REVENUE PAYMENT CYCLE
TAKING IT FROM START TO FINISH
1.
Account Success Manager
The first thing we do at Cascade Therapy Billing, is assign you a dedicated account manager. Their success is measured by your success, so rest assured that you will receive the personal attention your practice needs to operate efficiently.
2.
Client Demographics & Charge Entry
We maintain the client database. This includes client demographics (client contact information, family doctor, insurance provider information, etc. and then we enter all charges.
3.
Insurance Eligibility Verification
We do this for every client before submission to ensure no time is wasted. If the client has coverage, services that are being provided are covered, denials and appeals can be minimized, and payments are expedited at the appropriate rates.
4.
Claims Submission
We expertly process all technical protocols and industry standards that need to be met for an insurance claim. We submit EDI (Electronic Data Interchange) claims via your EMR (TherapyNotes, SimplePractice or ChARM) which means you can track from initial submission through posting of payments – all in one place. No need to worry about data entry errors in third party systems.
5.
Payment Review & Posting
We post the explanation of benefits (EOB) form – date received the service, amount billed, amount covered, amount paid and any balance required, and the electronic remittance advisory (ERA) form – details about the amount billed, the amount being paid by the health plan, and an explanation of any discrepancies between the billed and paid amounts.
6.
Secondary/Tertiary Insurance Claims
If your client has more than one insurance provider, we submit subsequent claims to the appropriate insurance companies. Multi-level payment claim processing can get tricky, but we've seen it all before.
7.
Denial Management
Denied claims are reviews and corrected before resubmission. Our experience has provided insights into why claims are denied, and how to limit denials moving forward, to get you paid faster.
8.
A/R Follow-Up
Our aggressive accounts receivable follow-up goes after any payments from payers or clients that have not been received. Unpaid claims do not slip through the crack. We want you to be paid correctly, and in a timely manner.
9.
Client Statements & Customer Service
Client statements are generated and sent. We also take their calls about their bills and answer any questions they may have. They received the same personalized service from us that you do.
10.
Reporting
Standard and customized reports, including insurance and client A/R aging report, are provided. This report shows items based on the date the claim was generated for the insurance plan. The lower the percentage, the better. It means more money in your pocket – not theirs.