Urgent Medical Billing is dedicated to providing substance abuse, addiction treatment, mental health professionals and laboratories with the best possible medical billing services available. We pursue full and fair financial reimbursement for our clients and to assist clients in the development and growth in their profession. We accomplish this with the highest levels of integrity, compliance, ethical practices, and urgency in our commitment to timely and accurate billing and collection services, support services, and in compliance with the laws and regulations that govern our industry.

Consultation and Support

Consultation and SupportUrgent Medical Billing will provide you with a complimentary consultation and assessment of your business needs.  Whether you are an existing medical business or a new medical business, working in the addiction and mental health services industry, UMB will work with you to strategize your business development plan, from reviewing licensure requirements and the first point of contact with your patient through to the therapeutic and medical treatment services, documentation and medical records, medical billing and collections services, laboratory billing services and all phases of your business structure as it relates to medical billing.

Insurance Verification

Insurance VerificationUrgent Medical Billing places great emphasis on the importance of Insurance Verification for those patients with whom you will be accepting health insurance as part or in whole, as their payment for addiction treatment and mental health services. UMB provides Insurance Verification staff for your benefit, as an option in your business plan. UMB will also assist you in training your employees in Pre-Insurance Verification procedures to begin the process in determining if a potential patient has the health insurance benefits required to receive your company’s services.

Insurance Verification Specialist will identify:

  • Policy restrictions on in-network or out-of-network providers
  • The patient’s financial responsibilities – Deductibles and Co-payments
  • The policy exclusions and limitations

Verifying the benefits of a prospective patient/client requires an experienced and knowledgeable individual.

Billing & Coding Done Right

Billing- and CodingUrgent Medical Billing exceeds industry coding and billing through experienced coding and billing professionals, using the most up-to-date current procedural terminology (CPT), ICD 9-CM and ICD 10-CM,  DSM-5, and a focus on the billing management standards that are unparalleled in our industry.  Our premier medical software, customized data bank of exclusive historical payer-source practices, and expedient medical billing procedures, provides you with efficient claims processing, claims management, and reimbursement on your claims with the urgency you need to continue to provide quality patient services, adhere to the Health Insurance Portability and Accountability Act and The American Medical Association, as well as maintain and grow your company.

Accurate and complete coding is fundamentally important to maximizing reimbursements for substance abuse, addiction treatment and mental health professionals as well as laboratory services.  The staff at Urgent Medical Billing, are knowledgeable in medical coding and reimbursement rules, which often change, requiring routine updates as to payer source practices and rules, so that our customers can receive their reimbursements.

Utilization Review

Utilization ReviewUrgent Medical Billing is dedicated to understanding the important connection between getting you authorizations, and establishing your treatment center’s reputation with Insurance payer sources.  We do this by providing detailed reviews that are supported by documentation that validates “medical necessity.”

This is done through our open and ongoing daily communication updating you clinical directors and therapists promptly of the number of sessions authorized, levels of care, next review dates, and even what information the care manager will require for the next review.

To this end, our experienced team assigned to your facility, will attend your clinical staff meetings at your request, to address and alert you of developing patterns of insurance companies, as well as address any of your concerns.  We will train your staff on documentation at your request, as per ASAM criteria to assure your progress notes and all documentation supply accurate detailed updates which validate medical necessity.

Urgent Medical billing is a well-oiled machine that makes the process from patient admissions to collections, smooth sailing.  We take the fear out of the insurance payer’s request for medical records and transform it into an object of pride and a tool for reimbursement.

Claims Management

Claims ManagementUMB manages your medical claims with specificity and precision, following your claims throughout the insurance payer process.  UMB and our billing software are specifically chosen to allow you to follow your claims in “real time”.  Accuracy of your claim is essential.  Medical necessity, clinical documentation, medical documentation, and all other related services, in accordance with your company policy and procedures, the insurance payer source, and patient eligibility must be maintained and submitted as part of your insurance claim.  UMB advocates on your behalf throughout your medical claim process.
Denials:  Part of the insurance payer process is to deny claims.  It is important to understand that claims will be denied.  UMB works with you to reduce the number of denials you might experience.  One of the basic reasons that a claim is denied is an error in the initial entering of information on a patient.  Incorrect information can unnecessarily slow down payment on a claim or cause the claim to be unpaid. UMB works with you to minimize errors.

Top 8 Reasons why entering patient information might result in unpaid claims.

