Insurance Eligibility and Verification
- Accurate and meticulous insurance verifications – eligibility and benefits can be a time-consuming process for clinics.
- Thorough eligibility and benefits verification help in reducing insurance claim denials due to incorrect billing, which can result in significant loss of revenue for healthcare providers.
- Our insurance verification process will check procedure-specific coverage and benefits and all out-of-pocket costs so that patients know what is due before their visit. This will help patient collections and prevent it from aging and eventually becoming uncollectible.
Submitting Claims & Working Rejections
- All claims are audited by our experts to make sure claims are billed according to the contract.
- Our audits have shown immense accuracy, allowing providers to get their reimbursements faster.
- If there are any denials it will be fixed the next day after receipt of the EOB.
- Any underpaid claims sent are worked and are addressed with high-level care to make sure that you are getting paid per the contract.
- Necessary actions are taken with the insurance representative to avoid underpayments on future claims.
Full Service Medical Billing
- Lake State Business Solutions offers a complete A/R management service from the time the patient first walks into your office, to the time their statement is received. Our staff will analyze your billing procedures, data, and paperwork, and custom design a solution for your practice that best suits your needs.
Account Receivable & Collections
- Our team will follow-up on any outstanding claims on the respective follow-up date. We will make sure all payments are paid on time.
- We will apply the required pressure to any party that owes you money. Let us focus on collections and you focus on providing quality services.
- Patient statements will be submitted monthly.
- Only after we have audited each invoice to ensure it matches the patient benefits.
- We send invoices out via mail or email depending on your preference.
- Reports like billing, deposits and AR percentages are submitted to you or your team on a monthly/weekly basis depending on your individual needs, keeping you up to date.
- Any other tailored reports that you request will be provided by us as well.
Provider Credentialing and Contracting is a vital process by which medical organizations verify the credentials of the healthcare providers to ensure they have the required licenses, certifications, and skills to properly care for patients in their scope.
What is the difference between Provider Credentialing versus Provider Enrollment?
Credentialing is the process of verifying the licensing, education, and training of the provider. Enrollment is the process of applying to and requesting participation with insurance companies. This is also essential if you are a brand new healthcare business, it is required that you follow CMS requirements and state law.
Healthcare Compliance is a continuous process of abiding by legal, ethical, and professional standards that apply to healthcare organizations. As Certified Professional Compliance Officers CPCO; we have the education of the key requirements that are necessary to effectively develop, implement, and monitor a healthcare compliance program for your practice based on governmental regulatory guidelines. This includes internal compliance reviews, audits, risk assessments, and educating and training of your staff.
Our extensive experience extends to numerous EMR programs. Chances are, we are already familiar with your records program, giving us an advantage when working on your behalf. Some of the EMR programs we excel with include:
- Advanced MD
- Jane App
- Web PT
- Collaborate MD and Practice Fusion
- Simple Practice