We don’t just submit claims. We create visibility and accountability around every unpaid claim—so management knows what’s being worked, what’s stuck, and why.
Know What’s Happening With Every Unpaid Claim
Behavioral health billing with complete visibility and accountability
98.1%
Clean Claim Rate
1.47%
Rejection Rate
0.32%
Denial Rate
5–10%
Denial Rate
10–20%
Average Revenue
Improvement
$0
EHR Software Fee
With Billing Services
With Billing Services
CLAIMS VISIBILITY
Your Claims May Be Getting
Submitted. But Are They Getting Paid?
Submitting a claim is only the beginning.
Your Claims May Be Getting
Submitted. But Are They Getting Paid?
Revenue is lost when rejected claims aren’t corrected, denials aren’t resolved, authorizations expire, payer requests go unanswered, and unpaid claims disappear into spreadsheets and work queues.
DENmaar gives behavioral health practices a clear view of:
- Which claims remain unpaid
- Why each claim is stuck
- What action has been taken
- Who is responsible for the next step
- When follow-up is due
- What the payer said during the last follow-up
- Which payers and problems are creating the most lost revenue
You no longer have to accept, “We’re working on it.”
You can see exactly what is being worked, what happened and what comes next.
The Improvement in Claims Can Pay for DENmaar
any practices are already losing more money through preventable claim problems than they would spend fixing them.
For a practice collecting $100,000 per month
6% = +$6,000 / month
in realized insurance revenue
That improvement alone could offset the cost of DENmaar’s billing services.
- Behavioral health EHR software at no additional cost
- Claims Copilot
- Eligibility and insurance workflows
- Payment posting
- Rejection and denial management
- Aging-claim follow-up
- Reporting and management visibility
- Support from DENmaar’s Insurance Knowledge Team
Claim Lifecycle
Every Claim Has an Owner, a Status
and a Next Action
DENmaar creates a structured process for managing the entire claim lifecycle—from appointment readiness
through final payment.
01
Prevent Problems Before Submission
Eligibility, payer, authorization, credentialing and documentation issues are identified before they become rejected or denied claims.
02
Submit Clean Claims
Claims are reviewed for common errors and payer requirements before submission.
03
Monitor the Payer Lifecycle
Claims are tracked after submission so unresolved claims don’t quietly disappear into aging.
04
Assign the Next Action
Every problem claim has a clear status, responsible team member and required next step.
05
Document Every Follow-Up
Management can see when follow-up occurred, what the payer said and what must happen next.
06
Escalate Unresolved Claims
Claims receive additional attention before filing limits or appeal deadlines are missed.
07
Measure Performance
Monitor clean claims, rejections, denials and aging by payer, provider, location, service and responsible team member.
Management Visibility
Your Billing Operation Shouldn’t Be a
Black Box
Monthly reports tell you what has already happened. DENmaar provides visibility into
what is happening now.
Visibility creates accountability.
A practice should not have to wait until collections fall to discover that claims aren’t being worked effectively.
- Whether claims are being worked consistently
- Whether follow-up is producing results
- Why claims remain unpaid
- Whether the same errors keep recurring
- Where responsibility for the next action sits
- Which workflows or team members need support
- Which payers are causing the most problems
- How much revenue remains at risk
Visibility creates accountability.
Accountability creates action.
Action moves claims toward payment.
Improve the Team You Have—or Let DENmaar Manage the Process
Some practices already have an internal billing team but lack the technology, payer knowledge and management visibility required to oversee it. Others want an experienced partner to manage the entire revenue cycle.
OPTION 01
Claims Copilot for Your Existing Team
Give your billing staff the structured workflows, claim intelligence and accountability tools needed to manage unpaid claims more effectively. Management gains visibility without immediately replacing the internal team.
OPTION 02
Full Revenue Cycle Management
Let DENmaar manage claim creation and submission, rejection correction, payment posting, denial resolution, insurance follow-up, aging claims, payer escalation, patient balances and revenue-cycle reporting.
Either way, management gains control over the revenue cycle.
Behavioral Health Expertise
Built Specifically for Behavioral Health
Behavioral health billing requires more than generic claim submission.
