Specialty Billing Services

Our Specialty billing service starts by designing a billing process custom-fit to your practice, focusing on the most efficient and rapid means to gather all needed information, quality and integrity checks built in.  At the same time, we perform a complete review and update of credentialing/provider enrollment information. Compliance issues and risks are highlighted and resolved throughout the process.

 

 

Accurate claims are sent to each of your payors within 30-90 days.  As claims are adjudicated, payments are posted and denials are automatically directed to the proper AdvantEdge expert for rapid resolution. Secondary claims and patient balances are automatically billed at the time the primary payment is posted.  Every day our accounts receivable experts  review and analyze all other outstanding payor and patient balances.   And at the same time,  your practice always has access to daily financial and operational summaries.

 

An AdvantEdge client manager partners with your practice throughout implementation and after; and is always available to your practice to answer billing questions and as a practice management resource.

 

If your current Specialty billing company isn’t surpassing your expectations, ask us to demonstrate why AdvantEdge is different. At AdvantEdge, we pride ourselves in addressing and meeting each client’s specific needs, with continual strong net collections and A/R performance. This “outsourced” (i.e. your work is done by our employees on your behalf) billing reduces your fixed costs, while you keep visibility and control of your practice, including online “anytime, anywhere” access to your current financial performance.

Can your Specialty Billing Benefit from our Proven Results?

Proof:

  • Collections up 5 to 50%
  • Denials down up to 90%
  • Achieve net collections of 95+%
  • A/R days outstanding reduced by 7 or more

Productivity

  • You focus on clinical matters, not the “back office”
  • Lower staff and overhead costs

Performance

  • Powerful tools and technology guarantee service to billing intervals in hours or days, not weeks
  • 99% of claims are processes electronically
  • Comprehensive, real-time reporting
  • Visibility and control for your practice

People

  • Highly trained, certificated, and ready to meet your specific needs
  • Expertise
  • Responsive service
  • Confidence

Process

  • Efficient and fully compliant workflow means
    • Expedited, efficient claims processing
    • Less denials, faster denial processing
    • Automation of routine tasks
    • Reduced compliance risk

Partner

  • Solutions tailored to the specific needs of your practice
  • An extension of your practice
  • Advisor
  • Payor contract negotiations
  • Credentialing
  • Industry expert in regulations, coding, compliance

How AdvantEdge Specialty Billing Serves your Practice

  • Demographics captured via hospital downloads (HL7 and other)
  • Specialty Charge Capture including ECC and EMR interfaces
  • Reconciled charge batches
  • Daily electronic submission of medical claims
  • Electronic Payer Remittance (ERA)
  • Payment Posting with Daily Reconciliation
  • Flexible Patient Statements
  • Rapid Follow-Up with Payers, Patients
  • Denial Management
  • Patient portal
  • Lockbox, other Banking Arrangements
  • Expected vs. Actual Reimbursement Analysis
  • Compliance Plan and Program
  • Sophisticated but Flexible Specialty Billing System
  • Line Item Posting
  • All transactions fully journaled
  • Ad hoc Reporting
  • Web-based dashboard with daily financial results
  • Client Management Expert Assigned to each Client
  • Chart auditing, credentialing, payer contracting, HR, Accounts Payable options and more