Nexus Bill
NexusBill is the fastest and most efficient way to manage the complex process of your claims reimbursement. The whole-team approach ensures that each member of your team understands how their role affects reimbursement. Over the course of 1 year your team will be trained on billing procedures with weekly coaching and on-demand support. Maintenance fees will be applied. Additional contracts per acceptance of services will be necessary based on payers. 1-year contract, renewable annually, renewal fees may apply.
Your team will:
- Become proficient in a Sleep/DMSD/TMD specialty medicine group practice & durable medical equipment network
- Have a team to help you and your patients do well: both clinically and financially
- Have options such as but not limited to: Out-of-Network, In-Network contracts for PPO plans: Aetna, UHC, UMR, Blue Cross, Cigna & more
- Connections with Specialty Physicians & nurse practitioners to supervise your patients and to provide the necessary face-to-face options, on-site or via telemedicine when needed
- Have a partner in reimbursement: Together we share the patient for best care & compliance
Nexus Bill has 3 phases:
Phase 1:
Establish Payor Landscape
• Learn how to process paperwork, learn the terminology
• Build claims experience + claim history
• Learn insurance landscape in area
• Understand who pays out-of-network, who needs in-network
Phase 2:
In-Network status
for office (if appropriate)
• Under offices NPI number
• Depending on rates Network Activation may be appropriate
Phase 3:
Billing Network Activation (if appropriate)
• Under Nexus NPI number
• Bill using our contracted rates
• IN-Network with major payors & plans
• Increased approvals
• Medical Director oversight
• Compliance oversight
• Continued team coaching to optimize medical reimbursement
Billing Network Activation
For practices that are experiencing roadblocks to reimbursement due to the local insurance environment or policies, the Nexus Network may be appropriate. Enrollment in the Nexus Network allows your practice to use our NPI number and our negotiated rates which may be higher than out-of-network through Nexus Bill. Participation in the Nexus Network includes case & compliance oversight by our Medical Director and continued coaching on a case-by-case basis to ensure optimal reimbursement. Your dedicated billing specialist will make recommendations for approval to be done with patient’s most favorable to your practice level of benefits. Each case will be analyzed to determine the best approach to proceed, utilizing the patient’s benefits In-network level or Out-of-Network level.
We will always guide you towards the billing option that pays the best rates in your area.
Contact us for a personal consultation:
