Taylor Prime Solutions Billing Framework

Auditing, Error Checks, Techniques & Controls That Power Accuracy and Results

Behind every clean claim and fast payment is a framework — and at Taylor Prime Solutions, we’ve built ours with precision. Our billing framework includes strategic processes, audit checks, system controls, and smart techniques that help behavioral health providers like you get paid faster, stay compliant, and avoid costly delays.

Whether you run an ABA therapy clinic, a mental health practice, or a substance use disorder (SUD) program, the Taylor Prime Solutions billing framework is designed to support every stage of the revenue cycle.

What Is the Taylor Prime Solutions Billing Framework?

It’s a structured system that includes:

  • ✅ Pre-claim preparation

  • ✅ Real-time claim validation

  • ✅ Post-submission follow-up

  • ✅ Denial resolution workflows

  • ✅ Continuous quality improvement

This isn’t “set it and forget it” billing — it’s a proactive system that protects your bottom line.

1. Pre-billing checks and Intake Controls

Before a claim is ever submitted, we:

  • Verify insurance eligibility

  • Confirm authorization requirements

  • Match sessions with proper codes

  • Review documentation for red flags

  • Check provider credentials and NPI alignment

🔍 Why it matters:
Catching errors before submission prevents rejections, saves time, and improves your reimbursement speed.

2. Real-Time Claim Scrubbing and Smart Edits

Using payer-specific rules and system-based logic, we:

  • Scrub claims for modifier accuracy

  • Review CPT/HCPCS codes based on service and duration

  • Confirm location, POS, and telehealth indicators

  • Apply the correct rendering provider, taxonomy, and billing NPI

🔍 Why it matters:
This prevents technical denials that can cost you weeks of follow-up.

3. Built-in Audits and Double Checks

We conduct:

  • Weekly internal audits for coding consistency

  • Cross-checks for missed claims or sessions

  • Spot reviews of denial patterns and payer response times

  • QA audits for compliance with HIPAA and payer rules

🔍 Why it matters:
A second set of eyes ensures that no revenue is left behind — and that your claims meet payer policy.

4. Denial Management and Root Cause Tracking

When denials occur, our billing framework kicks in:

  • Denial is categorized (e.g., auth, modifier, credentialing)

  • The root cause is documented and resolved

  • Claim is corrected, appealed, or resubmitted

  • The resolution is logged for reporting and prevention

🔍 Why it matters:
We don’t just fix denials — we solve the problems that cause them.

5. Post-Payment Reconciliation and Controls

Once payment arrives, we:

  • Post ERAs/EOBs and match to original claims

  • Review underpayments and file secondary claims

  • Track missing remits or payer delays

  • Flag anomalies for immediate review

🔍 Why it matters:
You get full visibility into what’s been paid, what’s pending, and what’s at risk.

6. Continuous Feedback Loops and Client Reporting

The final piece of the Taylor Prime Solutions billing framework is communication.

We provide:

  • Weekly reporting

  • Monthly performance summaries

  • AR aging reports

  • Denial breakdowns

  • Custom KPIs upon request

🔍 Why it matters:
You stay informed, confident, and empowered — with full insight into how your practice is performing financially.

Why the Taylor Prime Solutions Framework Works

Our system is built on:

  • ✅ Experience across Maryland behavioral health providers

  • ✅ Deep familiarity with payer requirements (Medicaid, MCOs, Medicare, commercial)

  • ✅ Daily audits and accountability

  • ✅ Proactive denial prevention

  • ✅ Real human oversight — not just automation

Let’s Put the Taylor Prime Solutions Billing Framework to Work for You

📞 Call 844-TAYLOR-9 or reach out here to learn how our billing framework can be applied to your practice — and finally get the results you’ve been looking for.

Taylor Prime Solutions Billing