Alvarez Consulting Blog

                                   An ongoing series of informational entries


Each insurance company has specific guidelines.  A provider manual is a document which sets forth the policies and procedures your clinic should follow in handling your day-to-day insurance transactions with the insurance company

The guidelines can be found in the Provider Manual. Some guidelines can be different depending on the insurance company.

When a  contract is approved  to join the network it is a good idea to obtain the program manual from the insurance company for your specialty. In the provider manual you will usually find information on how to obtain a prior authorization. Any forms needed will also be provided by the insurance company.

We treat practices well. 

Please contact us for a consultation today! (877) 811-0553


What is an authorization or prior-authorization?

Insurance companies from time to time require services to be pre-approved or pre-authorized.

Depending on the patient's medical plan, certain services may need approval from the health insurance carrier, before they’re covered. 

It is a good practice to check the eligibility, benefits and whether or not services need to be authorized before the patient is seen at the office.

This standard practice should be implemented for each new patient.

Did you know prior authorizations can affect your billing and revenue?

If you have any questions, please feel free to contact 

Alvarez Consulting & Management Services for a consultation. 

We treat practices well. 

Don't hesitate.  Call Today!  (877) 811-0553

Alvarez Consulting Blog

An ongoing series of informational entries

Problems / Solutions

Every entity has a business aspect to it. If you are a doctor you have probably heard the term "the business side of medicine". Although you probably don't want to think of your clinic as a business, the truth is that there is a business aspect to your practice that cannot be ignored.

When a practice assessment is performed we look at different areas and determine the "wellness" of your practice. Your practice has a pulse and a heart rate. 

In a Medical Economics article the writer tells of a time he visited a three-doctor practice and there was only one clerk submitting claims. The inexperienced clerk sent out many of the forms weeks late and had no time for follow up. The practice collection ratio was not where it could be. Follow up is a fundamental building block of your practice. Let us assess your practice and determine whether we can increase your revenue. Contact Alvarez Consulting & Management Services today for a consultation. We treat practices well.

medical billing coding alvarez consulting

 Doctors HealthCare Plans Mental Health

Effective Feb. 1, 2022, Magellan will no longer manage the Community Behavioral Health (CBH) and Targeted Case Management (TCM) services for the Medicare Advantage Dual Eligible Special Needs Plan (DSNP) members for Doctors HealthCare Plan. What does this mean for you?  Simply put, credentialing and contracting will be handled by Doctor's Healthcare Plan directly.  Please call us for all of your credentialing and contracting needs.  877-811-0553


A partir del 1 de febrero de 2022, Magellan ya no administrará los servicios de Community Behavioral Health (CBH) y Targeted Case Management (TCM) para los miembros del Medicare Advantage Dual Eligible Special Needs Plan (DSNP) para Doctors HealthCare Plan. ¿Qué significa esto para ti? En pocas palabras, la acreditación y la contratación serán manejadas directamente por Doctor's Healthcare Plan. Por favor llámenos para todas sus necesidades de acreditación y contratación. 877-811-0553


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