Facility or Licensed Program Services

Unlike any service model you have experienced before…That is Insurance Fight Club! We have a team of passionate advocates that are ready to work for you and your patient base. We utilize a collaborative approach that will assist you in decreasing patient churn, maximizing revenue, increasing outcomes, and being confident when you say that your documentation meets best practice standards. Join our club!
Our Service Commitment to your practice Includes:
VERIFICATION OF BENEFITS

We are passionately committed to help patients and families get into treatment as soon as possible and stay in treatment as long as possible by working with your team to set realistic expectations. If we need to talk to the patient to explain their insurance, patient contributions and reimbursement potential, we are happy to do so.

Things that set us apart from our competitors:

  • We talk to families, we are their patient advocates.
  • We call on every Verification of Benefits, and have an accuracy rate of 99.8% for 2022. Solid VOBs are the foundation of any successful revenue cycle.
  • Added support services such as assisting in calculation of upfront costs, or working through a particularly hard payer requirement, Advice on which payer reimbursement is more advantageous during tight census periods, etc.
  • We do single case agreements as needed, so if the situation warrants it we seek to have a case by case basis of in network status.
  • We will customize our system to meet your admissions department for their best success.
  • We provide payer training that is admission focused every month
BILLING SERVICES

We bill weekly or multiple times per week to ensure steady cash flow depending on patient volume.

Things that set us apart from our competitors:

  • We can utilize your existing software or utilize our billing systems. We will work with you to find the best solution for your practice.
  • We don’t require weekly census reports, we utilize the EHR software to determine billing needs, saving valuable employee time.
  • Flagged underpayments. Nothing frosts us more than working so hard to get paid to just get underpaid. We flag the underpayments and then fight for what should have been collected.
UTILIZATION REVIEW /PREAUTHORIZATIONS

We will preauthorize any services that require preauthorization by your patient’s insurance and continue performing concurrent reviews until they are no longer required.

Things that set us apart from our competitors:

  • We work with your clinical team in a collaborative approach and become part of the team. By doing so this helps us maximize days approved, so that the patient can remain with their primary clinician for services needed as long as possible.
  • We don’t require additional clinical UR forms to be filled out, wasting valuable clinician time. We utilize the chart notes for all reviews and our notes from treatment team meetings.
  • We work with your clinical team and teach and train to maximize patient stay.
  • We are an added value in risk management reviewing clinical documentation to ensure you are in compliance with accreditation and payer best practices.
MEDICAL RECORDS

Medical records requests of all kinds can be managed by our team.

Things that set us apart from our competitors:

  • We review all records prior to sending out to ensure the records meet best practice standards.
  • If we find clinical deficiencies or Risk Assessment flags, we notify the clinical team to fix the errors prior to send out.
DENIAL MANAGEMENT

If claims are denied, we will appeal the decision and passionately fight for its overturn.

Things that set us apart from our competitors:

  • We have an 88% overturn in medical necessity denials. Comparatively the industry average is in the 30th percentile.
  • We pursue level 1 to legal level appeals, where most companies do one form letter appeal.
CLAW BACK / TAKE BACK LETTERS

We will assist you in resolving any type of communication that is received requesting a refund from a payer.

Things that set us apart from our competitors:

  • We will help you with these issues regardless if we billed for the services or not.
  • If we billed for the services, we will refund all fees incurred for those services back to you.
REPORTS AND REAL TIME DATA

We will meet monthly to go over your practice health by the numbers and ensure your practice is maximizing revenue for all services provided. If you have a scaling plan for future services, we can work on structuring this phased growth with you to support you in your growth endeavors.

Things that set us apart from our competitors:

  • We are your partner in revenue and growth management. We don’t just provide you with reports, we partner with you to maximize the health of your programs.
CREDENTIALING

We have an excellent credentialing and payor enrollment service. Whether you want to ‘join the network’ with a few payors, change locations, add staff to your rosters, recredentialing needs, attestations and provider updates– we offer a full-service model at very reasonable rates.

CONSULTING

We offer a wide range of consulting services. We can help with internal training of billing departments, audits, UR training and stabilization, Increasing and maximizing authorized days, JCAHO or CARF Accreditations, and much more. Click the consultation below or the live chat button and let’s see how we can help.

FAQS

HOW MUCH DO YOU CHARGE?

We operate on a unique model of pass through costs plus gross up. This is different than the industry standard of ‘revenue share’ model which can take as much as 10% of what you receive from payors. To get a specific quote for your facility, please click the make a practice consult request button below.        


HOW FAST CAN I START SERVICES?

Typically within 2-4 weeks depending on practice complexities.


DO I STILL RECEIVE MY INSURANCE PAYMENTS OR DO YOU?

Nothing will change. You will still receive all insurance payments.


DO YOU TAKE ON ‘START UP’ OR NEW FACILITIES OR PROGRAMS?

Yes


DO YOU CHARGE ‘START UP’ OR NEW FACILITIES/PROGRAMS ANY SPECIAL DEPOSITS OR ADDITIONAL FEES?

No


CAN WE GET HELP WITH JUST SPECIALIZED SERVICE REQUESTS (EXAMPLE: WE ONLY NEED HELP WITH VOBS)?

Yes! We offer A La Carte service pricing plans. Reach out for a consultation meeting or live chat and we can see how we can best help.


WHAT AREA OF THE COUNTRY DO YOU DO BUSINESS IN?

We do business nationwide.

WE FiGHT FOR YOU.
TALK TO AN EXPERT.