Revenue Cycle Management
Most providers and facilities are not familiar with the Employment Retirement Income and Securities Act which often regulates how plans are funded, created and managed. ERISA is a governing principle that holds insurance payers accountable when determining fee schedules, identifying and documenting medical appropriateness and determining what a service is worth and how it should be paid based on the level of care or location of the treating provider.
Honu’s team of ERISA specialists helps healthcare facilities, treating providers and patients identify the most cost-effective treatment plans that will reduce out-of-pocket costs, reduce denials, reduce time spent on prior authorizations. With any services that Honu is hired to manage, providers and facilities obtain access to:
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Coding and Fee Schedule reviews
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SOAP Template reviews and assistance in developing documentation that utilizes LCD and NCD guidelines to improve reimbursements
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Independent Audit Guards to prevent SIU and RAC audits
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Real time verification of services to identify products and services that are covered
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Prior Authorization and Claim Status Checks services
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ERISA appeals on partially paid and/or denied claims
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Claim settlements when insurance payers arbitrarily underpay a claim