Clear Choice Services

Experienced, Personal Dental services consulting

Services

Payer Reimbursement

Fee Schedule Analysis

Did you know 80% of dental practices do not negotiate fees with payers. Increase your payer reimbursement by letting us negotiate for you. We can also optimize your payer plans by coming up with a strategy to take the best ones and push back on the difficult ones to reduce denials and other common insurance issues.

Fee Schedule Analysis

When is the last time you reviewed your UCFs to market? You could be missing out on lots of revenue by not being competitive in the market. Take the guess work out of setting fees and let us give you a comprehensive analysis and fee increase plan.

Credentialing Services

Revenue Cycle Process Improvement

Credentialing your doctors with the insurance plans is a cumbersome and time-consuming process. Take the pain and guess work out of your practice by using Clear Choice Consulting’s credentialing services. Powered by HealthStream software, Clear Choice Consulting will handle everything from initial enrollment of new hires, adding new insurance plans, re-credentialing, adding new offices, TIN changes, monitoring your expiring certificates and more. We make it easy for you, so Credentialing is not a headache. It is a clear choice to have Clear Choice Consulting handle your credentialing needs.

Revenue Cycle Process Improvement

You could be leaking revenue from your revenue cycle or billing practices. Let us review your processes and suggest money saving improvements.

Top 5 Areas -

1) Insurance A/R

2) Verification and Benefits

3) Denials

4) Posting

5) Credentialing

Spotlight on - Payer Reimbursement

How do we help you with Payer Reimbursement?

We will use a simple and proven approach to get you more from your insurance carriers.

1) Using our years' of experience, we will review the PPO plans you accept. If you are not sure which plans you are directly contracted with, we will find out for you.

2) We will when do a comprehensive fee analysis by code to access your current reimbursement. We do not limit this analysis to your top codes, we do a comprehensive review to ensure we maximize your revenue.

3) We then make a recommendation on which plans you should continue with or terminate, plans to negotiate with and something that is often missed, plans you can maximize by utilizing payer leased networks.

4) Next, our over twelve years of experience and vast payer contacts will go to work for you to negotiate on your behalf to get you an increase in payer reimbursement.

5) Once completed we will summarize the results and get you the new schedules to load into your PMS.

6) Lastly, we can assist the credentialing to add any news plans or terminate plans as well.

Later, we can assist in ensuring you are getting paid correctly, answering questions on EOBs, pushing back with payers on denials/downgrades and renegotiating again in 12-24 months.

Spotlight on - Credentialing

How can we help you with Credentialing?

We handle all aspects of Credentialing from A to Z.

Credentialing Service Features:

· Powered by HealthStream software, your payer enrollment is handled quickly and efficiently and with no bother to your doctors.

· Payer Verification – We will verify participation by doctor by insurance and by office.

· Doctor Information Gathering – Whether it is new hires or existing doctors, we handle gathering your doctor information with a simple 1-page paper form or by using an easy online form submission tool.

· Insurance Enrollment Preparation – We will prepare and complete all of the proper insurance forms for your plans and offices.

· Application Submission and Follow Up – We will submit all of the completed forms to the insurance companies and follow up with the carriers until the doctor is participating in all of your in-network insurance plans.

· Reporting and Tracking – We will report network participation status by doctor on a regular basis to ensure claims pay correctly and as expected.

· Re-Credentialing - We will handle all re-credentialing required by the insurance companies.

· New Offices and TIN Changes – We will complete and submit all of the new office paperwork and follow up to help make acquisitions smooth and easy.

· Expiring Certificates – We will track and report on upcoming expiring certificates for your doctors, licenses, DEA, COI, and more.

If your office has a need or would like a low-cost solution for credentialing, Clear Choice Consulting’s credentialing services are the way to go.

Email Chad at chad@clearchoice-consulting.com to obtain a free quote and get started!