Services & Solutions

Synergy Concepts revenue cycle management services and solutions

Synergy Concepts, Inc. is a specialized RCM company with expertise in Substance Use Disorder (SUD) and Mental Health care. Our team consists of seasoned professionals in benefit verifying, utilization management, coding, billing, collections, credentialling and compliance. We leverage continually advancing technologies and produce solutions tailored to address the distinct challenges faced by behavioral health facilities and providers. 

\Whether you’re a new facility or looking for a better medical billing partner, we are the optimal choice. We are all here for the same reason: to help people. At Synergy Concepts, we believe in handling the stress of claims and collections so that you can focus on helping your patients get better. Let our services help you operate your addiction treatment facility with ease.

Our Insurance Billing Services & Solutions

Problems suck, especially when insurance companies are playing games with paying your claims. Let Synergy Concepts deal with the insurance companies so that you don’t have to.

Verification of Benefits for Addiction Treatment

Synergy Concepts’ verification of benefits process is efficient, timely, and comprehensive. We want you to receive your VOBs as quickly as possible so that you and your patients are left waiting to start their addiction treatment processes.

Our verification of insurance benefits service standardizes admission processes to improve patient flow. As your authoritative source, we will navigate through the misinformation that is often provided by carriers and guide you through the proper documentation for a thorough utilization review.

60 minutes or less

We regularly achieve a 45-60 minute turnaround time. We utilize a combination of experienced verification team members together with our advanced technology for optimal speed and accuracy.

    • Timely: 45-60 minute turnaround time on average
    • Accurate: Cross-checked and thorough verification with 99.9% accuracy
    • Informative: Warning disclaimers on questionable or unreliable payers
    • Intensive: Double verification

Our Verification Specialists Retrieve:

    • Patient policy deductible and out-of-pocket responsibility
    • Co-insurance and co-payments
    • Benefit limits
    • Reimbursement estimates
    • Pre-authorization and clinical requirements for admissions

Read More about our VOBs!

Insurance Prior-Authorization & Utilization Management

Insurers are increasingly contracting with third-party vendors of utilization management programs, or “UM,” to administer the rehabilitation benefit. This can create both challenges and opportunities for behavioral health addiction treatment centers.

Before insurance companies will agree to pay for some medications, medical procedures, and medical equipment, they require advance notice. Utilization management programs are also an essential part of a provider organization’s revenue cycle, helping to prevent unnecessary costs and claim denials.

Our Behavioral Health Utilization Management Services Include:

    • Pre-authorization of services
    • Concurrent planning, discharge planning
    • Medical record review to determine proper documentation supporting billed medical services
    • Assist in educating clinical staff in medical record reviews and clinical case appeals, to show proper documentation that supports the billed services

Valuable Services

Experienced the value of our tried and true utilization management approach. We have an effective appeal process with elevated overturns and 44% of authorization denials. Let us help you control healthcare costs, increase revenue, and improve patient outcomes.

Read More about our Prior Auth and UMs!

Medical Billing and Coding

We know that the billing and insurance management processes are complex, frustrating, and time-consuming. Let us take these burdens off your shoulders.

Better Medical Billing & Claims

    • Electronic claim submission results in 99.9% clean claims
    • 4% of paid claims process under 60 days with an average of 23 days overall
    • 6% claim denial rates
    • 44.8% overturned denials through written appeals

Read More about our Medical Billing and Coding.

Denial Management

Swift resolution of claim denials through thorough analysis, appeals, and continuous process improvements to minimize financial impact.

Synergy Concepts creates specialized denial management services, designed specifically for addiction treatment facilities like yours. With our expertise in tackling complex claim denials from insurance companies and third-party payers, we can help you optimize reimbursements while reducing administrative burden.

Benefits of Working with Us

    • Comprehensive Denial Identification
    • Strategic Appeal Process
    • Actionable Insights & Reporting
    • Maximizing Revenue Recovery

Read more about our Denial Management.

