Information for Providers
Process Overview
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Implement a pre-screening process of upcoming scheduled patients
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Execute Prior Authorizations for qualifying treatment plans
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Code and process claims as well as provide any follow-up / support services including, but not limited to, additional information requests, medical history, denials, rejections, and appeals
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Weekly Reporting
Credentialing
The most important step in implementing medical billing into your practice is to medically credential all providers and the facility. Medical insurance plans require all rendering providers and facilities submitting medical claims to be credentialed. claimSTAT will provide credentialing services for all rendering service providers at each facility as well as each rendering facility. This is a yearly process that is renewed at each payer. There is a cost associated with credentialing. Please contact claimSTAT for more information
Does this add work to my office team?
There is no EXTRA WORK for your staff as claimSTAT handles everything. The only new process that your staff will be introduced to is collected the patient's medical insurance card. claimSTAT handles the rest.
Operative Note Consulting
claimSTAT offers training on effective and efficient operative notation and documentation standards that will ensure clean, smooth billing and reimbursement cycles. The documentation standards that claimSTAT has been proved to be essential for medical billing success. Be sure to ask your consultant about this service.
Timeframe for Claims
We see a typical timeframe from claim entry to claim payment from 3 business days to two weeks.
If the claim is sent for medical review, this timeline can be extended. However, your claimSTAT analyst will work to ensure your claims are settled with the payer as quickly as possible.
Pre-Screening Process
claimSTAT will establish a secure, HIPAA compliant VPN connection to each practice server. This allows claimSTAT the ability to review scheduled patients along with pending services to predetermine if medical billing is applicable. claimSTAT works with the office administration to set an identifier for the appointments that are preapproved for medical billing and what co-insurance and/or deductible needs to be collected from the patient.
Prior Authorizations
For proposed services more than $2,500, claimSTAT is able to perform prior authorization submissions at the payer level. claimSTAT will provide the treatment coordinator with a breakdown of the patient's approved services and coverage as well as any applicable co-pays and deductibles owed. Most prior authorizations are completed and returned to the office within 48 hours.
