Southwest Medical Billing & Consulting Services

Consulting and Startup Services for New Treatment Facilities

Whether you’re staring a new business or already have an established one, SWMBC can support all your business needs and help develop the needed strategies required to succeed. Our extensive knowledge in the Medical and Behavioral Health Industry can help in a smooth transition.

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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.

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.

Utilization Management

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

  • CALL FOR INITIAL AUTHORIZATION

  • RE-CERTIFICATION FOR ADDITIONAL DATES OF TREATMENT

  • PROVIDE MEDICAL INFORMATION & TREATMENT PLAN

  • TRACKING AND MANAGEMENT OF ALL SERVICES AND AUTHORIZATIONS

  • DAILY CENSUS

Medical Coding

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

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What we provide:

  •  WE ARE EXPERIENCED IN CPT, ICD10, HCPCS CODING, INSURANCE GUIDELINES AND PAYER SPECIFIC CODING REQUIREMENTS.

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.

  • CLAIMS FOLLOW-UP AND INVESTIGATION: OUR STAFF IS EDUCATED IN MENTAL HEALTH / SUBSTANCE AB– USE CHARGES, CONDITIONS AND CURRENT REIMBURSEMENT RATES, WE CONSISTENTLY FOLLOW-UP WITH PAYERS REGARDING PENDING PAYMENTS, RESUBMISSIONS, MEDICAL RECORDS SUBMISSIONS AND PAYMENTS NOT RECEIVED

  • DENIAL MANAGEMENT: SWMBC WILL TRACK DENIAL AND TRENDS FOR TRAINING, UPGRADE AND CORRECTION ON ALL PROCESSES.

Standard and Custom Reporting for Your Facility

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

  • TOTALY MONTHLY CHARGE REPORT

  • TOTAL MONTHLY PAYMENT REPORT

  • AGING REPORTS

  • CUSTOMIZED REPORTS