  1. Incorrect spelling of the patient’s name
  2. Incorrect spelling of the primary insured’s name
  3. Incorrect patient address
  4. Incorrect social security number
  5. Incorrect date of birth
  6. Incorrect insurance card
  7. Incorrect Group number
  8. Incorrect frequency of testing

Appeals: Urgent Medical Billing approaches appeals with professional courtesy, armed with medical necessity and documentation, and works with the insurance company case manager to successfully appeal the denial of a claim, thus gaining or increasing the reimbursement due.

Collections Management

Collection ManagementUMB works to Increase Your Collections and Decrease Your Worries.   UMB monitors your accounts receivables, also known as aging of claims, to minimize the amount of time between submission of your medical claim and the reimbursement of your claim. UMB monthly aging reports will provide you with your entire history of accounts receivable on open claims.  UMB staff monitors your accounts receivables daily, maintains correspondence with the insurance company to manage your claims and brings your claims to the reimbursement process.  UMB works with you to correct patient or clinical and medical information, re-submit claims with requested information, and submit charts upon request, once the chart has been review by your clinical staff and/or our collections management team for accuracy.

Our collections management is inclusive of a specialized department called <strong>Hard Collections</strong>. Where they specialize in collecting outstanding 90, 120, 180 plus days of accounts receivables.  Collections Management is a “must have” service for your company.

Training & Compliance

Training and ComplianceUMB is comprised of a team of experienced professionals, qualified to train your staff for their role in the medical billing cycle, as well as training your staff for licensure and accreditation, remaining compliant in licensure, and training for the creation and addition of departments and services to enhance your infrastructure and strategic company expansion. Licensure and Accreditation compliance is the key to successful medical billing and reimbursement practices.

Training: The UMB experience has demonstrated that when staff are properly trained and an addiction treatment and mental health treatment facility is in compliance with both DCF ( or local state licensing bodies) and the insurance company, not only are claims reimbursed, but future claims are satisfied more quickly and with less scrutiny and resistance because of the reputation that has been established as a result of policies and protocols that UMB has put in place.

Compliance: UMB can prepare your facility for licensure compliance, successfully passing DCF (Division of Children and Families) audits (or local licensing body), as well as assist you and your staff in successfully completing an accreditation process, such as a CARF or  JCAHO accreditation and other national accreditations as deemed appropriate or necessary.

Local Licensing Compliance: Throughout the United States, the laws that regulate drug and alcohol rehab facilities and other professional services related to addiction treatment centers, vary from state to state. Each state has its own licensing agency and often, each county governs it’s own licensing procedures and issues county-specific requirements for licensing.  UMB works with you to remain compliance with your local governing body for addiction treatment and mental health treatment centers and related services, as it relates to your medical billing needs and practices.

Insurance Payer Source Compliance: Insurance Payer Sources are holding addiction treatment facilities and health care providers accountable to insurance company definitions, criteria, and guidelines, specific to each insurance company and payer source.  UMB works with you to maintain your company compliance within the guidelines of payer sources.  Patient eligibility, co-pays and deductibles, medical necessity as defined by the insurance payer source, levels of care, continued stay, ancillary services, and discharge planning are compliance worthy issues to be addressed and managed as they relate to your medical billing procedures and submission of claims.  UMB is compliant focused and reimbursement centered for your benefit.

CARF: (Commission on Accreditation of Rehabilitation Facilities) like most accreditations, signals a service provider’s commitment to continually improving services, providing feedback, and serving the community of addiction treatment and mental health services. Accredited providers have applied a comprehensive set of standards to their business and service of addiction treatment and mental health practices. Because CARF accreditation signals a provider’s demonstrated conformance to internationally accepted standards, it can significantly reduce local licensure monitoring and help to establish best practices in your company, and provide your company with an expanded insurance payer source.

JCAHO: (Joint Commission on Accreditation of Healthcare Organizations), also known as TJC (The Joint Commission) is an accreditation sought by addiction treatment and mental health organizations, looking to establish standards of practice to identify their company as a company of excellence.  Although national accreditation is an arduous process, it is worth the time and financial investment.  JCAHO Accreditation can:  Address and provide quality of care issues, thus improving risk management and risk reduction, reduce liability insurance costs, enhance staff development, provide a framework for organizational structure and management and meet state regulatory requirement and meet insurance payer source requirements.

Urgent Medical Billing and our staff works with you to create a reciprocal relationship between the insurance companies and your facility. Through experience, we know that by providing the care managers with the information they want; that is-by making their jobs easier, they are more likely to authorize services for your patients.