claimSTAT Process Overview
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Implement a pre-screening process of upcoming scheduled patients
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Establish Access via VPN Connection to System
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Execute Prior Authorizations for qualifying treatment plans per request
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Code and process claims as well as provide any follow-up / support services including, but not limited to, additional information requests, medical history, denials, rejections, and appeals
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Weekly Reporting
Information for Providers
Medical Payer Credentialing
At claimSTAT, the credentialing process for providers with medical insurance payers is meticulous and comprehensive. We begin by gathering essential documents, including proof of, licenses, and certifications, followed by a thorough verification of the provider's professional background and any disciplinary history. Our team meticulously reviews this information against requirements set by each payer to ensure compliance. Once all credentials are validated, we submit necessary paperwork to the insurance companies, facilitating a smooth onboarding process for dental providers to start delivering quality care to their patients.
Does Billing Medical Insurance Add Extra Work to my Office Staff?
ClaimSTAT's procedures and processes for medical billing in dental services are designed to streamline workflows and reduce the administrative burden on office staff. By automating key tasks such as claim submission and tracking,STAT ensures that staff can focus more on patient care rather than navigating complex billing processes. Additionally, the user-friendly interface and dedicated support team mean that any questions or issues can be resolved quickly, minimizing interruptions to daily operations. With ClaimSTAT, offices can benefit from efficient billing practices without the added stress of complicated procedures, allowing staff to maintain a high level of service to their patients.
Operative Note Consulting
claimSTAT offers specialized operative note consulting services as an essential add-on to enhance the efficiency of claims processing. Properly documented operative notes are crucial in substantiating the services rendered, ensuring that claims are accurately processed and paid in a timely manner. By leveraging our consulting expertise, healthcare providers can improve the quality of their operative notes, leading to faster claim approvals and reduced denials. This proactive approach not only streamlines operations but also maxim revenue, supporting the overall financial health of medical practices.
Timeframe for Claims
We see a typical timeframe from claim entry to claim payment from 3 business days to two weeks.
If the claim is sent for medical review, this timeline can be extended. However, your claimSTAT analyst will work to ensure your claims are settled with the payer as quickly as possible.
Pre-Screening Process
claimSTAT will establish a secure, HIPAA compliant VPN connection to each practice server. This allows claimSTAT the ability to review scheduled patients along with pending services to predetermine if medical billing is applicable. claimSTAT works with the office administration to set an identifier for the appointments that are preapproved for medical billing and what co-insurance and/or deductible needs to be collected from the patient.
Prior Authorizations
For proposed services more than $2,500, claimSTAT is able to perform prior authorization submissions at the payer level. claimSTAT will provide the treatment coordinator with a breakdown of the patient's approved services and coverage as well as any applicable co-pays and deductibles owed. Most prior authorizations are completed and returned to the office within 48 hours.
