Background
Since 2002, one of our clients has excelled at providing contract rehabilitation therapy services to hundreds of Long-Term Care (LTC) and Skilled Nursing Facility (SNF) operations across 800+ facilities in 40 states.
In addition to providing contract therapy services for many LTC/SNF operators, they decided to expand and offer direct bill therapy services for senior living facilities.
However, the process of insurance billing has become more complicated over time. Payer rules and regulations are ever-changing, and understanding the ins and outs of therapy billing and provider enrollment requires deep knowledge in an already complex industry.
Rather than completing direct billing tasks in-house, they decided to work with an experienced revenue cycle management company that shared their values.
Summary
A leading provider of contract rehabilitation services for LTC and SNF facilities, sought a reliable revenue cycle partner to manage their direct billing services for senior living facilities.
After a thorough evaluation, they chose us, Advantum Health, to manage their direct billing services, including provider enrollment and credentialing. Our service-oriented approach, extensive implementation experience, and flexibility gave us the edge compared to other candidates.
In September 2022, we started our partnership and completed the initial implementation by December of the same year.
Throughout the implementation, we leveraged our knowledge and experience with EMR systems to successfully rollout direct billing and provider credentialing at four senior living sites.
Next, we plan to deliver direct billing services and provider enrollment at 25 more locations.
Challenges
The rehabilitation services organization faced a few challenges managing direct billing services for senior living facilities. These challenges included:
- Complex Billing Processes: Direct billing complexity stems from insurance policies, regulations, coding requirements, reimbursement rates, and administrative processes. They would have needed to hire, train, and manage staff who require specialized knowledge, resources, and systems to execute direct billing successfully.
- Provider Credentialing: Verifying therapists’ credentials can be time-consuming, especially when dealing with multiple sites nationwide.
- Communication and Follow-Up: Timely communication and follow-up with senior living facilities, insurance companies, and healthcare providers are crucial for smooth revenue cycle management. These tasks would have required the client to hire dedicated resources.
Solution
Advantum Health tailored a comprehensive revenue cycle management solution for the rehabilitation services company. The key elements of our offering included:
- Therapy Billing and Provider Credentialing Expertise: We have extensive experience handling complex billing processes and provider credentialing in rehabilitation therapy.
- Pricing Flexibility: We offer flexible contract options, allowing our client to optimize their revenue cycle management costs while maintaining high-quality services.
- Implementation Experience: Our highly skilled and efficient implementation team has a proven track record of successful revenue cycle outsourcing rollouts.
- Communication Follow-up: Throughout implementations, we promptly address concerns and provide regular project updates. Our two-way transparent communication channels help maintain strong client relationships.
“Advantum has been a great resource to have on our team. I have someone I can bounce ideas off of, and I know they’ll answer my questions quickly and accurately. “
––National Director, Leading Rehabilitation Services Vendor
Our partnership progressed smoothly from the contract signing in September 2022 to the initial go-live in December 2022. The implementation process was seamless, with our team demonstrating a deep understanding of the client’s EMR systems and the specific requirements of direct billing and provider credentialing.
Results
We successfully integrated our revenue cycle management processes and tools with our customer’s existing systems. We also ensured minimal disruption to client operations and relieved their staff of the additional administrative burdens associated with direct billing and provider credentialing for rehabilitation services.
This project’s implementation demonstrated Advantum Health’s commitment to delivering high-quality revenue cycle management services. Additionally, it showcased our ability to adapt to new requirements.
This project’s strong start laid the foundation for a productive and long-term partnership that continues today.
Conclusion
Advantum Health and a leading rehabiliatation services company quickly and effectively implemented direct billing and provider credentialing processes at four senior living facilities.
A rehabilitation services vendor selected us, Advantum Health, as their revenue cycle partner, and considers us a trusted and capable solution provider. Our expertise in billing and physician credentialing, pricing flexibility, and effective communication follow-up exceeded their expectations.
Contact us to learn more about how Advantum Health can complement your business.