End-to-End Revenue
Cycle Management
From the moment a patient is admitted to the final payment collected, we manage every step. Each service is handled by specialists who understand behavioral health reimbursement.
Verification of Benefits
Know exactly what you're working with before admission.
Our VOB process is the most thorough in the industry. We don't stop at a quick eligibility check. We dig into the details that matter: coverage specifics, policy limitations, exclusions, authorization requirements, and out-of-network considerations.
Each verification includes a soft VOB delivered immediately upon receipt, followed by a comprehensive full verification completed via direct calls with the insurance carrier. We verify behavioral health and SUD-specific benefits including service type codes for mental health, substance abuse, and detox services.
The result: your admissions team has the complete financial picture before making decisions, reducing surprises, minimizing write-offs, and setting the stage for clean claims.
Capabilities
- Immediate soft VOB upon receipt
- Full phone verification with carriers
- BH/SUD-specific benefit verification
- Out-of-network benefit analysis
- Authorization requirement identification
- Payer-specific policy review
Utilization Review
Licensed professionals who fight for every authorized day.
Our Utilization Review team is staffed entirely by licensed clinical professionals with deep experience in behavioral health. They don't just submit reviews — they advocate. Every concurrent review and precertification is handled with the clinical precision and persuasive expertise needed to secure maximum authorizations.
We coordinate directly with your clinical teams to gather the documentation that matters, present cases in the language that insurance companies respond to, and push back when initial authorizations fall short.
The difference between a good UR team and a great one is measured in authorized days — and revenue. Our team consistently delivers both.
Capabilities
- Licensed clinical UR professionals
- Precertification (initial authorizations)
- Concurrent reviews
- Peer-to-peer review support
- Clinical documentation guidance
- Authorization extension advocacy
Billing & Collections
Clean claims in. Maximum revenue out.
Claim submission is where precision meets persistence. Our billing team ensures every claim goes out clean, with accurate CPT codes, proper modifiers, and complete documentation. But submission is just the start.
With over 100 claim calls per day, our collections team is relentless in following up on outstanding payments. We track every claim from submission through final payment, identifying and resolving issues before they become aged receivables.
Whether it's a routine claim or a complex multi-service submission across levels of care, our team has the expertise to get it right the first time and the persistence to collect every dollar owed.
Capabilities
- Clean claim preparation & submission
- CPT code accuracy & optimization
- 100+ daily collection calls
- Aged receivables management
- Payment posting & reconciliation
- Payer trend analysis
Appeals & Denials
A denied claim is just the beginning of the conversation.
Denials are inevitable in behavioral health billing. What separates great billing companies from the rest is what happens next. Our appeals team treats every denial as a recoverable opportunity.
We analyze each denial to identify the root cause, whether it's a coding issue, documentation gap, authorization mismatch, or payer error. Then we build targeted appeals with supporting documentation that addresses the specific reason for denial.
Our approach is systematic but never formulaic. Every appeal is crafted for the specific claim, payer, and situation. We know the rules each carrier plays by, and we use that knowledge to recover revenue others write off.
Capabilities
- Root cause denial analysis
- Custom appeal letter preparation
- Supporting documentation compilation
- Payer-specific appeal strategies
- Underpayment identification & recovery
- Denial pattern tracking & prevention
Let's Talk About Your Revenue Cycle
Every facility is different. Tell us about yours, and we'll show you exactly how we can optimize your reimbursements.
Request a Free Consultation