At CodeMax Medical Billing, we offer a team of experienced, passionate, and committed individuals who will work to provide you with the best solutions for your medical billing challenges and increase your revenue.
Choosing CodeMaxMB allows you more time to focus on what you do best: patient care. You’ll have peace of mind knowing that all medical coding and billing needs will be taken care of by an expert team. The services we offer include:
- Billing and claims management
- Utilization management
- Consulting services
- Verification of benefits
- Quality assurance
Contact our team today at 866.471.3267 or reach out online to learn more.
Billing and Claims Management
Are you looking for someone to handle claims submissions, tracking, and payment posting? We offer a dedicated team of professionals who will seamlessly handle each step of the billing process. We double verify and update your verification of benefits. We enhance your utilization review. Our billing and claims coders are experienced and 100% reliable in sending out clean claims, and our claims management and appeals team challenges every payment below UCR thresholds. Our quality assurance team works hand in hand with our appeals department to make sure your documentation is perfect when sent to the provider. Finally, our payment posting and reporting teams generate reports weekly so you know where you are financially when you need it most.
Utilization Management
We are experts in maximizing your client’s insurance benefits. Our utilization management team is led by an ASAM certified physician who provides oversight to our UR staff of clinicians by reviewing medical necessity documentation to make sure your patients obtain the longest stays at the highest levels of care.
We’ll help you and your staff in a number of ways, including:
- Helping you gain a thorough understanding of admission and continued stay criteria
- Auditing your current practices to make sure you have effective clinical documentation, intensity of services, and program scheduling
- Explaining the peer-to-peer review process with our physician countering any UR medical necessity issues brought up on claims review or appeals
- Utilizing our established relationships with care managers at the top providers frequently contacted for UR management
Consulting Services
Our deep operational experience allows us to better understand the real issues your treatment center or practice faces. Our management team is made up of seasoned behavioral health treatment center owners committed to helping improve your day-to-day operations and clinical care and streamline your processes to increase your revenue while maintaining regulatory compliance. Best of all, our consulting services are built into our service guarantee at no additional cost.
Verification of Benefits
CodeMax’s verification of benefits process is efficient, timely, and comprehensive. We regularly achieve a 45-60 minute turnaround time. How do we get results so quickly and accurately? Our team members have extensive experience in verification and use advanced technologies.
Too often, the verification of benefits process is overlooked. However, it’s one of the most important steps in the revenue cycle management process. If verification of benefits is done incorrectly, all processes that follow will fail.
What to expect from verification of benefits from CodeMaxMB:
- Timely – 45-60 minute turnaround time on average
- Accurate – Cross-checked and detailed
- Informative – Warning disclaimers, exclusions, details revealed on unreliable payers
- Comprehensive – We compare prior data from similar payers and plans
- Guaranteed accuracy – We cross-check our results
CodeMax takes pride in our detailed processes when verifying benefits for our treatment providers’ patients. We use our large database of insurance policies and track the outcomes of the policies and insurance carriers.
Quality Assurance
Quality checks ensure that your billing and coding is always accurate and timely. At CodeMaxMB, we treat quality assurance as part of our regular processes. Our team double-checks everything we do. One inaccuracy can lead to a multitude of problems and wasted time, which is why quality assurance is such an integral part of our services.
Average Daily Rates
Discover the difference that CodeMaxMB can make for your bottom line.
Industry Averages
- Detox Classification$1,400 a day
- Residential Treatment (RTC)$1,000 a day
- Partial Hospitalization (PHP)$1,200 a day
- Intensive Outpatient (IOP)$250 a day
Our Clients’ Average Daily Rates
- Detox Classification$2,500 to $2,800 a day
- Residential Treatment (RTC)$2,200 to $2,500 a day
- Partial Hospitalization (PHP)$2,200 to $2,500 a day
- Intensive Outpatient (IOP)$550 to $750 a day
These averages are from our clients who are typically 6 bed residential facilities located in Southern California and offer the above services as Out of Network providers.
CodeMax’s internal processes and seven interconnected departments have been established to make sure that claims are submitted 100% clean and accurate, that your intake department is versed on all exclusions on the VOBs you submit through us, and that when claims are assigned references, we check to make sure initial settlement offers are within established thresholds for that insurance provider on similar claims made to providers within your area. We perform thorough audits and suggest best practices and help your staff by explaining the peer-to-peer review process.
Connect With CodeMaxMB Today
Find out how our expertise can help your business grow. Connect with us online, reach out at 866.471.3267, and download our exclusive app today to learn more.