SWAT outsmarts payers to resolve billing issues
Beating the insurance companies at their own game can be extremely frustrating and time-consuming for chiropractors who want to improve the cash flow at their clinics. Even when a provider makes time to deal with the payers instead of treating his patients, he usually lacks the necessary expertise to resolve any issues and often ends up losing massive amounts of profit due to delayed, denied or reduced payments for submitted claims.
So, when the going gets tough and a provider finds himself overwhelmed by complex billing issues that keep him from getting paid, Genesis’ SWAT (SPOCs With Attitude and Training) Team steps in to save the day and discover underpayment and delay tactics in massive volumes at the request of the provider’s account manager (a.k.a. SPOC). By analyzing large amounts of data to discover trends for underpayments and delay tactics SWAT puts the combined expertise of over 50 years of billing, practice management, and Vericle experience to use to come up with creative solutions to counteract the payers’ tricks and outsmart them. These solutions are then shared and implemented as concerted effort by multi-specialty teams, including practice managers, billers, account managers, audit and quality assurance managers, systems development, customer support, and the technology team who focus on large-scale problems.
The SWAT team is not geographically limited in any way and works effectively to solve chiropractic cash flow issues across multiple states and specialties regardless of any differences.
As case in point, SWAT helped a practice collect $5,418 in payments after months of not receiving any money for submitted claims in spite of being re-credentialed as group provider by Medicare. The solution consisted of correcting an incorrectly entered provider’s Group NPI number so that the practice can now enjoy steady income from Medicare.
In another example, SWAT helped a practice increase their income from $600 to $15,147 by discovering and correcting inaccurate data that had led to denied claims. These corrections also resulted in steady income from Medicaid and significantly increased profits.
Ultimately, Genesis’ billing SWAT team will go to bat for the practice owners against any and all payers who try to avoid paying what they owe for claims.