Consulting and Start Up

Whether you are a new business or established, let SWMBC support all of your business needs and help develop the needed strategies required to succeed. Our knowledge in the Mental Health and Substance Abuse Practices can help in the smooth transition.

Practice Set-up: We can assist in the creation of a fully functioning and credentialed facility that will meet the needs of your clients and their addictions. With support from our trained staff, we can help with your dream of opening a SUCCESSFUL treatment facility.

Utilization Management and Review

Calling to request authorization or re-certification? This is our job!

go to my site ·      Call for Initial Authorization
this post ·      Re-certification for additional dates of treatment
·      Provide medical information, treatment plan and any required medical information
·      Tracking and Management of all services and authorizations
·      Provide a licensed vocational staff for UR/UM processes 
·      Daily Census

Collection and Follow-Up Services

Unlike many outsourced billing companies, SWMBC takes full responsibility for collecting the amount due to each and every facility for the full benefit amount. Denials will be researched and appealed with accuracy and timely follow-up.

Our staff is educated in Mental Health/Substance Abuse Charges.                   We consistently follow-up with payers regarding pending payments,Re-submissions, Medical Records submission and Payments not received.
·          DENIAL MANAGEMENT : SWMBC will track denial and trends for training, upgrade and correction on all processes.

Verification of Benefits

Mental Health and Substance Abuse benefits differ greatly from medical benefits. Our trained staff will ask a series of questions that only pertain to Mental Health services. With confidence and accuracy, we provide full benefit details.

Medical Coding

We will track trends to ensure correct submission for new or updated codes and research data for any inconsistencies.

What we provide:

·      We are experienced in CPT, ICD9/ICD10, HCPCS Coding, Insurance guidelines and payer specific coding requirements.
·      Electronic Claim Submission: SWMBC files claims electronically or paper and ensure accurate and timely filing of all claims therefore increase your cash flow by maximizing first pass acceptance of claims.
·      Statements: client statements are reviewed and sent out monthly for full/partial payment and or signed agreement

Reporting

AR reports can be produced for a clear view of the practice highlights and possible modifications. Specific reports outlining trends are viewed weekly by upper management for process, investigation and possible reconsideration.

At SWMBC, we will ensure that all services are charged and billed out correctly.
·     Charge Capture/Reimbursement Overview: On a Monthly basis, you will receive

·     Total Monthly Charge report by: Patient, dos, level of service, responsible payer, aging and balance.

·     Total Monthly Payment report by: Payer payment or patient payment

·     Aging Reports

·     Customized Reports