You will get credentialing and contracting services for your Group or Providers
You will get credentialing and contracting services for your Group or Providers
Project details
I'll work for group or providers to do process of contracting and credentialing with payers in different states. in my 5 years of tenure I contracted 12+ groups, and credentialed 60+ providers both medical and behavioral.
You will get quality credentialing and contracting services because I have worked with almost all the major insurance and other state-based insurance when it comes to credentialing. Some of them are BCBS (Anthem), UHC, Medicaid, Medicare, Wellpoint, Physician groups, Medstar, Aetna, Kaiser, Molina, HealthNet, Geico, VA etc. I am well aware of the insurance requirements and their process of credentialing.
I look forward to discussing how I can be in assist to build your network.
You will get quality credentialing and contracting services because I have worked with almost all the major insurance and other state-based insurance when it comes to credentialing. Some of them are BCBS (Anthem), UHC, Medicaid, Medicare, Wellpoint, Physician groups, Medstar, Aetna, Kaiser, Molina, HealthNet, Geico, VA etc. I am well aware of the insurance requirements and their process of credentialing.
I look forward to discussing how I can be in assist to build your network.
Purpose
BusinessLanguage
EnglishWhat's included
| Service Tiers |
Starter
$800
|
Standard
$1,200
|
Advanced
$1,500
|
|---|---|---|---|
| Delivery Time | 1 day | 3 days | 5 days |
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About Kavish
Medical Biller | AR, Coding, Denial Expert | DME Billing Specialist
100%
Job Success
Islamabad, Pakistan - 10:40 pm local time
• Eligibility & Benefits Verification
• Accurate Demographic and Charge entry
• ICD-10, CPT coding
• Pre-Authorization
• Insurance claims submission via clearinghouse and Paper submission
• Denial Management
• Account Receivable
• Appeals
• Insurance and patient calling
• Healthcare project management
• Backlog management
• Patient billing for PR -1,2,3 and PR 96 and PR 119 etc
• Financial reporting/ Practice Audit
• KPI's
NSA Billing
• Underpaid appeals/ reopen NSA claims for negotiations/ Arbitration & Mediation
• TDI Submission (For State of Texas)
• IDR Submissions (All states)
• Negotiations (All states)
• No surprise act (All states)
• Out of network billing (All states)
Home Health and Mental health billing
• Article 28 Facility billing
• Article 31 billing/Community mental health
• Practice Audit
• Claims F/U on denials from insurances
My comprehensive understanding of the No Surprise Act (NSA) and related regulations equips me to navigate Federal Independent Dispute Resolution (IDR) processes, state-specific surprise billing laws and arbitration protocols effectively. This knowledge enables me to secure maximum reimbursement for providers while ensuring compliance with payer regulations.
I have extensive experience managing Article 28 facility billing which involves navigating the stringent requirements for licensed healthcare facilities in New York, including hospitals, diagnostic centers and clinics. I also specialize in out-of-network billing, helping providers recover payments from insurance companies by handling complex negotiations and claims resolutions.
Additionally, I have a proven track record in DME (Durable Medical Equipment) billing, which requires a detailed understanding of HCPCS coding, documentation standards and payer-specific requirements to ensure proper reimbursement. I am highly experienced in billing for hospital beds, Orthotics and prosthetics, respiratory equipment's like oxygen delivery systems such as stationary compressed gaseous oxygen systems and Hearing AID devices. My knowledge of Medicare’s 36-month rental payment cap and 5-year equipment ownership rules enables me to ensure compliance while optimizing provider revenue. I am well-versed in differentiating between Nocturnal Oxygen Therapy (NOT) and Long-Term Oxygen Therapy (LTOT), which helps ensure claims meet medical necessity criteria. I routinely handle Plan of Care (POC) requirements, home assessment documents and Advance Beneficiary Notices of Noncoverage (ABNs), ensuring all necessary documentation is in place to reduce denials. My strong HCPCS and DME billing skills allow me to advocate for providers and vendors effectively, securing higher payouts. DME prior authorizations, claim submission and resolving denials—especially those related to Medicare guidelines or coverage limitations—are tasks I manage with efficiency and accuracy. My deep understanding of regulatory compliance positions me as a reliable asset in any DME billing operation.
Software Proficiency:
CareCloud, eClinicalWorks, Athena, Tebra, Office Ally, Simple Practice, Kareo, Bflow, Brightree, Medbill, Prompt EHR.
Specialties:
Mental Health, Orthopedics, Spine Surgery, Neurosurgery, Anesthesia, Pain Management, Ophthalmology, Cardiology, Dermatology, Family Medicine, General Surgery, Gynecology & Obstetrics, Internal Medicine, Pulmonology, Pathology, Pediatrics, Physical Medicine & Rehabilitation, Physical Therapy, Psychiatry, Neurology, Radiology, Gastroenterology, and Durable Medical Equipment (DME) Orthotics and Prosthetics.
Driven by a commitment to accuracy and compliance, I offer reliable support to healthcare providers and groups ensuring both financial health and regulatory adherence.
Steps for completing your project
After purchasing the project, send requirements so Kavish can start the project.
Delivery time starts when Kavish receives requirements from you.
Kavish works on your project following the steps below.
Revisions may occur after the delivery date.
Communication and Submission
Will communicate with insurance and will submit required documents to complete credentialing request