For our members, we reduce your overhead and headaches by managing all of your billing related labor. Our professional and experienced staff has decades of experience in billing for this field, greatly increasing your reimbursement rate while reducing denials and/or rejections. Over the last three years, our claims versus payments reimbursement rate is greater than 95%!
Additionally, we are all familiar with the difficulties in securing a contract with an insurance company as an individual provider. By joining our group, our members have access to all of our contracts.
For doctors and insurance companies, we offer a one stop referral destination, allowing the doctor to focus on him or her being a doctor instead of a bureaucrat always searching for a destination to refer to.
We took extra pains when we organized our group to ensure that “every” aspect of the O&P/DME field and every geographical location is incorporated within our group. If there is anything needed in the O&P/DME field, chances are that we have the foremost specialist on that procedure/item.
Unlike some chain-store entities or wall street backed enterprises that have infiltrated the O&P/DME field over the last few years where dollar signs is all that matters. Our group consists of passionate individuals who entered this field with enthusiasm and vigor to help people. As such, between our members we hold many patents and proprietary solutions for almost every conceivable ailment. Our patients are not just the best cared for administratively, they receive the best care, medically!
For insurance companies, we are proud to offer our utilization management services, where we evaluate the appropriateness, medical need and efficiency of the requested procedure according to established criteria, guideline and under the provisions of the individual plan and/or CMS.
We can offer one or all of the facets of utilization management; Demand Management, Case Management and Utilization Review.
By utilizing our service or services, your administrative costs from the front end is shifted to us greatly reducing your financial burden. Furthermore, since we are one step closer to the person in need of the service, patient satisfaction and outcome is greatly improved.
Providers in the O&P/DME arena (as well as in all of medicine for that matter) are being squeezed from every direction.
• Reduction in rates from the insurance companies as the government and industry struggle with the ever increasing cost of healthcare.
• Increased cost of goods and production, as commodities like metal, plastic and rubber are on a constant march upwards, with labor costs on the same trend.
• Constant pressure from the mega-facilities, as they are hawking referral sources with their marketing teams, economically infeasible for a small individual provider to replicate.
However, as a cooperative we can and are bending these curves in our direction. By contracting as an IPA, we save money for the insurance companies, leaving higher rates for reimbursement, compared to individual contracts. In addition, as a cooperative we have greater clout when an issue arises.
By buying in bulk, where we buy a large quantity of an item and allow our members to draw from that inventory, significant savings can and is being recognized.
By sharing our “Fab-Lab” our members do not need to support their own lab, technician and inventory, all at a great expense to the member. Instead, our members can utilize our state of the art fabrication lab, where our members pay only what it actually costs to produce.
By sharing in our marketing resources, our literal and figurative name is well marketed to all potential referral sources, providing our members with an answer to the mega-facilities, resulting in increased patient referrals, leading to an increase in your overall bottom line.