Bringing Sanity to Your Behavioral Health Collections

Verification of Benefits

Speak to a certified verifications specialist – weekdays, 8:00 a.m. to 8:00 p.m. Eastern time – to request verification of benefits (VOB) during your intake process. Substance Solutions performs an online VOB check and calls the insurance company to confirm coverage with a live representative. Typically, results are returned to you within an hour. In addition to verifications, we give you a “playbook” so you can plan for maximum coverage throughout the patient’s stay. You will also receive an Estimated Insurance Value (EIV) that allows you to forecast revenue reliably for every admission.

Utilization Review

Our reviewers are Masters-level, licensed clinicians who are adept at keeping your EMR compliant with insurance requirements. We obtain initial authorizations as well as concurrent authorizations , often asking follow-up questions of your clinicians to make sure the best case possible is presented to the insurance company. As an added value, Substance Solutions UR experts periodically audit your records for insurance compliance. We will support your quality assurance initiatives by consulting with staff and physicians who need a gentle reminder of how important compliance is

Billing

Medical billing is based on the census you submit to us each week. Our billers have the knowledge to ensure claims are optimally submitted based off individual payor guidelines while safeguarding maximum reimbursement.

If you use Substance Solutions for utilization review (UR), we check your census against authorizations on file for accuracy. We post charges to your patients’ ledgers and submit claims to the insurance companies weekly. Most of our clients receive payments within 30 – 45 days of claim submission.

A/R Audit

Why should you switch to Substance Solutions?

If you’ve been verifying benefits, conducting UR, billing, and chasing collections yourself…when have you had time to focus on the patient? Wouldn’t it be nice to focus on the reasons you started your practice in the first place?

If you’re considering Substance Solutions to replace your current medical billing company and wonder if this will just be a repeat of the last unpleasant experience, let us demonstrate the difference we can make in your practice.

Substance Solutions welcomes every new Billing customer with a retroactive AR claims audit. If you or your past billing service have left money on the table, Substance Solutions will file appeals and fight to get you paid.

Collections

Substance Solutions diligently follows up on your claims once every 30 days, at minimum. This is the customary timeframe for insurance companies to process claims. If claims deny, we aggressively pursue the appeal process until the claim is paid or until all appeal options are exhausted. Write offs are a last consideration for Substance Solutions. You’ve already provided the services. You should be compensated for them.

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