Daily Managed Care imposes a considerable administrative burden, often distracting from your team’s ability to focus on crucial objectives.
The volume of technical work is overwhelming and leads to oversight of critical details, potentially resulting in costly consequences.
Recognizing these challenges, Guided Care is uniquely positioned to alleviate your technical input. We fully handle verifications and authorizations.
Our specialized Case Management service enables you to regain valuable time and drive sustainable success.
Remaining on top of reimbursement involves advanced knowledge of Managed Care as well as persistence and time to follow up on each case.
Providers do not have the experience and time to expend on patient individual reimbursement while focusing on raising their organization’s level of care.
Guided Care’s Case Management department handles each detail of patient specific reimbursement by managed care. We work on review and better documentation and advise on missing components the payor needs for approval on optimal reimbursement.
We educate relevant facility departments on drivers behind additional insurance reimbursements. We write detailed cover letters on authorization and appeal determinations to emphasize medical necessity to lean the decision in the facility’s favor. We also use our contractual knowledge to ensure proper level of care reimbursement for care delivered.
