Utilization Review is the process insurance companies use to approve, authorize, or decline services. The purpose of Utilization Review is to screen, and approve the “least-restrictive” clinical services on a peer case basis. The reason insurance carriers use this process is to standardize approval criteria – to only pay for services deemed medically necessary. Our…

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The ever-changing reimbursement policies of insurance companies have left behavioral health providers struggling for new solutions to maximize revenue. Inner Circle Billing will ensure that you, and your staff, are up-to-date on new compliance standards, and regulations that could delay a claim or result in claim denials. STAFF DEVELOPMENT Admissions, Intake, and Clinical staff are…

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Inner Circle Billing provides accounts receivables reports monthly. This gives our facilities, or providers, an accurate account of all the payments collected. We don’t just get you paid, we want you to know exactly what you are getting paid for with the maximum reimbursement possible. In many cases, insurances have flawed systems. During our weekly claims…

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Our Inner Circle Billing staff undergo regular training to stay up to date on new coding requirements, and insurance regulations to prevent errors, and ensure compliance with insurance.  We want our clients to be 100% satisfied with our services and how effectively we accomplish tasks. CLAIM SUBMISSION Having a state of the art claims submission program…

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At Inner Circle, we provide a fully detailed, and accurate benefit analysis. This provides our facilities a snap shot of clients insurance coverage, and estimated payment history. MEDICAL NECESSITY ANALYSIS Inner Circle Billing will provide an estimate of authorization, potential based, on a brief clinical snapshot given to the facility, or provider. Using this information,…

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APPEALS If a claim is denied, the facility, or provider, has the opportunity to appeal the decision(s). These appeals take time to process, but they can be won if the correct procedures are followed. At Inner Circle Billing, we differentiate ourselves by relentlessly pursuing payment on denials, and appeals, unlike other billing companies. TIMELY FILING…

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