Services & Solutions
Complete, Effective Services & Solutions
MedPro specializes in providing comprehensive solutions to Mental Health and Substance Abuse facilities and individual providers nationwide. We take an integrated approach in providing the following services:
Benefit Verifications & Eligibility
With our team of knowledgeable benefit verification specialists, you can be confident that you will receive the most comprehensive and accurate benefit and eligibility information. All verifications:
- Are verified both electronically and with a live insurance representative to ensure accuracy
- Include coverage, authorization requirements, and other coverage restrictions
- Provide deductible, co-insurance/co-payment, out-of-pocket maximum, and benefit limitations
- Are completed and returned within 1 hour or less,including after hours and weekends
- Are cross-referenced with our database for historical comparison of allowables, usual and customary rates, and clinical restrictions
What’s more, our sophisticated software network and skilled team enable us to deliver an in-depth eligibility analysis, giving your company the competitive advantage.
Utilization Review
Our licensed and experienced clinical staff can help maximize your patients’ benefits by obtaining longer stays at the highest levels of care. With our knowledge and relationships with the various managed care companies we are able to provide you with the medical criteria needed to ensure accurate evaluation of your client based on ASAM and established criteria. Our utilization review team also examines all aspects of your facility including your mission statement, daily schedule, protocols and program, and will even assist you in the implementation of the required clinical forms and processes. At MedPro we take pride in representing your program and in serving as an extension of your company.
Billing & Collections
Our follow-up on claims is what truly separates MedPro from the competition. MedPro’s expert staff and cutting-edge medical software enable us to deliver the most efficient processing, management, and collection of your accounts. Our services include:
- Customized electronic claims processing
- Front end auditing to ensure error-free claims transmission
- Filing of secondary and tertiary insurance claims
- Submission of UB04 and HCFA-1500 claims for both facilities and individual providers
- Persistent follow-up on all claims
- Prompt posting of payments
- Individual patient notes to keep you informed about all outstanding patient accounts
- Patient billing questions answered personally and efficiently
- Unparalleled custom weekly and monthly reports
- Analysis and recommendations for fee structuring
- Fee negotiations and single case agreements
- Monthly patient statements
- Reporting on allowables and usual and customary rates