Mental health therapy
Psychiatry and medication management
Substance-use treatment
Intensive outpatient and partial hospitalization programs
Community behavioral health
Multidisciplinary practices
Telehealth billing
Time and unit requirements
Rejections and denials
Built Specifically for Behavioral Health
- Behavioral health payer carve-outs
- Eligibility and benefit verification
- Prior authorizations
- Provider credentialing
- Therapy and psychiatric coding
- Same-day services
- Telehealth billing
- Missing or incomplete documentation
- Coordination of benefits
- Rejections and denials
- Aging insurance balances
Before Billing Begins
Problems Are Often Created Before Billing Begins
Many claim problems originate before the claim reaches the billing team.
An appointment may be scheduled with the wrong payer. Eligibility may not be verified. An authorization may be missing. Documentation may not support the code or units billed. A provider may not be enrolled correctly.
DENmaar connects scheduling, eligibility, authorizations, documentation and billing in one operational system.
This helps prevent bad claims—not merely work them after they fail.
Prevent the problem upstream.
01
Scheduling
Right payer • right workflow
02
Eligibility & Authorization
Verify before service
03
Documentation
Support code and units
03
Billing
Submit cleaner claims
More Than Billing
Technology, Insurance Expertise and
Human Follow-Through
Most billing companies provide reports. Most software companies provide tools. DENmaar combines:
Technology, Insurance Expertise and
Human Follow-Through
You get a system designed to improve the financial performance of your behavioral health practice.
Enterprise capability with small-practice simplicity.
- Behavioral health EHR technology
- Claims Copilot
- Revenue-cycle services
- Insurance knowledge
- Human payer follow-up
- Management visibility
- Operational accountability
Billing Review
See What Better Claims Performance Could Mean for Your Practice
If too many claims are rejected, denied, aging or simply unexplained, let’s look at the process together.
Current monthly insurance revenue
Baseline performance
Clean-claim rate
Rejection and denial rates
Claims over 30 days
Value of unpaid and aging claims
Follow-up process
Where accountability is breaking down
Let’s Determine Whether There Is Operational Alignment
We begin with a discussion focused on:
- Organizational structure
- Insurance workflows
- Operational goals
- Implementation fit
Request Information
Capterra, Software Advice And Get App 2023 / 25
Best Of Badges Awarded To DENmaar
2023 / 25 “Best of” badge winners = DENmaar Neuro has earned a well-deserved Best Value Badge.
See our reviews for our software being recognized as an impactful solution for your business.
Our Latest Blogs
Top Insurance Companies to Be Credentialed With
What are the top insurance companies to be credentialed with?
It wasn’t long ago when practitioners considered credentialing to optional. You could start your own practice and derive profits from it without ever caring for credentialing. Plus, insurance companies weren’t even allowing certain medical practices like mental health clinics a place on their panels.
Fast forward to modern time, and things are not what they were just a couple of years ago. Credentialing has become crucial for medical practices to survive in an increasingly volatile and competitive industry.
Most American citizens today are covered by an insurance plan provided by some company or the other. If a budding practitioner fails to get credentialed with the insurance companies, then he will lose clients to his competitors.
Hence, having the knowledge of the top insurance credentialing companies is essential in a practitioner being able to thrive in the industry.
So let’s look at some of the top insurance companies to be credentialed within the USA.
So, there are a few ways to determine which top insurance companies in the USA are the biggest in terms of a client base. Their popularity can be due to the following factors:
- Companies Goodwill
- Lives Covered
- Company revenue
- Accessibility etc.
Based on the above factors, we were able to list down the following behemoths. If you are a provider looking to get credentialed, you might want to get in touch with them.
1) United Health Group
Our first name on the list is ranked 3rd on the 2019 fortune 500 lists. United Health Group is a for-profit healthcare company based in Minnesota. As of 2019, it is one of the largest healthcare insurance companies in the world with total revenue of $226 billion, along with 115 million customers. It is divided into four divisions that together provide health benefit plans and services for large national employers, to individuals age 50 and older, to serve state programs that care for the economically disadvantaged, and medically underserved.
2) Anthem
Anthem INC is also one of the largest providers of health insurance in the United States. As of 2019, the company has over 40 million customers under its belt. It is one of the largest for-profit healthcare companies in the Blue Cross Blue Shield Association. Today it operates as Empire blue cross blue shield in the state of New York and as Anthem Blue Cross Blue Shield in 10 other states.
