Financial process in healthcare from patient registration to final payment.
Credentialing with insurance networks is the verification of healthcare providers' qualifications to join and provide services within these networks.
Focus on Quality Care & Increase in Practice Collections and Revenue. Help to Decrease Administrative Burden.
Billing assessments and compliance ensure that healthcare billing practices adhere to legal and regulatory standards.
Starting a new medical practice requires securing financing, licensing, and a location, hiring staff, and ensuring compliance with healthcare regulations.
Ensures that our clients get paid faster by providing efficient Denial Management solutions to resolve.
We make sure your Practice or Group has the most varied, popular and effective in-network payor mix. Our credentialing team has extensive experience in enrolling physicians with Medicare, all Medicaid’s Managed Care plans along with all commercial payors. Our team reaches out to each shortlisted payor that you want to enroll with and gets accurate timelines and open panel availability.
We send you a complete checklist of all the information and documents that are required to file the applications. As soon as we have the details from you, our Enrollment team goes ahead and files the appropriate contract applications and makes sure it’s a flawless submission in the first go, owed to our extensive experience. As a result of our first-time correct application submissions, we proudly boast of the shortest turnaround time in getting the contract.
Our team follows up on the submitted application every two weeks, to ensure that the submitted application has been received and is in the payor’s system and that no additional information is being requested and everything is smooth. We follow-up regularly until the contract comes through and is delivered to your physical location.
Payors like UHC, Aetna and BCBS sometimes have closed panels for Labs for a particular area. We make sure to send an extensive appeal outlining the key points of your service, including niche services and details on how you bring exceptional patient care in your area. All these details are included in your business plan and submitted to senior provider representatives at that payor. While it can be difficult to overturn the closed panel decisions, we have a 30% success rate.
We not only get you the contracts, but we do fee rate negotiations for you as well. We have an extensive database of all payors’ latest fee schedules. We study your competition and this data helps us to make sure we get you the best possible rates for your procedures, thus solidifying optimum reimbursements for your medical practice. We revisit your older contracts and try and get better rates as per availability from the payor at the current time.
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Whether you’re a private practice or larger healthcare facility, insurance credentialing is the first and most important step in implementing your new revenue cycle. Yet, even when you know which insurance companies you want to participate with, getting credentialled is a time-consuming and often frustrating process. That’s why many healthcare organizations outsource this crucial step.
ORMBS wants to be your Practice Management Concierge service. We handle insurance credentialing for physicians, hospitals and a wide variety of other healthcare institutions. From start to finish, we will walk you through each step of getting approved with an insurance payor. Learn why countless healthcare professionals and organizations entrust us for medical insurance credentialing services.
ORMBS’s Practice Management Concierge service offers healthcare professionals and organizations a reliable and efficient solution for insurance credentialing. By leveraging ORMBS’s expertise and support, clients can navigate the credentialing process with ease and focus on delivering quality patient care. ORMBS is committed to simplifying the insurance credentialing process for healthcare organizations, whether they are private practices or larger facilities. By offering a Practice Management Concierge service, ORMBS aims to alleviate the time-consuming and frustrating nature of insurance credentialing
NETWORK RESEARCH
Proactive approach to credentialing and enrolling physicians with a varied and effective in-network payor mix demonstrates a commitment to maximizing patient access, optimizing reimbursement, and ensuring compliance with payor requirements. This strategic approach contributes to the success and sustainability of your practice or group.
APPLICATION FILING
Our commitment to providing a seamless enrollment experience, coupled with your experienced team and efficient processes, positions your organization as a reliable and preferred partner for healthcare providers seeking to expand their network participation.
APPLICATION FOLLOW UP
our team’s diligent follow-up process plays a crucial role in ensuring a smooth and efficient enrollment experience for our clients. By actively monitoring the status of submitted applications and providing ongoing support, We enhance client satisfaction and contribute to the success of their practice or group.
APPEALS FOR CLOSED PANELS.
To appealing closed panel decisions reflects our commitment to advocating for our clients and ensuring that patients have access to essential healthcare services. By leveraging comprehensive appeals, strategic business plans, and advocacy efforts, we contribute to improving healthcare access and enhancing client satisfaction.
OUT OF NETWORK ENROLLMENTS
Our team’s support with out-of-network enrollments and NPI registrations is invaluable for medical practices looking to navigate the complexities of billing and reimbursement when staying out of network with certain payers. By providing assistance with these processes, we help practices maintain financial stability and continue providing quality care to their patients.
CONTRACT NEGOTIATIONS
Our service offering to negotiate fee rates with payers on behalf of medical practices demonstrates a commitment to optimizing reimbursements and ensuring financial success. By leveraging data, expertise, and proactive contract management, we empower practices to thrive and provide high-quality care to their patients.