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Scope of Service – Facility Partner

Scope of Service

What services does Sleep Apnea Treatment Centers of America provide their Facility Partners – Ambulatory Surgery Centers, Vascular Access Centers, Urgent Care Centers, and Hospitals?

Our company, SATCOA, has created a comprehensive treatment program that allows ASCs, VACs, UCCs, and hospitals identify the estimated 80-90% undiagnosed OSA patients and offer them curative treatment options.

Our protocols identify potential OSA patients in ASCs, VACs, UCCs, and hospitals. The patients are screened by using simple screening tools such as, the STOPBANG questionnaire. When the questionnaire concludes, the facility partner physician prescribes and sends the patient home that day with a home sleep test (HST) device. The patient returns the device the next morning. Less than 24 hours later, the ASC, VAC, UCC, or hospital has the HST report, which has been read by one of SATCOA’s board-certified sleep physicians.

If the test is found to be positive for sleep apnea, the patient is referred to a SATCOA trained, independently contracted ENT to assess the patient’s candidacy. If the patient is found to be a candidate, he or she is started on our treatment algorithm designed to cure OSA. The surgical OSA patient is started on autoPAP preoperatively and encouraged to use the autoPAP during the post-operative period throughout the treatment program. The non-surgical patient is also started on autoPAP and begins the treatment program as soon as practical.

Our procedure is between 37% and 72% effective in eliminating the need for CPAP in severe OSA and mild OSA, respectively. We spend the necessary time to gain a thorough understanding of each patient’s sleep disorder and individual medical needs to effectively provide the best care and treatment solutions available.

Excellence in Clinical Operations and Patient Delivery Model

Clinical Operations

Our clinical operation’s best practices allow our comprehensive treatment platform to be utilized without adding stress to your current staff. Our clinical operations and patient delivery model drive accelerated, sustainable improvements in quality care, patient satisfaction, and financial performance.

• Compliance training and clinical audits
• Capacity planning and management cycle
• Training of all physicians and related staff
• Protocol support to track all patient outcomes
• Setting up procedures to ensure full
• HIPAA compliance
• Creation of best practices, quality of care initiatives,
and efficiency programs unique to your facility

Streamlining Insurance Reimbursements – Medical Billing

Medical Billing

SATCOA’s team of billing experts handles the entire process from insurance pre-certification/verification through reimbursement. Our medical billing department coordinates the health care billing, payment, and claims reconciliation process for each of our facility partners. Our medical billing team has the luxury of focusing and becoming experts with one CPT code, CPT 41530.

While a prospective patient is on the phone speaking with one of our medical concierges, he or she is seamlessly sent to SATCOA’s medical billing department for real-time insurance verification and pre-certification. By using all electronic transactions, our facility partners are eliminated from many of the manual daily processes, so more time can be spent on direct patient care. Our medical billing department has decades of experience in experimental and conventional medical billing and have been over 97% successful overturning denials for coverage.

SATCOA’s proprietary medical billing system provides our facility partners with real-time access to reimbursement forecasting and financial reporting. Our medical billing team integrates within and works with our partners to establish and set financial policies relating to co-pay collections, trigger-points for escalating collection efforts, and write-off guidelines.

Our medical concierge team and billing experts handle the following:

• Insurance Verification: Our medical concierge team pre-certifies and verifies each patient’s insurance.
• Demographic and Chart Entry: Our medical concierges enter each patient’s information into appropriate electronic medical record (EMR) and customer relationship management (CRM).
• Coding and Audits: Our medical billing team compiles CPT and diagnosis codes based on carrier requirements.
• Claim Submission: Our medical billing team submits audited claims and coordinates with carriers for processing.

• Payment Posting: Our medical billing team applies the payment to the appropriate patient account.
• AR Analysis: Our accounting department insures claim problems are identified and resolved.
• Optimizing Billing and Insurance Reimbursements
– Management and set up of cloud-based EMRs
– Corporate billing management and collections
– Streamlined billing, appeals, and collection management staff at corporate office
– Patient pre-certification and insurance verification coverage

Accounting: All Back Office Needs and Support

Accounting

By fully integrating the business operations of each location with our corporate office’s centralized accounting department, SATCOA assists our facility partners with various accounting functions. It is our goal to help reduce the amount of time that you will need to spend on accounting. SATCOA’s accounting department guides our facility partners through today’s complex issues associated reimbursements and collections under the scope of practice management. SATCOA’s accounting department understands that the financial success of our facility partners’ operations or business is no longer solely dependent upon the skills of the medical professional. SATCOA’s accounting department  tracks revenues, improves cash flow, and enhances profitability.

• Legal support for licensing and credentialing
• Extensive medical and business instruction and training
• Daily, weekly, and monthly real-time financial reporting
• Accounts payable
• Accounts receivable
• Create profit & loss statements

Accurate and timely financial reporting is critical to the success of any healthcare organization. From daily accounting to statistics that measure capacity statistics, SATCOA’s team specializes in performing all the necessary financial functions to ensure operational efficiency. SATCOA’s financial services are tailored to meet the individual needs of our facility partners, thus allowing our partners increased time and flexibility to focus on providing exceptional patient care.

 

Enhanced Patient Experience

Scope of Service   |   Patient Experience Management   |   Diagnosis and Screening   |   Medical Literature

SATCOA PxM

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