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
Cigna Insurance Credentialing – Getting On the Cigna Panel
Let’s discuss the Cigna Insurance Credentialing Process.
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 U.S. 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.
As we mentioned, Cigna has an extensive network of people who subscribe to their health insurance. If accepted as part of the network, a medical service provider naturally becomes an in-network provider and people with Cigna plan will be more inclined to use their particular medical service.
The Process to Apply For Cigna Health Insurance Provider Credentialing
The entire process of applying to get into any insurance provider network can be long and complicated. However, it is necessary to tap into those clients who have insurance, thus making the process mandatory to run a successful medical practice.
1. Pre Application
Before applying, Cigna requires practitioners to handover some necessary information to confirm that the applying practitioner is meeting basic guidelines of insurance credentialing with Cigna.
A Cigna health Insurance Credentialing 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 Cigna’s guidelines, they send an e-mail with an application packet containing all the information needed to get started.
If the application information already exists on the CAQH aka Council for Affordable Quality Healthcare exists on the CAQH or One Healthport website, then Cigna Insurance Credentialing will with the applying parties permission, proceed to access it electronically.
The Following application information is required from the applying party, depending on:
- State Medical or appropriate professional License
- Drug Enforcement Agency Certificate (Mandatory)
- Controlled Dangerous Substances Certificate (Mandatory)
- Cigna participation in-hospital clinical privileges
- letter of interest for insurance credentialing for Cigna
- Board Certification Status
- Professional and Educational Training
- Work History
- Malpractice Claims History
- Adequate Malpractice Insurance
- Prior Sanctioning Activities
3. Follow Up
Once Cigna receives the application packet, they will start the credentialing process. The entire process will take 45 to 60 days to complete.
During this time, the applying party 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, Cigna Insurance Credentialing 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. Cigna Approval
If Cigna approves a particular practitioner’s application, the practitioner becomes an in-network provider with Cigna. Cigna will update the provider information in their database within the next 10 business days.
Being a Cigna Insurance Credentialing 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 like updating credentialing with insurance Cigna, without any complications and hassle so that you can work on other core areas of your medical practice.
Error: Contact form not found.
Mental Health Insurance Credentialing – The Process
Mental health Insurance Credentialing for psychologists and counselors have become extremely important today. Mental health specialists, just like other practitioners, need to go through an extensive credentialing process to validate their practice.
By forsaking credentialing, a practitioner compromises on a good number of clients covered under the federal insurance program. With a clamoring for more progressive ‘medicare for all idea floating in the United States political spectrum, credentialing has never been this urgent for mental health specialists.
Mental Health Insurance credentialing and billing for mental health professionals
Now, if we assume that a physician works on a $100/hr, pay, that’s approximately $20000/year in credentialing work per physician. This is excluding any paperwork; of course, you lose more money if you lose relevant documents.
In hindsight, you are spending way more than $20000/year. Credentialing services cost way less when outsourced to a third health insurance credentialing specialists like Denmaar.
Credentialing Cost Breakdown
Individual Practitioner Cost – 100-200$ per physician
CAQH Database
Initial Setup Cost can go up to $200-$500
Panel Application Cost
Practitioners should expect to pay $100 per panel
So, on average, the general cost of physician insurance credentialing services is somewhere between $2000-$3000/ year.
Most of the cost incurred in the process of Mental Health Insurance Credentialing services is because of its lengthy nature. You lose money if you lose your documents. You lose money, if you fail to follow-up with the insurance companies, resulting in the expiration of your application. The entire process has too many pot-holes for medical practices to crash and burn.
Hence, it is highly recommended to use the help of third-party experts like Denmaar for Mental Health Insurance panel credentialing.
Mental Health Insurance Credentialing Process
1.Getting Your Information in Order
As we mentioned before, credentialing requires a lot of information and documents from the
practitioner.
They are:
- Licensure Information
- NPI Number
- Resume
- Proof of Malpractice Insurance
- Taxonomy Code
- Proof of Liability Insurance from Landlord (Applicable on if you are renting)
- Credentialing Paperwork
2. Fill Out Your CAQH
You will find many companies who use the Council of Affordable Quality Healthcare for the purpose of credentialing. Before filling out the CAQH form, you are required to hold an authentic resume with no gaps in employment. The application is supposed to be completed online via the CAQH hub.
The entire process can be extremely confusing to follow, but we at Denmaar assist you till the end.
3.Contact provider Relations
Once you have gone through the CAQH process, you are now afforded the liberty of choosing which insurance panel you want to be on. The insurance companies you choose may vary in the department of reimbursement rates, provider friendliness, payment speeds, etc.
Some companies may have their own sets of rules and requirements to apply. Now here you might face an issue of rejection, or not being accepted because the panel is full.
In such cases, you can do the following to build relationships with networks to gain access for future openings:
- Evening and Weekend Availability
- Experience with special populations
- Crisis services
- Handicap accessible facilities
- Being located in an underserved area
- Multilingual fluency
- Having an in-network referral source.
