Services we provide:
Specialized Billing – we can bill for Licensed Midwives, Certified Midwives, Birthing Centers and Doulas.
Insurance Collections – you can transfer old accounts to us that you have previously filed claims on and we will collect from the insurance company.
Custom Claims - we will determine the best approach to filing your claims either global or itemized. Our goal is for you to receive the maximum reimbursement for your services. We are highly skilled at billing transfers.
Verification of benefits – we personally call the insurance company to verify your clients benefits for maternity services and well woman care.
Claim filing and follow up -all claims are filed daily and electronically using the latest industry technology unless a paper claim is required. Follow up calls are made regularly and payment pursued aggressively.
Appeal letters- often claims will process based upon “usual, customary and reasonable rates’’ or “non-covered” guidelines. Insurance companies will use these terms to reduce payment. In these cases we will appeal the claims to maximize your reimbursement.
Medipass Referrals - we will obtain the Medipass referral from your clients PCP if your client is a Medicaid recipient who is enrolled in the Medipass program.
Predetermination Letter – Some insurance policies are self funded or out of state and although they may provide maternity coverage they do not follow state law. In these cases we will work with the insurance company to have the services considered outside the terms of the policy.
Authorizations – some policies require an authorization in order for services to be covered, in these case we will obtain the necessary authorization
Gap exception requests – if an insurance policy has both in and out of network benefits and you are not in the network we can often request a “gap exception” to have the services considered in network
Referral request – certain plans require a referral from a PCP (primary Care provider) in order for services to be covered. We will contact your clients PCP directly and obtain the necessary referral
Rate negotiation - we will always negotiate the best possible rate for your services with any plan that is requiring a single case rate (per individual client.) These are often called LOA’s Letters of Agreement.
Contract negotiations – should you wish to contract with any insurance companies we will be happy to advise you and once discussed handle the entire process for you.
If your would like to find out more about how we can help you, or if you have questions about our contract rates. please contact us by calling, e-mailing us or filling out the form on the Contact Us page.
