Going in-network with insurance carriers is an essential part of running a successful business. For one, it allows you to get listed on providers' lists, which gives patients access to your care and gives you more billable patients. In this post, we'll explain why you...
Your practice’s annual revenue is dependent upon the health of your billing and coding processes. The better they are, the greater your potential to earn. Additionally, your bottom line relies heavily on your ability to collect payments in a timely manner.
However, many behavioral health organizations are strapped for time, as they struggle to retain staff and continue to manage a growing number of patients in need of their behavioral health services. This leaves them unable to dedicate ample time to the revenue cycle management process and more likely to lose revenue.
To maintain focus on patient care and to remove these tedious tasks from your plate, you may consider outsourcing management of your organization’s revenue cycle.
To focus on patient care and to remove these tedious tasks from your plate, you may consider outsourcing management of your revenue cycle.
At Cora Behavioral Health Solutions (Cora BHS), we provide RCM services with experts who are here to ensure our clients’ billing life cycle is set up for maximum revenue collection. We take care of the following steps:
Verification of Benefits
Cora BHS verifies each patients’ benefits before program admission. We have an electronic system for the verification process and also speak to each patients’ insurance carrier, if needed.
We advise our clients on best practices once a patients’ insurance is verified, explaining their existing coverage and how to optimize care. This ensures maximum cash flow as well as reduction in the collection’s life cycle time.
Billing and Claims Process Management
We start the claims submission process within 24 hours of receipt. This involves pulling patient reports directly from our clients EMR system, so that we can bill on a set schedule, allowing for maximum billing. Numerous EMRs integrate with our software directly, so that any patient information comes over automatically, allowing for instantaneous claim processing.
All claims are submitted electronically, running through various denial scenarios before submission to ensure the quickest turnaround time possible. The back and forth between the payers and Cora BHS is minimal; by the time the claims reach the carriers, 99% of denial scenarios have been vetted.
Cora BHS is available to process Professional and Institutional Claims or both, depending on our clients needs. We post all payments and ensure that our clients have received every payment that the payers say they’ve processed.
All Cora BHS clients receive custom reporting weekly and monthly, as well as a detailed claims submission report upon any submissions made, whether weekly or daily. This allows our clients to know exactly where their claims are at in the life cycle and when to expect payment.
Comprehensive Claim Follow Up
Our team follows up on any outstanding payments on a weekly basis, working with the payers directly to ensure timely collections are made. Cora BHS handles all denial resolution and follow-up issues, working with the payers and our clients to achieve paid claims.
On a monthly basis, we run patient collection statements and distribute them to patients, handling any patient collections upon request from our clients.
Reporting and Analytics
Cora BHS provides each client with custom weekly and monthly reporting and analytics. We customize reporting for our clients, so they understand where their claims are at in the process and what RCM services they can expect.
Who We Are
Cora BHS is much more than a billing processing firm. We work with our clients from day one to ensure that they have the best processes in place to maximize their cash flow—from training their front office team on the verification of benefits process to training their team on correct documentation and EMR optimization. We pride ourselves on transparency and reimbursement maximization by providing some of the best revenue cycle management services.