Services

Consulting

The first step with any good consultant is to have a conversation before presenting pricing or request for proposal. I would love the opportunity to discuss your current needs and areas of opportunities. Please inquire here for a free phone consultation.

Outsourcing

Unless you’re an all-cash practice, it may be better to outsource your billing and collection. Here are the reasons why I have come to feel that outsourced billing is the way to go for several reasons such as:

Payer relationships, payer reimbursements

Ever changing Regulations

Complexity of insurance plans and ACOs

Government and hospital reporting requirements

Claims denials

Patient balances

Benefit verification and prior authorization requirements

Cranial Prosthesis Billing

Many suffer from health conditions that can drastically cause hair loss, and do not know that cranial prosthesis (wigs) are covered by most health insurance:

Types of Hair Loss potentially covered by Insurance:

Alopecia Hair Loss

Chemotherapy Related Hair Loss

Radiation Related Hair Loss

Thyroid Related Hair Loss

Kidney Related Hair Loss

Cancer Related Hair Loss

Partnership with Hair Stylist

Revivify Revenue Cycle Consulting partners with Hair Stylist, to offer this unique service. Cranial Prosthesis falls under the DME (durable medical equipment) guidelines of your health plan, which can be very confusing and complex. We have a specialized team of medical billing experts who has the required skillset to deliver quality durable medical equipment billing services.

We’ll perform a comprehensive insurance review which will include:

Detailed benefit investigation. If out of network, we will submit written request for in network coverage if needed. We will perform pre-authorization or pre- determination, filing of claim, appealing any denials, and coordinate with the insurance carrier for payment of claim.

Revenue Cycle Analytics

Everyone knows that healthcare is a data driven industry. Your finger must constantly stay on the pulse of your healthcare organization. This requires investigating the source of discrepancy in key financial metrics, such as A/R days, collection rates, charges, and payments. This requires good analytics.

Revenue Cycle Training

Does your RCM team need a billing and collection refresher, in office? Your RCM department must stay abreast to the ever-changing world of healthcare reimbursement. Satisfying patient’s needs, protecting your margins and maintaining operational efficiencies requires constant evaluation, which revenue cycle competencies are priority. These competencies can change quickly as healthcare continues to evolve. This is the reason your team must be well versed within the full revenue cycle. By developing a high-performance team, you will be able to anticipate reimbursement issues.

DME Billing and Collection

DME billing and collection can be a very complicated process. There are many requirements that must be met before services are rendered to be reimbursed by Medicare or a Health plan.

Prior Authorization Services

This process can be considered the life blood of a medical claim. If the authorization process is not done correctly before services are rendered it can be very costly and time consuming trying to be reimbursed after the fact.

Drug and Infusion Billing and Collection

This is a very specialized billing and collection process. If you are billing for drug administered in office, hospital or home this can be a very complex process. The initial cost of the drugs leaves no room for error within the billing and collection process.

Credentialing and Insurance Enrollment

We also provide Healthcare Credentialing, if necessary and Insurance Enrollment. Credentialing is the process of assessing and validating the qualifications of a independent practitioner to provide patient care. Today’s healthcare system are highly technical and extremely complex. Regulatory and compliance issues, operational difficulties and financial challenges represent huge huddles for healthcare providers.