Rehabilitation Billing and Collections Outsourcing Services

Daily electronic and hard copy claims submission to Medicare, Medicaid, Workers Compensation and all commercial carriers. Immediately notify your facility if claims are unable to be submitted due to missing or inaccurate information. Follow up with clearing house to insure all claims have been accepted.

Claims are submitted the same day payment or denial is received form Primary payor. Respond to request for additional information such as request for scripts, progress notes or letters of medical necessity.

Facility New Clinic Locations, Change of Address for existing locations, Maintain up to date Provider numbers for all clinic locations.

Therapist Credential new Therapist with existing Managed care Contracts, Obtain NPI and Provider numbers for new Therapists.

Managed Care Providers Contract Review, Negotiate New Provider Contracts

The APFS Centralized Insurance verification Department can verify insurance coverage, eligibility, benefits, and obtain authorizations prior to the patient’s first visit.

Services Many carriers, including Medicare, require Electronic Claims Submission. In most instances, through a strategic partnerships with our preferred clearing house ZirMed, this can be done at a rate much less than what you are currently paying a clearing house or web-based electronic vendor.

ZirMed is able to receive electronic remittance files from hundreds of payers nationwide. Once they receive these files, they are immediately available to us on the ZirMed website. With your enrollment, we have the capabilities to download ERA’s from ZirMed and post payments in a more time efficient manner than the standard paper remittances.

Our Systems Administrator and certified Coder are qualified in maintaining the most current and accurate procedures that ensure compliance to all applicable laws, rules, and regulations governing Healthcare, Coding, and Third Party Billing.

Insurance Follow Up
Follow up on outstanding insurance claims based on payor specific collection philosophies. First follow up with the carrier is done within 28 days of original claim submission date. All claim follow up is done by telephone contact with the carrier. Our Account Follow Up Specialist keeps track of carrier’s specific requirements to reduce claims rejections. We track and document status all of your unpaid claims. You will know exactly what the status is at all times.

Patient Billing
By adopting the Patient friendly Billing standards developed by HFMA (Healthcare Financial Management Association), we provide patients with statements that are Clear Concise Correct You decide if and when to start Bad Debt collection activity and we will process these accounts for placement with an outside agency.

Every day, businesses put their entire accounts receivable database on the line and do not realize it. Proper backups are critical and we can successfully address these issues. To ensure that you are meeting all regulatory standards, you need an IT partner with compliance expertise. We understand these requirements and know how to satisfy them with both technology and related medical billing processes.

We will produce and make available only the reports that you will need to make business decisions on a day to day, month to month, and year to year basis. We will train you and your employees in the proper use to the information that is produced. Our menu of reports includes (BULLETED) Insurance Aging Reports Insurance Reimbursement Analysis Insurance Payor Mix Patient Aging Reports Income reports Productivity Reports Utilization and Operational Reports Other Reports based upon your specific request

It is our belief at advance Patient financial Services that you should be able to walk away from our services at any time and continue to be just as successful, if not more successful, than you were when you were a client of APFS. With this in mind it is our goal to retain you as a happy client indefinitely. However, we feel that we can be more effective in our performance if you and your staff are properly trained and educated as it applies to you practice management platform.

We strategically partnered with Source Medical and their practice management solutions because we feel they have the best product to offer any practice of any size. Our team of experts will train your staff in the proper and efficient use of the Practice Management Software to ensure maximum benefit from the system.