Facility billing for inpatient, residential, and outpatient treatment programs is different than traditional medical billing. Every level of care will be a different rate. The services offered at each level will vary per treatment program, payers, patient benefits or plan and of course the services and programs offered by each client.
We have a knowledgeable, experienced and professional team dedicated to Treatment Center Billing and serving as an extension of your internal team.
Insurance eligibility verification is often the first and most important step in the medical billing process for Nexsys. Verification and eligibility of benefits must be timely and accurate in order to increase your admissions and to maintain a healthy census and to continue to be able to help these clients. This process has evolved over the years and the changes ahead will continue and they come quickly. Now it is more important than ever that we work closely with our clients to inform them of payer benefits, risks, deductibles, limits, and expected reimbursement based on many metrics and years of experience. There is no substitute for an experienced staff working within the framework of our state of the art protocols and processes.
Nexsys has been an absolute game changer for our treatment center.
The VOB process is managed by our team at Nexsys and then all pertinent information will be inputted directly into your KIPU or internal platform. We work within your system to ensure documentation is consistent with your internal protocols. As a team we will compile and present exactly what you need before accepting a new patient for treatment.
Verification and eligibility requires that the sensitive personal information be transmitted to insurance companies and to our clients. Nexsys utilizes the newest and most secure means of communicating this information with our clients and the payers. Yes, our internal communications actually self destruct in 7 days!
Ongoing Clinical Reviews
Our team continues to work with our clients to conduct clinical reviews to ensure the information we provide you continues to remain accurate and defend against any lapses in coverage by the patient’s payer. Our processes help to solidify the verification process so you can provide the highest-level of service and extend the length of client stays, all while we hold the insurance provider accountable.
Utilization Review Management
Our Utilization Review Management Team (UR) work tirelessly to ensure the patients are not burdened with funding concerns and that our team is working to get the most amount of assistance as possible for Treatment. Clients should not have to worry about navigating payer review departments and should know that they have a team advocating for them and supporting them through a difficult and challenging process. We are going to hold the payers accountable to their commitments.
Your facility will have a dedicated, experienced, utilization review professional who functions as an extension of your clinical team. This model provides continuity of care through a client’s case. Having a designated utilization review professional who truly knows your facility and your treatment vision helps us accurately reflect the type of care your client is receiving.
To say we recommend them for billing and insurance management needs would be an understatement. Taking into account our previous experiences with other billing companies, Nexsys has single-handedly restored our faith in the institution of third party billers.
A vital part of our service and commitment is to keep our clients aware of payer expectations. These are some of the services our team provides:
- Clinical documentation consulting
- Charting to demonstrate medical necessity
- The value of Licensing and the requirements associated with it
- Individualized treatment planning
- Program Structure Guidance
- Level of care guidelines
- Intensity of service requirements
Transparent Billing that connects to KIPU and other EMRs
Transparency and Visibility
Quite simply it is the Nexsys way. We have built it into our DNA. Transparency, visibility are the cornerstones of trust; the foundation of any relationship. We provide you with month-end billing reports that detail the status of your facility and where you can expect payments. Additionally, we communicate weekly on status of claims for that week. Monthly reporting is a minimum, but often our clients want even more data, information, reporting, and we are happy to oblige.
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Contact Us Now
info@GoNexsys.com or Call 800.529.3962 ext 203
Contact Nexsys Billing & Practice Management today at (800) 529-3962 ext. 203 to learn more about how we can increase your revenue and lower administrative and practice costs for your Addiction Medicine practice, or contact us online.