Services We Offer

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We are expert in the fiscal oversight of disability and behavioral health services for the District of Columbia, Maryland and Virginia Medicaid programs to include, but not limited to Intermediate Care Facilities, Community-based Waiver services, Behavioral Health and Human Care Agreement contracts.  We can assist with:

1. Receivables resolution - we will work in coordination with the respective Government agencies and your organization to isolate the specific issues, develop a plan of action, gather the supporting documents, and implement actionable steps through resolution of your issues in efforts to maximize your collections in the most time efficient manner
2. Develop systems of authorization tracking and utilization to proactively process renewals and ensure seamless revenue continuity
3. Optimize cost classifications to be in alignment with reporting mandates
4. Individual Support Plan - Plan of Care implementation assistance
5. Assist in the renewal of acuities, authorizations, eligibilities (LON/LOC, SA/PA, acuities, 1445s, Medicaid recertifications) and develop processes to maintain
6. Customized reporting for claims billing details and payment posting, accounts receivables tracking
7. Billing and authorization access through various DC Medicaid portals (DC Web Portal, DC Vendor Portal, WINASAP, EDI/Conduent, MCIS, Quickbase, Qualis)
8. Assist in the setup and maintenance of persons supported finances oversight to include bank account and asset maintenance
9. Setup tracking tools to ensure seamless service delivery
10. Preparation of Medicaid Cost Reports
11. Human Care Agreement renewals / option year preparation assistance 

Having issues with revenue collections from Medicaid or Human Care Agreement contracts?  We have collected millions in aged receivables for providers.   Our ability to reduce aged receivables for Medicaid providers is second to none. We have successfully reduced accounts receivables aging totals over 50%-80% from 180+ days down to 30-60 days for multiple organizations.

We will work in coordination with the respective government agencies and your organization to develop workable plans to resolve the outstanding issues.  Whether the issues are related to acuity, authorization gaps, eligibility gaps, incorrect billing, transfers or overlaps, we will get to the root of the issue work directly to resolve the outstanding problems that are affecting your cash flow.  

Let us help you get the revenue you have earned so you can focus on your business operations.

 Our focus is simple; provider satisfaction and getting it done right the first time.  We are a multi-specialty billing provider with the capabilities of confidently meeting your billing services needs.  Our specialties in participating and non-participating billing and collections services for Gastoenterology Anesthesia and Long-Term Care Contracts has enabled us to expand into multiple states to include Maryland, Texas, Ohio, North Carolina and Oklahoma.   We strive ourselves on  providing the utmost dedication to provider satisfaction by providing the following: 

• Compliant expert coding and diagnosis review with focus on Provider reimbursement maximization
• Fast Electronic claims submission with the utilization of state of the art billing systems  
• Aggressive and consistent insurance follow-up to minimize the provider's aged accounts receivables and accelerate collections 
• Immediate response to denials and insurance requests
• Automatic payment posting
• Patient services support
• Provider credentialing and enrollment 
• Customized reporting
• Focus on accounts receivable minimization
• Customized financial analysis and reporting 
• Participating and non-participating billing services

Claim Coding and Diagnosis Review  Our expert billing team will ensure your claim is submitted right the first  time. This is accomplished by dedicated coordination with your team to  establish an efficient system to gather all the patient demographic and  charge data accurately and completely.  Our experts will "scrub" the claims to see that all compliance mandates are met to achieve a "clean claim" and  ensure that each claim is coded to achieve maximum reimbursement.

Electronic Claims Submission With the utilization of our state of the art billing systems, your "clean  claim" will be submitted within 48 hours of receiving. Our systems allow  us to track the status of each claim from acceptance by the clearinghouse  to the insurance company to final processing. This allows you to rest assured that you can receive real-time status on your claims every step of  the way.
 

Denials Management 

Our team of Denials Management Specialists are on constant alert for denials and requests for additional information from the insurance companies. Within 24-48hrs of notification of a claim denial and/or request for additional information, our specialists will respond immediately providing the necessary information in order to get the claim processed.  In the event of a valid denial, you will be notified immediately with detailed  explanations and options for appeal. 

