Managed Care

• Accounts reviewed for contract compliance
• Recommendations made on contract terms and contract language
• Ability to file or initiate complaints to Texas Department of Insurance for Prompt Pay violations
• Ability to pursue restitution under State guidelines
• Payer issues are trended and reported back to clients
• Denials and underpayments appealed if appropriate
• Legal intervention is initiated when contract issues are identified
• Insurance verification procedures are performed when new insurance information is obtained. Includes initial billing and resubmission of insurance claims as required