What We Do for SimplePractice:
- Claim Submission & Processing: We review and submit insurance claims using clearinghouses and insurance portals, ensuring all required documents are attached and correctly formatted.
- Error Resolution & Denial Management: If a claim is rejected or denied, our team identifies the issue, corrects errors, and resubmits claims to maximize payment success.
- Payment Posting & Reconciliation: Once insurance payments are processed, we accurately post payments, adjustments, and explanations of benefits (EOBs) into the practice’s platform.
- Provider & Patient Support: We assist providers with any billing-related questions, insurance follow-ups, and account discrepancies to ensure smooth operations.
- Insurance Verification & Eligibility Checks: We confirm patient coverage and benefits before services are provided, reducing claim denials and payment delays.
- Compliance & Accuracy Assurance: We follow industry standards and payer guidelines to maintain accuracy and compliance in all billing activities.
Why It Matters for Mental Health Practices:
- Faster Payments: Our process minimizes delays and ensures providers get paid on time.
- Fewer Errors: We proactively resolve issues, reducing claim denials and resubmissions.
- Less Admin Work for Providers: Clinicians can focus on patient care instead of billing complexities.
- Improved Cash Flow: By optimizing RCM, we help practices maintain financial stability.
Our experience with SimplePractice makes us a trusted partner for mental health providers looking to streamline their billing and revenue cycle. The Functionary ensures efficiency, accuracy, and reliability in every step of the process.
What is Revenue Cycle Management (RCM)?
RCM is the process of managing medical billing, from verifying patient insurance and submitting claims to following up on payments and resolving denials. It ensures healthcare providers get paid for their services.
What specific tasks does The Functionary handle in RCM for SimplePractice?
- Submitting insurance claims through clearinghouses.
- Fixing rejected or denied claims and resubmitting them.
- Posting insurance payments and explanations of benefits (EOBs).
- Assisting providers with billing-related issues.
- Verifying patient insurance eligibility.
- Ensuring compliance with payer guidelines.
Why is claim rejection and denial management important?
Rejected or denied claims delay payments to healthcare providers. Our team quickly identifies the issue, corrects errors, and resubmits claims to minimize revenue loss.
How does The Functionary help improve cash flow for healthcare providers?
By reducing errors, submitting claims on time, and ensuring quick resolution of denials, we help providers receive payments faster, keeping their finances stable.
What makes The Functionary’s RCM services different from other providers?
- Expertise in Mental Health Billing: We specialize in the unique needs of mental health practices.
- Proactive Issue Resolution: We actively monitor claims and resolve issues before they impact revenue.
- Direct Provider Support: We offer real-time assistance to help providers navigate billing challenges.
How does The Functionary ensure compliance with insurance regulations?
We follow payer guidelines, verify claim accuracy before submission, and stay updated on industry changes to maintain compliance and avoid costly errors.
What are the main benefits of outsourcing RCM to The Functionary?
- Less administrative burden for providers.
- Higher claim approval rates.
- Faster, more predictable payments.
- Fewer billing errors and denials.
- Expert handling of complex insurance processes.
