The Affordable Care Act (ACA) requires insurance carriers to cover certain routine services. As a result, universities nationwide are making the decision to bill students’ insurance carriers directly when they receive routine services within the university setting. Although this is a revenue-generating opportunity, it also creates a whole host of challenges related to contracting and provider enrollment. Some carriers refuse contracts with university providers because these health centers are not open to the public. Other carriers have specific requirements for enrollment that are complex and extremely nuanced.
As universities continue to branch out and take advantage of the ACA’s new coverage requirements, they need a strong billing partner that can navigate this uncharted territory with them.
Following is a list of the services we provide:
- Front-end contracting and provider enrollment. Simply obtaining contracts is challenging. NEMB’s staff works diligently to understand enrollment requirements to expedite the process.
- Comprehensive coding and billing services. NEMB specialists know what E/M codes to report for the services rendered in the university setting. We scour documentation to ensure correct code assignment and manually review each claim before sending it.
- Referral management. When students require referrals from primary care physicians, NEMB specialists go the extra mile to obtain those referrals. We notify and educate university staff members about referral requirements.