Automatic Payment Posting 

Our software systems allow for automatic electronic remittance postings as  received.  Paper Explanation of Benefits (EOBs) and correspondence is  posted 24-48hrs of receipt or as needed based on your needs.

Patient Services Support 

We have a dedicated patient services line and professional courteous staff  to answer any questions a patient may have regarding their EOBs and  charges to their insurance carrier.  Our staff is dedicated to providing the  utmost care and professionalism in discussing patient billing matters.  We  provide patient statements regarding any copay, deductible, coinsurance,  and patient responsibility.  

Provider Credentialing and Enrollment  

We have a dedicated team of credentialing experts to meet all of your  credentialing and enrollment needs.  Our credentialists are experts in the  swift preparation of all government, commercial and local insurance  carriers so rest assured that your credentialing process will be managed  with the utmost care, transparency and accuracy.

Standard and Customized Reporting 

We realize that each provider and practice has different and specific  billing and reporting requirements depending on their specialty.  Our team  of experts will work with you to ensure that we develop a billing and  collections process that caters to your specific needs and reporting requirements.  We are capable of providing daily, weekly and monthly  standard and fully-customized reports.  Just ask one of our  representatives and we'll be happy to show you the benefit of this type of  reporting.

Accounts Receivable Minimization 

Our focus is simple; provider satisfaction and getting in done right the  first time.  Our goal is maximize collections and minimize any aged accounts  receivables.  We have an expert team of Accounts Receivables Specialists  that aggressively pursue payment from the time the claim is submitted.   Many billing companies wait until the general processing times have lapsed  prior to any making inquiry.  We believe this is counter-productive and  inefficient.  Our specialists track the claims from submission and begin  inquiry immediately to ensure there is nothing prohibiting the claim from  processing on time.  

Customized Financial Analysis and Reporting 

We also offer a range of financial analysis services and reporting tools  that allow you to focus on your practice and not on your finances.  Our  financial experts can meet any of your financial analysis and reporting  needs such as:    Full Annual and Monthly Budget Preparation  Case Volume Analysis by Insurance Carrier/Self Pay  Profit and Loss by Procedures Offered  Proforma Analyses on Potential Business  Revenue Projections by Carrier/Procedure  Insurance Carrier Mix & Average Collections by Carrier    Speak to one of our representatives for more information on these and  other analyses and reports we can offer to make running your practice  easier and more efficient. 

Need help in establishing financial systems, development of policies and procedures?  Our experts can work with you to analyze and develop a plan for setting a foundation to support growth and success.  

Our experts are fully versed in Federal and various State credentialing for multiple commercial and governmental insurance payors.  Everything from in-network participating relationships to contractual rate negotiations, we can help get you established with your payors so you can start to see the revenue you have earned.   Need an NPI for your practice?  No problem, we will help establish your practice credentials and where applicable, facilitate the setup of electronic claims submissions and payment repositories.

We can assist in the completion of Medicaid applications and Human Care Agreements.  Please contact us for more details.

 We offer a wide range of Accounting and Financial services to fit your business needs.

1. Bookkeeping - Let us help you maintain your general ledger entries in a compliant and accurate manner.  Whether it is quarterly, monthly, bi-monthly, weekly or daily, we can cater to your business needs.  Our staff are fully trained trained Accounting clerks who will ensure your entries are in accordance with Generally Accepted Accounting Principles (GAAP).

            2.  Accounting - We offer a wide range of accounting services to include ,but not limited to:

• Financial statements internal preparation (for profit):
  • Profit and Loss statements (monthly, quarterly, annually)
  • Balance Sheet
  • Statement of Cash flows
• Financial Statements internal preparation (not for profit):
  • Statement of Activities
  • Statement of Financial Position
  • Statement of Cash Flows
  • Statement of Functional Expenses

           3.  Financial - Let us help you develop and enhance you financial reporting tools such as:

• Annual and monthly budgets
• Comparative reports
• Financial metrics
• Proforma analyses
• Benchmark data
• Trend analyses