Insurance Verification
Know the coverage before the first session.
Before a new patient ever sits down for their first appointment, we verify their insurance benefits — in-network and out-of-network — so you and your client know exactly what to expect financially. No surprise bills, no awkward conversations after the fact.
What's Included
- ✓Real-time eligibility and benefits checks for every new patient
- ✓Out-of-network reimbursement rate and deductible breakdowns
- ✓Copay, coinsurance, and session-limit verification
- ✓Prior authorization requirement flags before treatment begins
- ✓Periodic re-verification for long-term, active clients
Claim Submission
Clean claims, submitted daily, without the backlog.
Claims go out every business day via electronic clearinghouse using the CMS-1500 format. Sessions logged by end of business are typically submitted same-day. Every claim is scrubbed for coding and formatting errors before it ever reaches a payer.
What's Included
- ✓Daily electronic batch submission through clearinghouse
- ✓Automated claim scrubbing for CPT, ICD-10, and modifier errors
- ✓Same-day submission for sessions logged by EOD
- ✓Clearinghouse rejection monitoring and same-day correction
- ✓Claim status tracking from submission to adjudication
Payment Posting
Every payment reconciled, every shortfall flagged.
We record every EOB and ERA payment against the original claim, reconcile it against your contracted rates, and flag underpayments the moment they happen — so revenue you're owed never quietly slips through the cracks.
What's Included
- ✓Daily ERA/EOB payment posting against open claims
- ✓Contractual adjustment verification against payer fee schedules
- ✓Automatic underpayment and short-pay flagging
- ✓Patient responsibility (copay/coinsurance) calculation and tracking
- ✓Real-time accounts receivable balance for your practice
Denial Management
Denials get fixed and resubmitted — fast.
Denied and rejected claims are reviewed daily, the root cause is identified, and the claim is corrected and resubmitted within the payer's filing deadline. When a denial warrants a formal appeal, we handle the letter, documentation, and follow-up calls.
What's Included
- ✓Daily denial and rejection queue review
- ✓Root-cause categorization (eligibility, coding, auth, timely filing, etc.)
- ✓Corrected claim resubmission within payer deadlines
- ✓Formal written appeals with supporting documentation
- ✓Denial trend reporting so issues don't repeat
Monthly Reporting
Full financial visibility, every single month.
Every month you receive a clear, easy-to-read PDF report covering claims submitted, amounts collected, denial rates, AR aging, and revenue recovered through appeals — so you always know exactly where your practice stands financially.
What's Included
- ✓Monthly revenue summary and collections breakdown
- ✓Claims submitted vs. claims paid comparison
- ✓Denial rate trends with category breakdowns
- ✓Accounts receivable aging buckets (30/60/90+ days)
- ✓Payer mix analysis and actionable recommendations
Provider Credentialing
Get on insurance panels without the paperwork headache.
Credentialing with insurance panels is slow, repetitive, and full of follow-up calls. We manage your CAQH profile, submit and track panel applications, and follow up with payers on your behalf — all for a transparent flat fee per payer, with no surprise charges.
What's Included
- ✓CAQH profile setup, maintenance, and attestation reminders
- ✓Insurance panel application submission and tracking
- ✓Proactive follow-up with payers until approval
- ✓Re-credentialing reminders so you never lapse out-of-network
- ✓Transparent flat fee per payer — no hourly billing
Not sure which services you need?
Start with a free billing audit. We'll review your current setup and tell you exactly where Logicware can help.
Get Your Free Billing Audit →