Claim Submission
We specialize in billing and coding for practices of all sizes and scopes so that you can focus on patients. Let us help you increase reimbursements and stop worrying about collections.
Electronic
Through our clearinghouse, we are able to submit claims electronically directly to the insurances. Also includes ANSI835/837
Portal
Claims are submitted directly to the insurance's portal.
Mail/Fax
Claims can also be submitted via mail and fax.
Claims Management
Our EDI Department tracks the process of claims from submissions by:
- The GVS Hearing Billing Team will provide support and knowledge to avoid denials and rejections.
- GVS Hearing Billing Team will coordinate consistent updates on claim statuses and work with you to process your claims accordingly.
- Grant GVS Hearing access to payor portals to proactively react on rejections or corrected claims on your behalf, if needed.
- Standard TAT on claims submission is 5 business days.
Insurance Verifications & Follow Up
- Obtain benefits & eligibility by speaking with a live representative
- Use scripting to ensure consistent and accurate identification of patient insurance benefits
- Printable Benefit Verification Summary/Quote of Benefits to share with the patient
- Standard TAT for completion of verification requests is 48-72 hours* from submission
- Follow up on unpaid claims to avoid aging claims on AR
- Expedite payment, reprocess claim & resolve billing issues
- Increase payment turnaround times
Denial Review, Appeals & Resolution
Remittance & EOB Analysis
Denial Review
Positive Impact on Collection Rates
Client Services
Contact us by phone, email, fax, or mail any time to assist with concerns such as:
- Plan Billing Information
- Claim Research
- Explanation of Payment
- Refund Inquiries
- Issue Resolution
Contract Review & Negotiations
Negotiation with payers on reimbursement rates is essential for maximizing revenue, but it can be extremely complex. As a provider, it is your job to provide comprehensive care to your patients while maximizing your revenue, and payers have control over reimbursement to your practice. It is important for practices to perform periodic reviews of payer contracts to ensure that providers are receiving optimal reimbursements for their services. Navigating the relationship between provider and payer requires expertise, demographic knowledge, strong analytical skills, and organized processes.
Our Payer Contract Review & Rate Negotiation services include:
- Comprehensive contract review
- Contract language analysis to ensure optimal terms for Providers
- Working with payers to raise reimbursement rates
- Market analysis to present comprehensive proposal to payers
- Negotiate participation in additional payer plans in your geographic market
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Credentialling & Enrollment Services
Trust the experts at GVS Hearing RCM to help you navigate the difficult process of Provider enrollment and medical credentialing!
We specialize in the following:
- Commercial Insurance Provider Enrollment and Credentialing (i.e., Aetna, Anthem, BCBS, CIGNA, TriCare, Humana, United Health care, Many More!)
- Medicare and Medicaid Provider Enrollment and Credentialing
- Medicare and Medicaid Revalidation
- PECOS
- PAVE (California)
- CAQH Registration
- NPI Registration (Type I and Type II)
- Reimbursement Issues
- Managed Care Contracting Issues
The Benefits of having us as your Partner:
- Save on average at least 2 months of time and over 100 or more hours of work!
- Take away all the headaches due to the mounds of paperwork and endless applications!
- Increased patient referrals!
- Get you paid by the insurance companies faster!
- Contracts and applications are setup right the first time and we will not stop until the process is 100% completed!
- Dedicated project manager assigned to your project!
- We make all the phone calls, follow-ups, and submit all applications, e-mails, and faxes for you!
- The service is typically provided at a cost less than it would be for you to hire your own provider enrollment or credentialing team and we can handle any volume you have!
What we provide:
- An assigned credentialing manager to represent you with commercial and government payors
- We complete all applications and necessary paperwork on your behalf with your selected payor networks and government entities
- Status reports so you know where you are in the process with each payor
- Assistance with maintenance and update CAQH profile
- Complete all necessary credentialing requirements for each payor and follow through to completion
- Follow all payor contracts through to contract execution and provide copy of fully executed contract and fee schedules to your practice or billing company