Out-of-Network Claims Identification & Recovery
Zero Risk. Maximum Reimbursements.
Are you tired of leaving money on the table due to unpaid out-of-network claims with Aetna, Cigna, or UnitedHealthcare? Wakefield is here to help you maximize your reimbursement potential by recovering the full value of your services. With extensive knowledge of payer strategies and cutting-edge technology we have developed a unique approach that works alongside your billing team to optimize the highest out-of-network payments.
Upfront Recovery: Negotiations Service
When 3rd party vendors reach out to negotiate an upfront settlement, we step in using our proprietary data to maximize these reimbursements. Our typical providers have seen an average increase of 59% from initial offers. Some providers will see reimbursements as high as 90% of charges!
Post-Payment Recovery: Appeals Service
Collect Rx utilizes technology & specialized expertise to comb through payor portals, EDI feeds, and EOBs to identify denials, underpayments, and 3rd party priced claims. We then use our proprietary data to challenge the pricing decision and recover you more money. On average we increase our clients’ initial payments by 87%!
Other Services We Offer
If you're looking for revenue cycle services to assist a Hospital, ASC, Physician Group, Behavioral Health Facility, Lab & Diagnostic center, Dental Office, or Emergency Medical group, you came to the right place! Check out our service offerings below to learn which solutions are best suited for you.
Self-Pay & Early Out
Designed to contact patients early in the A/R cycle using a courteous and consultative approach to help patients find a way to pay their debt. We become an extension of our Client’s mission, vision, and values in all interactions with your employees and patients.
Billing & AR Management
Our staff reviews claims that need to be appealed or were billed incorrectly to resolve any problems with the documentation in order to receive payment taking that burden off of the client.
Bad Debt-Purchasing Debt
Many clients utilize Wakefield as a first and second placement option. We create a custom program for every client that ensures the monitoring of your accounts for compliance with your desired work standards and industry regulation.
Extended Business Office
With quick implementation, minimal IT assistance, and low cost, we work directly in your system for your short- or long-term needs. We integrate with outbound communication attempts and can build new, more enhanced workflows as needed.
Legacy AR
Outsourcing accounts from your legacy system can provide a clean start, allowing your staff to focus on learning the new system. Special Projects can be tailored to your specific needs
Complex Claims
Wakefield has the resources to handle this service line effectively and, in an attorney-driven environment by geographic and state region with a specialization in the related fee schedules and associated requirements.