4.Submit Application
Once you have taken care of the documentation and decided on which insurance panel to join, it’s time to submit the application and wait. The entire process of getting paneled is relatively swift, culminating within 9-10 hours.
All you have to do now is a follow-up. You have to keep tabs on the status of your application. Chances are it might expire while still in the process if taken too long, and you don’t want to start again. The insurance companies have to be notified every time you submit a document to ensure it has reached them.
5.Review after Approval
Once you have received approval, it is still not an appropriate time to celebrate. Do the following to be on the safer side.
- Review your contract carefully before signing
- Keep a file with the agreement and any addendums ready for future reference.
- Learn more about the insurance provider’s portal on its official website.
- Collect a list of phone numbers for the claims department, pre-authorization department and provider relations.
Once you have taken care of the above bucket list, you are ready to sign. To speed up the process, Denmaar’s will help you submit your claims electronically. This will help you save time, money, and paper.
ABA Insurance Credentialing -The Importance of Credentialing
ABA insurance credentialing is one of the many crucial aspects required to run a behavioral therapy clinic. A successful medical practice has many moving parts that define its performance every day. A healthcare organization must meet its credentialing requirements to provide services to their patients. If a medical practice fails, for whatever reason, to get credentialed with government medical agencies like Medicare, they cannot treat patients and collect payments from patients who are covered by the federal insurance program.
ABA Insurance Credentialing Therapy
Credentialing is the process of assessing the background and legitimacy of a medical practitioner and establishing the qualifications they require to become licensed professionals. As ABA therapists are practically board approved behavioral analysts, one cannot be an ABA therapist without meeting the credentialing requirements in their field of practice. With the help of ABA credentialing, behavioral therapy clinics are permitted to legally serve new patients and get paid by these patients for the services they perform.
Stop Losing Clients, Call us now on: 1-888-595-5101
Why Get ABA Insurance Credentialing
A Population Living With Autism Spectrum disorder
It is estimated that at least 3.5 million Americans today live with an autism spectrum disorder. The numbers signal the imminent demand for ABA therapists who have the skills and qualifications needed to provide medical attention to the ailing population.
Consistent Work
Probably one of its vital benefits is how it can get a medical practice onto an insurance panel, or better yet turn them into an in-network provider. This allows for dealing with billing codes, rates, and other reports and deliverables consistently. The overall uniformity this system offers can help healthcare enterprises make important decisions more effectively and efficiently.
Better Customer Support
As many insurance companies, today have their own team of autism specialists, in-network providers such as licensed ABA therapists have the chance to socialize and build valuable relationships within the organization that can help with faster claim resolution, or helps resolve queries regarding claim issues. This allows for pre-authorization, re-authorization, and claims information online. All of these factors ultimately enable clinics to provide better customer support to their customers.
Electronic Claims
Getting credentialed allows medical practices to send bills to insurance providers electronically. Electronic claims are a faster, more convenient way of receiving payments quickly than traditional paperwork. Unfortunately, this benefit cannot be enjoyed by medical practices that don’t possess the necessary credential requirements.
The Process of Getting Credentialed.
The ABA credentialing process is a tricky one. The whole process can take around 90 to 120 days to culminate. It is highly recommended that the credentialing process be started as soon as possible, especially for new medical practices. Because of its length of time, and complicated nature, it is highly advisable to seek the help of third-party support like denmaar who can get the job done for you.
The following is the process to get ABA Insurance Credentials
1.The first step towards getting credentialed requires medical firms to apply for an NPI aka National Provider Identifier. An online application requires the input of information like social security number, BCBA certificate number or BCaBA certificate number, Taxonomy code for behavioral analysts, and BA license number if applicable. The NPI is usually acquired within a day and is essential to receive reimbursements for ABA services with any carrier.
2.After the acquisition of NPI, the next step is to become a member of The Council for Affordable Healthcare. A medical practice can only become a part of CAQH. The medical practice needs an invitation from the insurance provider. Once the firm can log in to the CAQH system, they are required to submit a plethora of information such as employment history, references, resume, and W9, BCBA, or BCaBA certificates, educational history, information about medical practice.
3.After the application is completed, insurance companies will have access to the information provided. They will use the information to verify it with their agency.
ABA Insurance credentialing Medical practices need to be privy to all the plans and terms of coverage offered by insurance companies. It is also worth noting to get crucial information about a company’s ABA coverage. There is no point in the existence of a Behavioral therapy clinic without the necessary credentialing requirements. Credentialing is essential for medical practices to continue to accept new patients and receive payments to justify their services. The process to get credentialed can be tedious, a problem that can be alleviated by hiring third party professionals like denmaar who can do the heavy lifting for a medical practice.
Our Partners
Ready to get started?
Feel free to reach out if you have any questions.