Revenue Optimization

In today’s rapidly evolving market landscape, maximizing revenue is crucial for sustained success. That’s where our expertise in revenue optimization comes into play. We have a deep understanding of the challenges faced by clinics like yours. Our team has experience helping numerous facilities achieve remarkable growth through tailored strategies.

Our revenue optimization service offers a comprehensive approach that analyzes various factors impacting your bottom line. By leveraging cutting-edge technology and data-driven insights, we develop customized solutions specifically designed to meet the unique needs of facilities like yours. With our revenue optimization service by your side, you can empower yourself with valuable insights into your facility’s revenue cycle management process.

  • Comprehensive Claims Management
  • Coding Excellence
  • Fee Schedule Analysis
  • Denial Minimization Strategies
  • Insurance Contract Negotiation Support
  • Advanced Reporting and Metrics
  • Technology Integration & Automation

Read More about our Revenue Optimization.

Compliance Management

As a professional in the substance abuse treatment industry, you understand the importance of compliance management in your medical billing processes. It’s a complex task that requires a deep understanding of ever-changing regulations, meticulous attention to detail, and a significant amount of time and resources.

That’s where we come in. At Synergy Concepts, we specialize in providing comprehensive compliance management services tailored specifically for addiction treatment facilities like yours. With our expertise and dedication, we can ensure that your billing processes are not only efficient and accurate but also fully compliant with all relevant laws and regulations.

  • Regulatory Compliance
  • Risk Management
  • Training and Education
  • Documentation and Reporting
  • Peace of Mind

Read More about our Compliance Management

Credentialing and Contracting

By increasing the pool of patients our clients can accept and receive a profitable payment from their patient’s insurer.

You have undoubtedly witnessed the ever-evolving addiction treatment landscape and understand the importance of staying up-to-date with industry standards. This is where our credentialing and contracting service comes into play.

Our team at Synergy Concepts specializes in assisting experienced professionals like yourself in obtaining essential certifications such as Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS). We understand that navigating through various requirements can be overwhelming, which is why we offer comprehensive support throughout the entire process.

By partnering with us, you will gain access to a wealth of resources tailored specifically to enhance your expertise and boost your career prospects within medical billing.

  • Customized Guidance
  • Compliance Assurance
  • Ongoing Education Opportunities

Read more about our Credentialing and Contracting.

Aging Accounts Receivable in Behavioral Health Clinics

At Synergy Concepts, we have found that many addiction treatments and behavioral health facilities have large dollar amounts of outstanding accounts receivable.  We encounter this problem many times even when the facility has a billing solution partner. We have solutions and systems to help you significantly reduce or even eliminate your aging accounts receivable.

How Our Accounts Receivable Works

    • Probability of Reimbursement
    • Research Claims
    • Determine a Plan
    • Provide Comprehensive Reports

Read More about our Againg Accounts Receivable.

Medical Billing Solutions for Addiction Treatment

Working with Synergy Concepts will help you maximize collections, reduce time to payment, and decrease expenses by taking the unpredictability out of behavioral health medical billing and collections.

Our bottom line is improving our clients’ bottom lines, which means getting revenue in the door faster. We help behavioral health practices achieve this by improving their insurance billing and patient invoices, collections methods, and payment validation and posting processes to reduce average A/R days outstanding.

How We Increase Revenues

    • Accurate coding and claims management
    • Thoroughly documented claims collections
    • Expert payment processing and posting
    • Dependable, easy-to-use software tools
    • Seamless integration with EHR applications

Read more about our medical billing solutions.

Consulting and Training

Synergy Concepts offers consulting services and training services for a myriad of behavioral health billing and insurance management processes. We have over 20 years of historical data and professional behavioral health insurance billing experience. Our goal is to help you gain a deep understanding and knowledge of the relevant ethics and laws in the behavioral health industry that will enable you to offer a higher quality of care for your patients.

Choose Full Cycle Medical Billing or Customize Services

Choose the level of service that is best for you. We provide services for all areas surrounding behavioral health medical billing.

