Dean Dorton is your partner for tactical and strategic initiatives
Our physician practice clients rely on Dean Dorton Healthcare Solutions to assist them with numerous tactical and strategic initiatives:
- Medical coding and chart auditing
- Daily claims submission and medical billing
- Denial resolution and appeals
- A/R management and cash collections
- Provider credentialing with all payers
- New provider and practice setup
We support and advise medical practices in helping them reach their maximum potential with respect to operational and financial outcomes. Our range of assistance can be bundled with our more traditional accounting services to provide as much or as little support as needed by your practice. Access our team of experts to supplement your team’s needs related to accounting, tax compliance, strategic planning, enhanced information technology, compliance management, and financial oversight. Whether your practice needs help in specific areas or are looking for a complete back-office solution, put the expertise of Dean Dorton Healthcare Solutions to work for you.
Individual and group practice credentialing services
Practice demographic updates and changes
Charge-entry and revenue capture
Medical billing
Denials management
Third-party payer follow-up
Payment and adjustment posting
What is medical billing and credentialing?
The medical billing and credentialing process is the process of submitting insurance claims for reimbursement for medical services rendered. The process begins with the provider, who must first obtain a National Provider Identification (NPI) number from the Centers for Medicare and Medicaid Services (CMS). The provider then submits an application to be credentialed by each insurer with whom they wish to participate.
The insurer reviews the application and supporting documentation, including the provider’s credentials, prior experience, and malpractice history. Once the provider is approved, they are placed on the insurer’s list of network providers. Providers can then begin billing insurers for services rendered. Claims are submitted using industry-standard coding systems, and insurers reimburse providers based on their contracted rates. The entire process can take several weeks or months to complete.
Why it’s important
Helps to ensure patients are accurately billed. Not only does this protect the financial health of the practice, but also ensures more accurate medical records.
Helps establish that providers are properly credentialed to provide care. This provides an extra layer of quality control and risk management.
Helps ensure that providers are familiar with the latest coding and documentation requirements, which is important for both compliance and reimbursement purposes.
WHY DEAN DORTON?
With our team, you will get:
- Access to qualified professional staff experienced in your medical specialty
- Collaboration with subject matter experts and advisors who are focused on the success of your business
- Consistency—no need to worry about employee vacations, absence, or sick leave
- Increase your focus on practice operations, patient care, and clinical outcomes
- Reduced stress of hiring, training, and retaining qualified personnel
- Access to industry insights: What do other practices do that work for them?
- Co-development of improved process flows
