Specialized Medical Consulting Services

Transform your customer experience with medical consulting from Smart Healthcare Solutions. We recognize that success in service delivery can make or break your strategic advantage. Our team works with you to identify and bridge gaps, driving improvements that yield measurable and reportable results.

Smart Solutions

We craft business solutions tailored to your resources, budget, and technology, while considering their impact on your organization. Our approach helps you develop a customized roadmap that balances cost, quality, and revenue, optimizing outcomes for you, your customers, and your business.

What We Do

Practice Assessments Cover

Proper Use of Modifiers
Handling of Financial Plans
Front Desk Performance
Insurance Billing & Collections
Proper Billing for Services
Medicare Rules & Regulations
Auto & Workers Compensation
Maximizing Reimbursements
Assessment of EORs & EOBs
Insurance Appeals Procedures
Insurance Verifications (If Applicable)
Secondary Submission Procedures
Negotiation & Re-Credentialing of Managed Care Contracts
Patient Collections & Statements

Hospital/Insurance Company Services

Dispute Handling
Dispute Support
Report Analytics
Customer Support
Customer Service Center

Document Management

Imaging
Index & Labeling
Work Flow
Peer Review
Radiology Review
Nurse Review
Hospital Audit
Inbound & Outbound Mailroom Services
Automated Letter Generation
Medical Advisory Solutions
Independent Medical Exam (IME)
Physician Advisory Review (PHAD)
Telephonic Case Management (TCM)
Field Case Management (FCM)

Medical Bill Review

Automated Review
Fee Schedule
UCR
Rules, Flags, & Edits
Code Review
Utilization Review
Preferred Provider Organization (PPO) Network Access
Litigation & Arbitration Management
Out-of-Network Services
Payment Issuance
Claim Negotiations (For or with Provider)

Auto Solutions

DPR/Pre-Certification Services
Independent Medical Examination (IME)
Physician Review and Determination (PHAD)

Third-Party Audit & Analysis

Treatment Detail Report
Treatment Calendar
Level One through Level Four Solutions
Medical Bill Audit (Automated Bill Review)
Professional Code Review with Narrative
Professional Nurse Review with Narrative

Customer Service

We prioritize customer service, valuing and rewarding exceptional employees who drive client satisfaction. At Smart Healthcare Solutions, we enhance your service strategies through a blend of experience, hands-on training, research, and performance metrics. We help you develop approaches that exceed customer expectations. Contact us to learn more about our medical billing and consulting services.

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