Behavioral Health Insurance Billing Services

Consulting Services

Whether you have an in-house behavioral health medical billing team or you are looking for help with a specific area of your practice, we are here to help. We can provide an in-depth analysis of your facility’s revenue cycles. Beyond the basic behavioral health medical billing services, we offer comprehensive consulting services including:

    • Credentialing & Contracting
    • Coding & Chart Auditing
    • Collections & Billing Process Improvement
    • Internal Controls Assessment & Improvement
    • Fee Schedule Analysis
    • Benchmarking

Read More about our Consulting and Training.

Financial Reporting

Synergy Concepts simplifies the insurance management process for you by providing accurate financial reporting of your addiction treatment and behavioral health program’s performance. The report of claims is updated daily and is accessible when you need it.

Track your data

Our reporting is made possible through our advanced technical data system, which is viewable with updated reports of claims status via our enhanced portal. Our team is continuously working to refine and improve the means of providing you with the analytics and reports you need to monitor your key performance areas.

Performance Areas Include

    • Verification of benefits
    • Conversion rates
    • Average allowed
    • Paid amount for each insurance carrier at each level of care
    • Current and trending payer mix
    • Census trends
    • Average authorized days at each level of care
    • Revenue tracking and trends

Read More about our Financial Reporting.

Reporting Behavioral Health Billing and Claims

We know that the billing and insurance management processes are complex, frustrating, and time-consuming. Let us take these burdens off your shoulders.

Insurance Management Process

As your behavioral health billing partner and extended team, we offload these burdens with our experienced insurance and claim management team’s skills that are refined and perfected. As a result, you can expect decreased denials, overturned claim denials, and full transparency for improving your revenue and cash flow management outcomes.

The specialist experts at Synergy Concepts understand and keep pace with the evolving behavioral health billing and insurance management processes.  Our cost-effective billing solutions help you to achieve better billing and claim results.

Better Medical Billing & Claims

    • Electronic claim submission results in 99.9% clean claims
    • 4% of paid claims process under 60 days with an average of 23 days overall
    • 6% claim denial rates
    • 44.8% overturned denials through written appeals

Behavioral Health billing experts you can trust

Behavioral health medical billing is not a “one size fits all” solution. Finding the right partner that understands your practice, specialty, and billing needs can be difficult. We specialize in behavioral health medical billing so that we can focus our efforts on your facility.

Contact us today so we can show you why we are the behavioral health billing solution you need.

Revenue Cycle Management

Revenue Cycle Management (RCM) is the administration of financial transactions that result from the medical encounters between a patient and a provider, facility, and/or supplier. These transactions include, without limitation, billing, collections, payer contracting, provider enrollment, coding, data analytics, management, and compliance.

From claims submissions and receivables to coding and compliance, we can help you run your billing processes much more efficiently.

Read More about our Revenue Cycle Management.

Special Operations for Addiction Treatment

We collaborate with our clients using special operations – providing the information and tools your staff needs for successful admissions, utilization reviews, and treatment.

Insurance companies are tricky. Some of your billing claims will be returned and you have no idea why. Trying to figure out the “why” can be time-consuming which takes you away from your passion for helping your patients through their addiction treatments. Synergy Concepts specializes in tricky insurance companies and wants to take that headache away from you.

Read More about our Special Operations.

VA Addiction Treatment Solutions

We help your facility become an authorized Veterans Administration addiction treatment facility. Our veterans deserve the best of treatment and care for serving our country and we want to help you help them.

Becoming a VA community care provider can be a complicated process. Synergy Concepts is here to help. We work with you to become a TRICARE and VA contracted provider, which allows you to give back to those who served our country through the VA Community Care Network.

Read More about our VA Addiction Treatment Solutions.

Contact Synergy Concepts for Solutions

We specialize in behavioral health so that we can remain laser-focused on your patient claims. Let’s work together to help people get better.