BY PROVIDERS
FOR PROVIDERS
OUR TECHNOLOGY
EFFICIENT
Our efficient operations allow us to start submitting claims and maximize payments including Out-of-Network claims within 2 days after the on-boarding process is completed.
SECURE
Our billing software utilizes the Amazon Web Services cloud-based platform which implements the latest technologies for ease of access and newest security features.
PROPRIETARY
Our proprietary algorithms paired with operational efficiencies allow us to take the entire process of submitting claims and maximizing revenue so physicians can focus on the clinical side of their practice.
Maximizing Practice Revenue and in particular Underpaid, Out-of-Network Anesthesia Claims is a complicated business. We are a unique combination of two Anesthesia groups and experienced Reimbursement specialists with access to the latest reimbursement algorithms for Out-of-Network Claims along with a firm understanding of how to maximize the financial performance of Independent Anesthesia Groups in Texas.
MEET US
OUR STORY
As providers, we got tired of leaving additional collectible revenue from Out-of-Network claims on the table. Due to the limited literature available online and time it took away from performing the cases, we decided to seek out and partner with reimbursement specialists. Combining clinical experience with financial efficiencies added clarity and profitability to the process of maximizing revenue for Independent Anesthesia Providers.
OUR VISION
As a majority provider-owned company, we are focused specifically on the Anesthesia sector to provide our clients with a financially successful practice through greater profits and cash flow. We strive to provide operational efficiencies in the In-Network environment while maximizing profitability in the Out-of-Network setting in order to maximize yearly revenue for Independent Anesthesia Providers.
OUR TECHNOLOGY
As leaders in utilizing the latest reimbursement algorithms to prevent direct loss of revenue, we systematically update our operations. An unparalleled analysis of over 100K cases provides us with knowledge and data that we use to maximize your practice’s revenue while minimizing days it takes to get the additional payments from Underpaid Out-of-Network claims.
Our professional services allow providers to focus on the most important aspect of running an Independent Group Practice, which is performing cases.
Underpaid OON Claims FAQs:
How many Out-of-Network Claims are underpaid?
- After April of 2018, the majority of the Out-of-Network claims from large commercial insurances are underpaid.
How often do we follow up on underpaid Out-of-Network Claims?
- We review underpaid claims everyday. Once the EOB is issued, the payments/claims come in batches. We post the payments and analyze which claims have been underpaid. Then we identify if the claim qualifies for additional payment and what is the most efficient/effective way to get max payment. We execute.
How much additional revenue can Out-of-Network Claims generate?
- After the initial processing of Out-of-Network claims occurs, as much as +/- 15% of additional yearly income can be generated.
How long does it take to get additional income from underpaid Out-of-Network Claims?
- After the initial processing occurs, depending on the insurance company and type of the policy, it takes as little as 7 business days to start getting additional payments.
Can every Out-of-Network Underpaid claim be reprocessed to pay more?
- No, not every single underpaid claim will pay an additional income. Only certain underpaid claims are eligible to reprocess and generate additional income.
There is a MultiPlan logo on ID card, will the OON claim pay via my MutiPlan agreement?
- No, if the insurance card has MutiPlan's logo it does not necessarily mean that it will process/pay according to Global Agreement Rate, rather it means that this policy may provide access to MultiPlan's Network of providers.
Does every Underpaid and Eligible claim require patient participation?
- No, not every Underpaid and Eligible claim requires patient participation and the reprocessing can be initialed by the billing department after EOB has been issued.
Where can I read more about the processing of Out-of-Network Anesthesia Claims?
- Online research can be daunting and meritless, wealth of additional information can be aquired by reading our book "Out-of-Network, Underpaid Anesthesia Claims".
Part of our onboarding process includes a copy of our book "Out-of-Network, Underpaid Anesthesia Claims". Written by our providers and reimbursement experts, the book addresses operational and financial challenges that Independent Anesthesia Groups encounter daily in the Out-of-Network environment in Texas.
BILLING 3.0
Future Releases Include
CIRCADIAN
BILLING
APP
COMPUTER VISION
OPTICAL
CHARACTER
RECOGNITION
GET IN TOUCH
P: 817.479.6158
F: 817.479.8385
Patricia Kirkland
Operations Manager