Pre-authorizations And Eligibility Of Benefits

  • Verification and eligibility of all in-network and out of network benefits
  • Pre-authorizations start with assigning the appropriate code(s)
  • Knowledge of what clinical information insurance carriers need upon submission
  • Obtain Retro-authorizations
  • Obtain PIP ledgers to make sure there are sufficient funds on the policy to proceed with further treatment
  • Verify if patient chose their health insurance as the primary option on the policy
  • Knowledge of the internal appeal process for No Fault (PIP) claims
  • Interpretation of DOBI Rules on PIP reimbursements
  • Pre-authorization of Workman’s Compensation claims including knowledge of completion of the C4 form
  • Home Infusion authorizations – Alliance will inquire how many per diem visits, and their maximum limits allowed per year
  • Nursing visits, and refills for each specific medication that needs to be authorized along with the number of units allowed
  • Verification of ICD-10 codes and CPT codes including quantities and units needed
  • Monitoring of existing preauthorization expiration dates for processing of continued services
  • DME services will be authorized and verified
  • Pharmacy pre-authorizations – If the preauthorization needs to be initiated by the M.D., Alliance can collect all pertinent paperwork from insurance and/or the physician’s office to be completed

How to Find Us

Fill out the form and let us know how we can help

Alliance Medibilling, LLC.

37 W Century Rd.
Paramus, NJ 07652

Alliance Medibilling, LLC.

201-986-1003

Alliance Medibilling, LLC.

Email Us

Contact Us

[gravityform id=”1″ title=”false” description=”false” ajax=”true” tabindex=”49″ ]

Scroll to Top