Setting the standard to successfully process and manage claims for the highest insurance reimbursements.

Optimal Billing Solutions specializes in over 100 areas of healthcare billing, making us one of the most diversified and leading billing services in the country. Our team is here to help you focus on your patients, while we focus on getting you paid. We specialize in billing for all levels of care including detoxification (DETOX), residential (RES), partial hospitalization (PHP), and intensive outpatient (IOP).

If you are new to billing, have been billing in house or with a third party billing company, we will make the transition very smooth as you onboard with Optimal Billing Solutions.

We offer something no other billing company offers... Our clients are always in control of their reports and have full access to their account at all times.

Each facility has their own dedicated Account Supervisor who will TRAVEL to you and set you up to bill in house or you can have our team handle all the billing through us. We have customizable options for your billing needs.

Watch our short 2 minute video on how Optimal Billing Solutions bills for your facility and why we are the best in the business.

Behavioral Health Services

Dedicated Legal Counsel

  • Dedicated attorney who specializes in billing best practices, audits, consultation, and account reviews
  • Payor trends, government and policy changes to federal and state laws, level of care guidelines and criteria
  • Expertise in zoning and licensure

Credentialing and Account Set Up

  • Single-case agreement and in-network contracting negotiations
  • Enrollment with insurance payors to collect reimbursement
  • Onboarding and unlimited training of all financial forms for your patients to fill out upon admission
  • Dedicated Account Manager

Utilization Review

  • Optimal Billing Solutions Utilization review team works with insurance providers to obtain coverage for the entirety of your client’s treatment needs. Going beyond expectation, our educated professionals utilize their professional and inter-personal experiences which provide them the ability to address a clinical picture in its totality. In customizing a specific client process from intake; levels of care to length of stay; our highly experienced Utilization team gets its clients covered. While simplifying and effectively communicating complex information, our healthcare professionals excel under pressure. Maintaining strong medical and health science backgrounds with extensive knowledge in Mental Healthcare; Substance Abuse care; Chiropractic; and medical practices; the Utilization team's foundation is the client's needs.

Billing and Collections Management

  • Claim scrubbing software
  • Electronic claim submission for quicker reimbursements
  • UB04 & HCFA-1500 billing with appropriate ICD10 coding
  • Real time and customized reporting
  • Extensive follow-up on unpaid claims
  • 24-hour hotline and excellent customer service

Frequently Asked Questions (FAQ):

Q: Do you bill for physician groups or just treatment facilities?

A: Yes. Optimal Billing Solutions bills for doctors’ groups, physician groups and facilities including those who render services for the Detox, Residential, PHP, IOP, and Outpatient levels of care. We also bill for ancillary services like appropriate UA testing, chiropractic, wellness and acupuncture services, smoking cessation, and other services depending on your program.

Q: How soon can I start billing if I never billed insurance before?

A: We can get you started within 2 weeks.

Q: My facility admits patients on weekends and afterhours, will you still be able to verify their coverage?

A: Yes. Depending if the insurance company is open, we have full-time weekend staff who can help you. We have software that gives us a good idea based on the policy prefix information what that policy typically covers, then we can when the insurance company is open to verify on the phone with two rounds of live call checks.

Q: Do you provide training on all documents that our patients need to sign and those we are responsible for sending over to you?

A: Yes and our training is unlimited. If you have new staff or existing staff that need a refresh on their training, we can assist via online Skype and/or travel to your facility.

Q: I have an in house UR team, do I need to contract your UR services or can I just have Optimal Billing Solutions handle my billing and collections only?

A: Yes, we can customize a package for you that best suits your needs. Each facility has their own dedicated Account Supervisor who will TRAVEL to you and set you up to bill in house or you can have our team handle all the billing through us. We have customizable options for your billing needs and a la carte services.

Q: What makes Optimal Billing Solutions better than the others?

A: We know the headaches that come with finding the right billing company. Many concerns we hear is the lack of communication and timely results. While we have a very large operation and bill for numerous healthcare specialties, our Behavioral Health and Addiction Treatment Billing team is comprised of experienced staff who know the ins and outs of this industry. They will give you that interpersonal communication vs. a large overwhelming staff that do not know you on a name to name basis. Our team is the perfect mix of a having a fully equipped outside billing company to give you that in-house, personal feel.

We also have an in house Legal Affairs Attorney who handles all audits, client and insurance issues, billing best practices and consultation. This is included with your account so we can make sure you are set up the legal and proper way to bill reducing any red flags from insurance carriers.
Behavioral Health ServicesBehavioral Health Services