Insurance credentialing can be a nightmare. We are no stranger to this process, and know the ins and outs to do it quickly, and correctly. We waste no time getting your applications in process.
Our insurance-specific contacts allow us to move applications along, getting you credentialled as quickly as possible, and services are broken down so you only pay for what you need. A delayed application will most likely cost you MUCH more than the credentialing process itself. Let an expert handle this.
Billing & Claims
Submitting claims, sounds easy right? There’s more to it than filling out the blanks and submitting. Billing and Coding go hand-in-hand, and proper codes, modifiers, authorizations, etc can easily be botched.
Each claim is reviewed, cleaned, and looked over for potential changes that may maximize the encounter. The claim is then submitted electronically, giving us much more control on its status, and resubmissions.
Paid claims are easy to manage, and reconciled to your EMR. As part of our onboarding process, all insurance payments are set up for EFT, so no more checks to worry about. Claim denied? No problem, we will research the issue and resubmit, or communicate any needed information with your office. A non-paid claim results in a complete write-off. We get paid when you do, so it makes sense we want to do everything in our power to get your claim paid, every time.
Pivotal Billing Solutions utilizes a full service model, consisting of more than just claim and EOB management. Insurance and patient receivables are extremely important and go hand-in-hand.
Failure to properly manage all these could result in thousands lost. Many in-house billing personnel allow their receivables to get out of hand, resulting in lost revenue.
Not sure where to start? Staff having troubles verifying benefits correctly? Need help maximizing your encounters? Our consulting services offer assistance in most areas. Our previous clients prove that there’s a phenomenal return on investment learning to verify, code, and bill insurances correctly!
Had a bad experience with a previous company, or in a mess with your current in-office biller? Think it’s too late to recover lost revenue? Not always. Let us help clean up the mess and get you back on track.