As a behavioral health facility, your primary goal is always to give your patients the best care available, for the longest period of time possible. However, as a business, it is essential that you be reimbursed adequately for those services. That is where utilization review comes in. Our U.R. specialists work closely with your clinicians, keeping the lines of communication open for maximum efficiency and responsiveness. Our mission is to always advocate for your patients and receive the longest length of authorization possible.
When it comes to securing the optimum care authorization for your patients, it is essential that the utilization review team and clinical teams work together to gather all pertinent information and ensure that correct procedures are followed. As a boutique behavioral health billing agency, we view all our client relationships as partnerships.
The personalized relationship that we will develop with your admissions team means pre-certification of new patients 7 days a week. This open line of communication is what makes the CA Billing experience exceptional. You’ll never miss out on a potential admit because you couldn’t get authorization we are there to support you so that you can always meet medical necessity. When you partner with CA Billing, you are assigned a dedicated UR Specialist who will:
- Forecast expected authorizations based on a patient’s treatment history
- Stay up-to-date with insurance carriers’ requirements for all levels of care
- Foster and maintain beneficial relationships with all carriers and the care managers who work there
- Handle authorization appeals (exhausting all avenues) to obtain maximum authorization length at the highest levels of care
- Obtain initial recertification when admitting a new patient
- Always maintain a direct line of open and responsive communication with you to answer any questions regarding current or potential patients
- Open lines of communication
- Immediate responses to requests
- Full handling of communication with insurers
- Maximum length of authorization
- Optimum level of clinical care
- Documentation review and training
Talk to our behavioral health billing team to find out how we can become partners in advocating for your patients’ care.