3) Aetna
Aetna is recognized as one of the leading providers of health insurance in the United States. Aetna continues to grow stronger, with millions of users enjoying its medical plan. Hence many physicians and medical practitioners want to become participants in the Aetna healthcare network. The company’s extensive network includes over 22.1 million medical members, 12.7 million dental members, 13.1 million pharmacy benefits management members, 690,000 primary care doctors, 1,200,000 healthcare professionals, and 5700 hospitals.
4) Humana
Humana Inc is a health insurance company based in Kentucky, Louisiana. Over the years, it is responsible for amassing over 13 million Americans into its healthcare program. With revenue of $41.3 billion, Humana was ranked 56 on the Fortune 500 list.
Now, Humana credentials and re-credentials all licensed independent practitioners including physicians, facilities and non-physicians who fall within its scope and authority.
5) Cigna
Cigna is a popular American health service organization based in suburban Bloomfield, Connecticut, and Philadelphia, Pennsylvania. Their insurance subsidiaries are major providers of mental, dental, accident, and life insurance to American citizens.
Cigna is known to provide Medicare and Medicaid programs to an individual in the US and some international markets. Hence many physicians and medical practitioners want to become participants in the Cigna healthcare network. To become a participant, however, healthcare services need to apply for Cigna Insurance Provider Credentialing.
According to Market Share, US News and World Report rated the following top insurance companies to be the most popular in the US.
- United Health
- Kaiser Foundation
- WellPoint INC.
- Aetna
- Human
- Independent Blue Cross Group
- Highmark
- Cigna
- Blue Shield of California
How Denmaar Can Help you Get On these Panels
Getting on insurance panels has never been as crucial as it has been today. With many American citizens now covered under an insurance program, it would be foolish not to get credentialed with an insurance company. However, credentialing has also become a challenge because most panels are almost full and are not taking in new providers.
Denmaar knows the credentialing world from top to bottom. We have assisted many practitioners, both group and private through the entire credentialing process and continue to do so till date. We are the insurance credentialing experts you need to crack the overwhelming process of credentialing for the best of your merits. At Denmaar we do the heavy lifting, so you can concentrate on tending to your clients.
Insurance Credentialing and Contracting-Their Merits
When it comes to insurance credentialing and Contracting, you have to understand that they are two sides of the same coin. Both need to seamlessly go hand in hand for an individual or group practice to get on insurance panels.
In this article, we’ll try to simplify the concepts of both Insurance Contracting and credentialing and find out how the two concepts intertwine with each other.
Insurance Credentialing
Credentialing is a process providers need to mandatorily undertake if they seek to serve clients covered by the federal insurance program. The applying provider needs first to verify his/her professional records to get credentialed.
This includes NPI, CAQH, professional licenses, diplomas, certifications, attestations, references, etc. All of these documents are essential to verify the accuracy and reputation of the concerned provider.
The same process applies if the Individual provider is applying for privileges in a group practice such as hospitals and surgery centers. They will be asked to submit a completed application which would be later sent to the credentialing entities for verification.
They will request the provider’s professional documents which may include National Data Bank records, credit card records, and criminal background searches.
They will also indulge in what is called primary source verification, which basically means verifying the source of the provider’s diplomas and educational certificates. There is no way to avoid this as hospitals are mandatorily required to check the above-mentioned documents to protect their patients from bad actors.
The Entire Credentialing process can be summed up as follows:
- Getting Information in Order
- Filling out the CAQH form
- Contacting Provider Relations
- Submit Application
- Reviewing Contract after Approval
As you can see, Insurance credentialing is a lengthy process. It is advised to seek help from third-party service providers like Denmaar to efficiently carry out the overwhelming process. The entire Insurance Credentialing and Contracting process culminates with the approval of the contract by the insurance company.
Contracting
If credentialing was the process of gathering and submitting information, contracting is the process of submitting the information and obtaining credentialing approval. This is where the provider finally obtains participation on an insurance panel. This means he/she can now take in clients that are covered by the health insurance coverage of that particular company. We often see providers enroll in these plans, only never to renew them again.
