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Idea and Inspiration
Welcome to the inaugural ClinicSpectrum newsletter! Each month, we'll be bringing you customer stories to share best practices from your colleagues, providing news and updates on our cutting-edge products and new innovations from ClinicSpectrum, as well as highlighting activity from social media to help you stay up-to-date with the latest and most active discussions relevant to you and your business.

As many of you know, ClinicSpectrum's mission is to provide a hybrid workflow model of products and services that streamline processes for physicians' practices and billing companies, and help you maximize revenue and cost efficiency. Healthcare reform continues to modify the way Americans receive and pay for healthcare, and we aim to help you adapt and succeed in the face of the constant change. Recently, many of our customers have come to us seeking help as high-deductible plans become the new normal. Many patients are unable to pay their expected out-of-pocket costs, resulting in a financial loss for the practice. Keeping up with outstanding payments is often a full time job, which adds stress to the bottom line. I recently contributed to Physcian's Practice on this topic.

Technology, coupled with an outsourced back-office team, can help to maintain your practice's revenue stream. By verifying insurance benefits prior to an appointment, your clinicians are able to know what treatments will be covered by a patient's health plan. Secondly, an automated billing platform provides a streamlined way for practices to recoup fees. In this first issue, Psychology Behavioral Consultants explains how our benefits checking solution has saved more than 30% of the total cost on this process.

Enjoy your reading, and please stay connected and reach out.
Psychology Behavioral Consultants in Cleveland, Ohio has over 90 clinicians on its roster and is the largest, privately held mental health practice in Ohio. With such a large practice, benefits authorization had become a major, time-consuming and costly task. Eligibility checking is the single most effective way of preventing insurance claim denials; however, significant time and effort was going into this lengthy process.

Since installing ClinicSpectrum’s benefits authorization service several months ago, the practice has been able to cut costs on this process by more than 30%. Don Sykes, the Managing Director of PBC shared: “Working with ClinicSpectrum on benefits and authorizations has not only saved us money, but the quality and timeliness of the work surpasses what we were accomplishing internally. Practice management is no easy task, but ClinicSpectrum’s benefits credentialing services makes my job easier.”

“We have been so impressed by ClinicSpectrum’s methodical approach to addressing this issue that we recently implemented a second component, CredentialingSpectrum, to further optimize administrative tasks, and we have been thrilled with the results.”
How does your practice prevent the headache of insurance claim denials? ClinicSpectrum’s Eligibility checking service begins with retrieving a list of upcoming scheduled appointments and verifying insurance coverage for the patients. Once the verification is complete, coverage details are put directly into the appointment scheduler for the office staff’s notification.

We provide three methods for checking eligibility: online, Automated Voice system (IVR), and personal calls to an insurance company representative. Our three-pronged approach gives us the flexibility to provide a custom solution to our clients, which best fits their individual needs.

Credentialing is another lengthy, yet necessary, process for medical practices. Practice administrators must review and verify that a health care provider has obtained the necessary certifications to participate in insurance plans.

Items to be checked include, but are not limited to, current professional license(s), current Drug Enforcement Administration and Controlled Drug Substance Certificates, verification of education, post-graduate training, hospital staff privileges and levels of liability insurance.

ClinicSpectrum’s process begins with requesting credentialing application kits from all the commercial and government health insurance plans. After submitting the signed applications, we follow-up with the payers to retrieve the provider or group ID #, confirming that the doctor is participating with the insurance. We also give bi-weekly status updates to the provider until an effective date of enrollment is determined so the provider can begin claim submission. Outsourcing this labor-intensive task allows your practice to run more smoothly.
LinkedIn Update - Red Flags in Credentialing Process
For More Information Please contact us on
Phone (908)-834-1608
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2222 Morris Ave, 2nd Floor, Union, NJ 07083 Ph: (908)-834-1608 Fax: (877)-600-9390
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