Clean Ratio
1 st Submission Page Rate
Revenue Increase
Our team conducts real-time insurance verification before every appointment, including detailed benefit checks for Nebraska Medicaid (Heritage Health), Medicare, and commercial plans. We also identify prior authorization requirements to prevent costly surprises and ensure clean claims from day one.
Certified coders apply the most current CPT, ICD-10, and Nebraska-specific modifiers while cross-checking against payer-specific rules. We stay updated on coding changes for behavioral health, primary care, and specialty services to maximize legitimate reimbursement.
All claims undergo quality reviews before being electronically filed within 24 hours—well within Nebraska Medicaid's 95-day window and private insurers' 30-45 day deadlines. We monitor submission receipts to confirm payer acceptance.
Our proprietary scrubber catches 99% of errors pre-submission by flagging Omaha-specific issues like missing GP modifiers for Medicaid or incorrect Place of Service codes for telehealth visits.
Every EOB and ERA is meticulously matched to claims, with payments posted same-day. We track underpayments using Nebraska fee schedules and initiate immediate appeals for discrepancies over $5.
Our 45-60-90 day follow-up protocol targets aging claims, with personalized strategies for stubborn denials from Nebraska payers like Blue Cross Blue Shield NE and UnitedHealthcare Midlands.
Customized patient statements with flexible payment options improve collections while maintaining your practice's reputation. Our staff handles all billing inquiries to protect your patient relationships.
Monthly performance dashboards highlight Omaha-specific metrics like: Payer mix analysis Nebraska Medicaid acceptance rates Top denial reasons by insurer Collection percentages by provider
From initial CAQH setup to Nebraska-specific payer enrollment (including Medicaid and Medicare), we manage the entire credentialing lifecycle—including license renewals and periodic revalidations to prevent network disruptions.