How we fight

Griffin assists your agency in the Credentialing Process for your and medical staff. “Insurance Credentialing” is the process of obtaining, verifying, and assessing the qualifications of an agency and/or practitioner to provide care or services in or for a health care organization’s network.

Service providers that give medical and/or clinical interventions to individuals who rely on third party payors, must verify whether the insurance is valid and that the agency is eligible for reimbursement as per insurance guidelines. Verifying insurance coverage is a very important part of understanding if the patient’s insurance is active and whether it covers the services that need to be rendered.

Griffin will conduct “pre-authorization” on each individual admitted. Pre-authorization” is a process used to determine if the recommended procedure or services will be reimbursed by the insurance company. This can be referred to as “prior authorization”, “prior approval” or “precertification”. Many health insurances require preauthorization for certain services before they are rendered. Preauthorization is a notification to the third-party payor you are applying for services, listing the type of services and the initial diagnosis to establish an account for financial reimbursement.

Griffin continuously reviews client -specific documentation of the health care services provided, keeping a close watch of the documentation of the severity of the individual’s symptoms and their response to interventions, ensuring the services are appropriate to meet the individual’s needs and guarantee rapid reimbursements. Concurrent Review: Following the Preauthorization, StarMed Billing will perform “Concurrent” Reviews. We will maintain the relationship with the payor. Continuous relaying of the individual’s symptoms and their response to clinical interventions ensures for approval of extended stays in treatment, providing the individual with an opportunity to maximize the resources for long term growth. Retrospective Review: Griffin will perform “Retrospective Reviews”. A review with the payor of the clinical documentation and the individual’s response to treatment AFTER the services are rendered.

Griffin submits all claims for payment to third party payors. An insurance claim is a formal request to an insurance company for compensation for rendered services provided by a doctors’ office, hospital or facility. The insurance company validates the claim and, once approved, issues payment to the appropriate party in accordance to the payer’s policy and guidelines.

Failing to adequately work denials from payers translates to a lost in revenue for your medical practice. Griffin utilizes the nationally-recognized process for effective denial management— Identification, Management, Monitoring, and Prevention.

Griffin can accommodate both electronic payment posting and manual payment posting, depending on the need of your agency. Electronic payment posting removes the possibility of human error, ensuring faster and more accurate payments.

Griffin utilizes aggressive collection practices to ensure your revenue is maximized. Collections is the final phase of the billing process. We ensure bills received by each payer, are adjudicated timely. If an appeal is need, that is also part of the collections process as well.

Griffin customizes reports to give you informational summaries of billing activities, and allow you to monitor how different areas of your business are performing. In health care billing our summaries are comprehensive and provide a snapshot of any amount owed to the health care provider and provide reasons for lack of payment. This report is used to keep track of delayed receivables.