Services

StarMed Billing Services will implement and administer a revenue management system to maximum reimbursements for third party payors.

UTILIZATION REVIEW

StarMed Billing Services will continuously review client -specific documentation of the health care services provided. Keeping a close watch of the documentation of the severity of the individual’s symptoms and their response to interventions, ensuring the services are appropriate to meet the individual’s needs, guarantees rapid reimbursements for services. In addition to the initial Pre-authorization for care, StarMed Billing Services provide:

  • Concurrent Review: Following the Preauthorization, StarMed Billing will perform “Concurrent” Reviews. We will maintain the relationship with the payor. Continuous relaying of the individual’s symptoms and their response to clinical interventions ensures for approval of extended stays in treatment, providing the individual with an opportunity to maximize the resources for long term growth.
  • Retrospective Review: StarMed Billing Services will perform “Retrospective Reviews”. A review with the payor of the clinical documentation and the individual’s response to treatment AFTER the services are rendered.

PREAUTHORIZATION

StarMed Billing Services will conduct “pre-authorization” on each individual admitted. “Pre-authorization” is a process used to determine if the recommended procedure or services will be reimbursed by the insurance company. This can be referred to as “prior authorization”, “prior approval” or “precertification”. Many health insurances require preauthorization for certain services before they are rendered. Preauthorization is a notification to the third-party payor you are applying for services, the type of services and the initial diagnosis to establish the account for financial reimbursement.


ELIGIBILITY VERIFICATION

Service providers, who provide medical and/or clinical interventions to individuals who rely on third party payors to cover their services, must verify the insurance is valid and that the agency is eligible for reimbursement based on the insurance guidelines. Verifying insurance coverage is a very imperative part of understanding if the patient’s insurance is active and covers the services needing to be rendered.


ELETRONIC REMITTANCE & PAYMENT POSTING

StarMed Billing Services utilizes Electronic remittance which helps you save time by automatically posting insurance payments based on electronic reports delivered to your practice. By receiving electronic payments and automating the payment posting process, you can get paid faster and save time.

  • Insurance Payment Posting: All payers either send an EOB (explanation of benefits) or ERA (electronic remittance advice) towards the payment of a claim. The medical billing staff posts these payments immediately into the respective patient accounts, against that claim to reconcile them.

CLAIM SUBMISSION

StarMed Billing Services submits all claims for payment to third party payors. An insurance claim is a formal request to an insurance company for compensation for rendered services provided by a Doctors’ Office, hospital or facility. The insurance company validates the claim and, once approved, issues payment to the payment to the appropriate party in accordance to the payer’s policy and guidelines.

CUSTOMIZED REPORTING

StarMed Billing Services customizes reports to give you informational summaries of billing activities to allow you to monitor how different areas of your business are performing. In health care billing our summaries are comprehensive and provide a snapshot of any monies owed the health care provider and any reasons for lack of payment this report is used to keep track of delayed receivables.

COLLECTIONS

StarMed Billing Services utilizes aggressive collection practices to ensure your revenue is maximized. Collections is the final phase of the billing process. We ensure bills received by each payer, are adjudicated timely. If an appeal is need, that is also part of the collections process as well.


DENIAL MANAGEMENT

Failing to adequately work denials from payers translates to lost in revenue for your medical practice. StarMed Billing Services utilizes the four steps to effective denial management — Identify, Manage, Monitor and Prevent.


PHYSICIAN CREDENTIALING

StarMed Billing assists your agency in the Credentialing Process for medical staff. “Insurance Credentialing” is the process of obtaining, verifying, and assessing the qualifications of a practitioner to provide care or services in or for a health care organization’s network. And or the process of licensures, training and other qualifications to bill to an insurance payer for the first time.

  • A/R ANALYTICS & BUSINESS INTELLIGENCE – StarMed Billing Services will identify business intelligence, reporting, and data analysis needs. We will work closely with clients and IT teams to turn data into critical information and knowledge that can be used to make business decisions.

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