOCUS compliance
Proactive monitoring to prevent coverage gaps

AR Reporting & Revenue Insights

Monthly AR reports with KPI tracking (aging, denials, rates)
Custom reporting for executive leadership
Revenue projections based on utilization and payer data

Additional capabilities

EHR Integration

Familiarity with KIPU, Aura from Sigmund, Best Notes, and Zen Charts Electronic Health Records

Staff Training

Facility staff training regarding documentation and medical necessity guidelines, including ASAM 4th edition, LOCUS and CALOCUS

Ongoing Monitoring

Proactive monitoring of medical necessity to prevent coverage gaps and avoidable claim denials

Performance Tracking

Monthly reporting of facility KPIs and utilization review trends