I'm Greg Kostelac, and I am here to help you achieve your goals. With over six years in the dental industry, I've held roles from Patient Coordinator to Head of Credentialing, gaining comprehensive expertise in claim management. My skills encompass insurance verification, claim submission, claim follow-up, payment posting, denial management, credentialing and fee schedule administration. I specialize in streamlining these processes through automation, without relying on AI, to maximize your revenue and ensure efficient claim handling.
Choosing to outsource any part of your revenue cycle management is difficult, and I understand that. I provide 100% transparancy to my clients so that you know exactly what you are getting with my services. Let me take care of your insurance issues so you can focus on patient care. If you are not happy, I am not happy.
Patient insurance benefits are verified 1-2 weeks out, eligibility is rechecked 1-3 days prior to the appointment.
Benefits are input directly into your PMS, a standardized breakdown is saved for the patient, and coverage information is corrected when receiving claim payments.
Claims are submittied daily for the day prior, giving providers time to finish notes at the end of the day. This ensures all information required for your claim is sent the first time. This increases the clean claim rate and gets you paid faster, decreasing your AR days.
Claims are followed up on by running an outstanding claims report weekly and using a proprietary formula to calculate a "risk score." This risk score is determined by many variables including the dollar amount of the claim as well as timely filing.
Payments are posted directly to ledgers according to EOBs and applicable non-covered services laws, and EOBs are uploaded into your PMS so you have access to all the information to answer patient concerns easily.
I always recommend signing up for EFTs/ERAs! A common misconception is that this costs extra money; however, it does not have to. Insurance companies are requred to offer free EFTs in some way shape or form! This does not exclude them from also offering a paid service, such as Zelis, but means you just have to know where to look!
Denials happen! It is the insurance companies way of earning interest off of your well deserved money before having to pay it out. For any denied claim, it is determined if the claim is payable and, if it is, it is resubmitted. If it is not payable, the reasons why are documented, and feedback is provided to the office to decrease the amount of denials going forward.
Fee schedules are converted from the given format to .csv and uploaded to your PMS for accurate estimates for your patients.
Found yourself with a messy practice management system? Whether you need help consolidating carriers or plans, inactivating patients, auditing accounts, or something else, let me know and I can get you a quote!