Yes. Our services and software protect patient privacy and adhere to all HIPAA regulations as well as site-specific procedures and compliance standards.
Frequently Asked Questions
Out-of-State Medicaid Enrollment & Billing
Absolutely; there are specific guidelines that must be met, but we take care of everything – from getting the physician and hospital enrolled to billing and following up on the claim until payment is secured or denial. If a denial can be or should be reconsidered, we handle the appeals process until a final decision is reached.
Our services are strictly contingent. We don’t get paid until you do.
We do everything in our power to enroll each provider as quickly as possible. The enrollment timeline depends on the provider and our company working together to be successful. We need documents and signatures from the provider and/or facility and personal and sensitive information (home address, Social Security number, driver’s license, place of birth, etc.) from the physician and board members. We rely on receiving these documents back in their entirety to proceed. Given that the requirements vary from state to state, there is no master resource and each state varies dramatically. So, the sooner we receive these requirements, the sooner we can get providers enrolled.
Yes, you can send referrals directly via email.
This varies from 30 days to 6 months, depending on the state.
Yes, if we receive a referral in which an enrollment with the HMO is required.
We will request facility documentation upon initiation of contract and will request physician information only if an enrollment is required.
Yes. We verify eligibility on all referrals sent to us prior to pursing enrollment or payment.
Why expend time and resources, not to mention stress, on complicated out-of-state Medicaid claims when it’s more efficient and cost-effective to let experts do it for you?
We are experts in out-of-state Medicaid and all 50 states’ differing rules, government and payer regulations, compliance laws, coding requirements, and the guidelines of MCOs and HMOs – so you don’t have to be. You also never have to worry about being kept on hold with a call center, because we provide designated contacts to work your accounts.
We combine cutting-edge technology, which includes various reporting options, with professional and personal human beings to ensure you collect the revenue you’re due as quickly as possible.
Additionally, most out-of-state Medicaid and external billing services charge you a flat fee that you must pay up front. We offer a contingent fee pricing model; you only pay us after we’ve fulfilled our obligation to get you paid. Contact us today and we’ll get to work recovering the revenue you’ve been missing out on.