7 Aspects Every Behavioral Health Facility Should Know About Billing

Frequently Asked Services Questions

 

Verification of Benefits

What is the response time when a facility submits a Verification of Benefits to Axis?

Axis has a team consisting of 9 Claims Representatives that also verify benefits for our facility. As soon as we receive a Verification of Benefits, within minutes a claims representative will be on the phone with the insurance company. We believe in very thorough verification of benefits processes. We will cross reference all information to ensure accuracy before returning the Verification of Benefits to your facility.

On average a thorough Verification of Benefits will take about 45 minutes or less.

What can my facility expect when Axis verifies benefits for a patient?

You can expect the Axis to take every pre-caution to ensure accuracy of benefits for every level of care. We understand how paramount the Verification of Benefits process is to the entirety of billing processes. If the Verification of benefits its not done thoroughly it will have a domino affect for the patients authorizations and billing processes. We not only give you the benefits that were quoted to the Axis team, but we also provide a benefit summary which is more comprehensive.

We also provide additional information on the insurance carrier or policy and let you know what our experience has been with the insurance carrier or the specific policy. We want to make sure you understand the benefits to the fullest in order to best help your patients.

Utilization Review / Authorizations

What is a Utilization Review / Authorization?

There are 2 components of Authorizations. The first is the Pre-authorization, this process is typically done using a very specific format which Axis has refined over the years to cater to the insurance companies needs. When a patient arrives at your facility we request that your clinician fills out the entirety of the pre authorization from which we provide to you.

Once this is complete you will submit the form to the Axis Authorization team and we take it from there. As soon as we receive the authorization from the insurance company, we then notify the representatives at your facility to let them know when we will need a Utilization Review to obtain further authorization.

The Utilization Review is done anywhere from every 3 days up to being on a monthly basis. This is dependent on the level of care in which the patient is at as well as the complexity of each case. We also supply your facility with a Utilization Review template in which your clinicians will fill out and again submit to the Axis Authorizations Team. The authorizations team will then contact the insurance carrier using the provided information and obtain further authorization.

What are the benefits of having your team manage authorizations for our facility?

The Axis authorizations team is comprised of clinicians who are specially trained to work with insurance carriers. They speak the language of the insurance companies and spend countless hours researching and staying up on the changes in the substance abuse and mental health field. They also are very familiar with the medical necessity criteria for each insurance carrier.

This allows the authorizations team to advocate  for your patients and maximize authorizations for your patients.

The Axis authorizations team does not take no for an answer when it comes to helping a patient receive treatment. We have specific policies and procedures that the authorizations team follows to manage any denials and have set a new standard of overturning denials. Above this all of the individuals in our authorizations department are extremely passionate about helping individuals receive the treatment they need.

Claims Processing and Management

How long does it take to receive payments after submitting claims?

The turn around time for claims to be processed and paid is highly dependent on the insurance carrier. Axis made an analysis for the past 6 months and found that the average time it takes to receive payment on a claim is roughly 45 days from the time it is submitted to the insurance company.

Does Axis help with appeals and denials of claims?

Yes, Axis manages all aspects of claims processing including denials management. We have very defined processes for appeals and managing denials. Similar to the authorizations team, we do not accept denials lightly. We  appeal the denials using specific denial management tools to ensure that we are fighting the denial until there is some type of determination. Our staff is specially trained in managing denials and understand the insurance processes thoroughly.

This allows us to successfully overturn many denials and receive payment on claims.

Axis is follows up on all claims every other week. This allows us to catch any problems with claims processing in a very swift manner. While many 3rd party billing companies submit claims and wait for remittance from the health insurance carrier, which can be 30-60 days from the time a claim is submitted, we take a very proactive approach to the claims management processes.

By utilizing our expertise and our diligent approach we will know if a denial happens before any remittance is submitted to your facility as well as have the ability to manage claims on our end without needing to contact your facility to assist with these processes.

 

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