Additional Services

Credentialing, Denial Management, and Prior-Authorization Services with Xpert Medical Billing Solutions, LLC

Credentialing

Verification and evaluation of a doctor's training, education, and experience constitute the procedure. Patients can feel confident that they are in capable hands, and doctors can trust one another. Enrollment in a physician health plan also requires credentialing so that services can be charged.

Denial Management & Appeals

Denial management is a tactical procedure designed to identify and address issues resulting in rejecting medical claims. The approach should reduce the chance of further denials, ensuring that practices receive payments quickly and have a steady cash flow. This gives the knowledge to recognize opportunities to identify and address the problems that lead to insurers denying claims. It outlines the four steps to effective denial management: Identity, Manage, Monitor, and Prevent.

Prior-Authorizations

Medical diagnosis and treatment require prior authorization, mainly when the claims are to be paid by an insurance provider. It involves asking the insurance company for permission to treat specific services. Getting the payer's approval in advance increases the likelihood of a hassle-free claims settlement. The procedure requires obtaining an authorization number, which must be written on the claim when submitted.