It is almost as if they forget that their application with a said insurance panel comes with an expiration date. A lot of time may pass by, and insurers may not review your contract, thus failing to reflect on the provider’s reimbursement rates. This spells a recipe for disaster as it can lead to thousands of dollars lost and payments interrupted.
Denmaar’s Insurance Credentialing and Contracting for Providers
Although time-consuming, there is a reason why credentialing requires such a high level of scrutiny. The affordable care act has raised the standards of such scrutiny to reduce fraud and abuse when it comes to Medicare and Medicaid enrollment.
The same applies to the contract. It is essential to be aware of the information contained in the contract of approval. Attention needs to be paid on when the period of credentialing may expire, to apply for re-credentialing quickly.
Denmaar is a mhBilling company that helps providers with both credentialing and re-credentialing. We offer a fully automated system to our clients that keep them updated in real-time with updates regarding their application. At Denmaar we are not just concerned with verifying your forms. We also ensure you are always in touch with your process to ensure your credentialing process is as smooth as possible.
Oscar Insurance Credentialing – Getting on Insurance Panel
Let’s understand the process of Oscar Insurance Credentialing
Oscar insurance company is a technology-focused healthcare company that was founded in 2012.
Headquartered in New York City, Oscar provides its services in 9 states across the USA. These 9 states include New York, New Jersey, Ohio, Texas, California, Tennessee, Arizona, Michigan, and Florida.
The company has been popular for using advanced technology to engage with their clients. They use telemedicine; healthcare based technological interfaces, and transparent claims pricing systems.
Oscar began selling insurance the same year the affordable care act exchanges and individual mandates went into effect. In the first year, Oscar managed to secure 16000 members, and it has progressed into even more significant numbers ever since.
As of today, there are at least 25000 members covered under Oscar’s insurance program. They have not only partnered with 3500 nationally ranked doctors, but also work with 20 top health systems in the US.
Hence credentialing with Oscar is crucial if your practice falls under their jurisdiction. This will allow you to tap into a client base that is covered under the Oscar insurance program. So without much further ado, let’s look at the process Oscar Insurance Credentialing for providers.
Oscar Insurance Corporation Provider Credentialing – The Process
1. Pre Application
Before applying, Oscar requires practitioners to submit the necessary information to confirm that the applying practitioner is meeting basic guidelines of insurance credentialing with OSCAR. An Oscar representative is assigned to the practitioner who informs whether the applying party meets all the mandatory guidelines or not.
2. Submit Your Application
Once the practitioner is deemed compliant with Oscar’s guidelines, they send an e-mail containing all the information the provider needs to initiate the process.
If the application information already exists on the CAQH aka Council for Affordable Quality Healthcare, then OSCAR will with the provider’s permission, proceed to access it electronically.
The following information is essential from the provider, depending on :
- Basic Personal Information
- Education and Training Information
- Specialties and Board Certification
- Malpractice Insurance Information
- Work History and References
- Disclosure and Malpractice History
Here are some materials you’ll need:
- CV or Resume
- Malpractice or Insurance Policies
- Drug Enforcement Administration Certificate
- State Licenses
- W9’S
- Various applicable ID numbers
3. Follow Up
Once Oscar Insurance Credentialing receives the application packet, they will start the credentialing process. The entire process will take 45 to 60 days to culminate.
During this time, the provider will receive e-mails regarding:
- Confirmation of Application received
- Request any missing documentation or application information. If any fundamental document or information is found to be absent during the process, Oscar will send a notification, notifying about the closure of that particular application.
- Constant updates about the status of an application, including delays if any.
4. Oscar Approval
If Oscar approves a particular practitioner’s application, the practitioner becomes an in-network provider with OSCAR. Oscar health Insurance Credentialing will updates the provider information in their database within the next 10 business days.
Being an Oscar in-network provider can be a very long and tedious process. The entire process requires at least 90 – 120 days to be completed and approved. There is a lot of paperwork, which makes the whole process quite frustrating for medical practitioners who want to accept clients with medical insurance. That is where the professional assistance of Denmaar comes into play.
With the help of our credentialing experts, we can walk you through the entire process by accomplishing tasks without any complications and hassle so that you can work on other core areas of your medical practice.
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