Discrete provider set-up includes:
Health Assets will assist the clinician to provide the necessary documentation needed to submit applications to health plans/insurance company panels.

Health Assets will review the National Plan & Provider Enumeration System website to ensure clinician information is up to date.

Health Assets will be listed as the credentialing contact for CAQH.  Clinicians will provide the CAQH login and password to Health Assets to review and update clinician information when necessary.

Application to provider panels includes:

Credentialing Services are provided by our Credentialing Specialists

Included in your Billing Services Setup:
Health Assets will assist the clinician to provide the necessary documentation needed to submit applications to health plans/insurance company panels, and maintain up to date files.

Credntialing Staff will review the National Plan & Provider Enumeration System, Office of The Professions, and commercial insurance systems to ensure clinician information is up to date.

Our credentialing staff will be listed as the credentialing contact for CAQH. We will be the manager of the provider’s CAQH profile.

Application to provider panels includes:
Health Assets Credentialing Staff will request the initial application from the health plan/insurance company. If the application is denied, we will notify you. If the application request is accepted, Health Assets will complete the credentialing process.

If anything additional is required from your office, the Credentialing Staff will contact you to request the additional material or information.

Health Assets Credentialing will provide you with your effective date and provider ID# upon approval.

The executive and management staff at Health Assets offer consulting services to practices who are beginning, expanding and looking for ways to improve. Consultations are offered on an hourly basis to individual and group practices as well as clinics. Such topics as documentation, forming a group practice, working with NYS Office of the Professions, Credentialing and Record Keeping are offered. The staff is available to Associations to speak to groups of mental health providers on topics relating to Outpatient Practice. Reach out to Health Assets to arrange for your individualized consultation.

Authorization Service includes:
Health Assets will contact the health plan/insurance company to obtain necessary authorization for care.

Health Assets will maintain records of all services you provide and prompt you to send Outpatient Treatment Reports (OTR) or other request for additional visits, in a timely fashion.

Verification of Benefits/Eligibility Services includes:
Health Assets will contact the health plan/insurance company to confirm eligibility for outpatient mental health benefits.  We will confirm the amount of co-payment, deductible, maximum visits allowed per year, visits used/remaining, and mailing address for claims.

Out Patient Treatment Report – (OTR)-authorization for additional visits includes:
Health Assets will track the authorizations and make every effort to inform you prior to expiration.

Health Assets will complete as much of the OTR as possible and fax or email it to your office.  Once the clinician completes the remainder of the information and signs the form, your office will fax, email or mail the OTR to Health Assets.  We will ensure the insurance company received the form and authorization is approved for more sessions.

Set-up Includes:
Group/Clinician setup for electronic billing and remittances with Medicare, (Medicaid, when appropriate) and commercial insurance companies. Billing system license fees are included.

Correction and/or Clarification of information including written and telephone interaction with insurance companies and other payers is included.

Verifying the benefits for all of your current patients to ensure accuracy, including information on copayment and deductible amounts, if applicable.

Billing Services includes:
Health Assets will submit claims for all sessions electronically whenever possible.  (Some EAP, worker’s compensation, and others must be submitted by paper.  We will send those for you, also.)

Health Assets will provide clinicians with a simple, personalized transaction sheet to record sessions.

Health Assets will receive the electronic remittance advice – Explanation of Benefits (EOB). We will email these to you, or if you prefer, send in the mail.

Health Assets will review remittances/EOB’s to ensure claims were paid accurately.  Should any claims be denied, we will follow up with the insurance company.  If necessary we will resubmit the claim or advise your office staff if denial is valid.

Health Assets will follow up on unpaid claims.  They will be corrected and resubmitted for payment, or reported to you, if there is a valid reason that they should not be paid.

Health Assets will provide reports so that you can track what was billed and what was paid. Additionally, annual reports are issued which are appropriate for your tax preparation.