We begin by checking each patient’s insurance coverage for ketamine therapy: whether the indication is supported, limits on the number of sessions, prior-auth requirements, and payer specific documentation rules. Early clarity eliminates surprises later.
We manage all-in pre-authorization tasks: collect clinical documentation, facilitate communication with payers, track approval status, and alert your team if any session risks noncoverage. We align scheduling, treatment delivery, and billing so sessions proceed smoothly.
Our coders specialise in behavioral health and medical infusion services. We apply appropriate CPT/HCPCS codes, ensure modifiers are used correctly, align documentation to payer expectations (monitoring, progression, supervision), and keep you audit-ready.
We submit claims promptly using clean workflows, monitor payments and denials, perform rootcause analysis on rejected claims, and manage the full A/R process until resolution. Our goal: faster cash flows, fewer surprises, and less administrative burden on your team.
You receive dashboards and monthly statements that track key metrics: first-pass approval rate, days in A/R, denial reasons, revenue per session, payer trends, and more. With this data, you can optimise your program whether you’re scaling up or refining operations.
Practice intake and patient scheduling alignment, so that clinical and billing workflows are integrated.
Insurance eligibility and benefits verification specific to ketamine infusion or intranasal therapy.
Prior authorization management across all payers (commercial, Medicare/Medicaid), including tracking, appeals, and denial management.
Service coding and documentation oversight for initial and follow-up ketamine treatments, including infusion setup, monitoring, drug administration, session tracking, supervision, and modifiers.
Claims submission, payment posting, under-payment review, denial appeals, and A/R recovery aligned with ketamine workflows.
Monthly review meetings, KPI tracking, and revenue-cycle optimisation recommendations tailored to your treatment program.
Audit-readiness support: documentation review, compliance checklists, payer communication support, and pre-audit preparation.
