Our Process
Go ahead and spend time with your patients. We’ve got you covered.
Worry less. Make more money. Live a better life.
WHAT WE DO AND HOW WE DO IT
It starts and ends with you
Business, like life, is about relationships, about people. Your job is to make them healthier and live longer. Our job is to make you and your practice healthier and grow faster. After filling out our contact form or calling 800.527.0336, you’ll hear from us by the next business day or sooner.
After that initial consultation, we will be busy saving you time and making you more money. That’s what it’s about for us here at 51 Oakwood.
Once you’re part of the team…
We’ll set you up with a secure entity to be your e-filing cabinet. Every document we touch, every document you send is there. Whether it’s a chart, claims status, or a monthly report from seven years ago, it’s there for you when you need it.
And it’s safe. Medical Management is about the details. That’s why all of our data is backed up with triple redundancy. We have servers in-house, one in Colorado, and one in the Cloud.
We’ll make it as easy as possible. Whatever EHR software you currently use – works for us. The systems we have in place are either compatible or we will establish a VPN (virtual private network) to access your EHR.
We’ll handle the headaches. Billing and dealing with insurance companies can be confusing. It takes time and patience. Both of which could be better used on your patients. We will talk to your patients, to their insurance providers, and anyone else we need to in order to save you time.
At the end of each month, we invoice you for our percentage of the total amount you’ve already received.
Our 11-Step Medical Management Process
Our 11-Step Medical Management Process is how we give you more time to focus on patient care and also insures you receive optimal reimbursements. Our in-depth knowledge at every step of the process provides our clients with confidence to run their day-to-day operations while we handle their claims processing.
Step 1: Credentialing
It starts with you. We handle your provider enrollment. We also make sure your licenses are up to date
Step 2: Negotiating
You never have to negotiate with a provider again. We will maintain your contracts and re-negotiate them when it’s time. We also re-validate providers with carriers before expiration.
Step 3: Verifying
We save you time. We check your patient demographics and insurance eligibility online. Saving time. Increasing workflow. Making it easier.
Step 4: Retrieving
We capture the charge within 24 hours.
Step 5: Claims Auditing
We use a 4 point in-house Audit Process:
- Payor Guidelines
- CCI Edits (Claims/Coding Audit)
- Medics Elite Claim Scrub
- Change Healthcare, WebMD, Advanced MD, IMSPro, and Centricity, Clearing House Pre-Claims Submission Scrub
Step 6: Submitting
We upload charges every day to our Clearing Houses.
Step 7: Monitoring
We check and verify all electronic payments. We reconcile them to your Lockbox. And don’t worry about the underpayment of your contracts. We watch that too.
Step 8: Re-filing
Twice? Three times? However many it takes. We mail all subsequent claims and keeping mailing them with eobs to your carriers.
Step 9: Contracting
We send statements monthly to your patients. If they have questions they call us – not you. If and when it’s time to go to collections, we create the file and implement your policies.
Step 10 Appealing
We handle your A/R follow up and deal with denials. We use carrier guideline to quickly file appeals. We monitor all denials to track trends and then communicate with you about how to minimize them in the future.
Step 11: Reporting
Our customized billing reports are tailored to your practice. It’s data that’s meaningful to you – delivered every month to help make decisions going forward.
What our clients are saying…
