Consultant

Medical & Mental Health Billing, RCM, Insurance, Credentialing & Compliance Services

• · Specializing in Group Practices, Solo Practices, Clinics, Ambulatory, Non-for-profit
• · Enrollment – NYS Medicaid, Medicare, Commercial, HMO, Managed Care, and Private Insurance 
• · Enrollment - Georgia Medicaid (GAMMIS) Enrollment/ Training 
• · Core functionalities of the EHR system
• · Streamline the Intake Process
• · Policy and Procedure Manual Creation – Staff guidelines (Optional)
• · Direct Deposit and EFT Set Up for Claim Reimbursement 
• · Claim Denial and Approved Remittance reports 
• · System Implementation, Salesforce, EHR, CMR, EFT and others 
• · Remote or Office Staff Training – EHR Implementation/Training 
• · Updating EHR systems, Pt Info. Charge Entry, CPT code, ICD-10 Codes, Providers
• · Portal, Email, or Telehealth Services Set-up – Billing services (Optional)
• · Patient eligibility verifications and authorizations 
• · Entering patient demographics and claim information
• · Templates, Charts, Spreadsheets, PowerPoint Presentations
• · Streamline Payment Process
• · Revise Notes, forms, and memos
• · Managed Client Care in Real Time  
• · Submitting secondary claims – COB
• · Follow-up on unpaid claims, back billing, and appeal process 
• · Monthly patient data statements 
• · Answering patient billing inquiries 
• · Monthly reporting/ Claim Filing Process reporting, denial quarterly reporting
• · Posting insurance and patient payments 
• · Adjustments, denials, and Appeals processing
• · Practice Marketing services for a client roster 
• · Submit claims either electronically or by printing paper CMS 1500 or UB-04, 
• · Variation of claims that involve routine follow-up of unpaid claims 
• · Audit prep and guidance on OMH Regulations 
• · Itemized budgets, expenditure, and variance reports - payroll guidance (optional) 
• · Analytical Reports – Know how your practice is performing in real-time
• · Construction of Practice revenue cycle (RCM)
• · Back billing and scrubbing of old claims 30/60/90-day buckets 
• · Staff training on reading EOB’s, COB’s and CMS 1500, UB04 forms
• · Live classroom training on practice procedures and policies
• · Chart Errors for compliance issues or regulatory guidelines
• · HIPPA compliance training – organizational set-up (optional) 
• · Free Industry resources as a client of Claim Care Solutions 7 days a week