Questions practices ask
Every plan has a defined monthly scope so your practice knows what Ellery Health Partners owns and what it costs.
Questions practices ask
Do unused cases roll over?
No. Monthly case and verification allowances reset each billing period and unused volume does not roll over.
What happens if we exceed our monthly volume?
Additional volume is billed at the applicable contracted case rate. Practices with consistently higher volume can move to a larger plan or request a custom monthly scope.
Can we purchase only one service?
Yes. Prior Authorization, Insurance Verification & Benefits, and Claims Follow-Up are available as individual service desks.
Can we combine services?
Yes. Payer Desk plans combine Prior Authorization, Insurance Verification & Benefits, and Claims Follow-Up under one monthly scope.
Are appeals included in Payer Desk plans?
No. Formal denial and appeal work is priced separately because the administrative workload can vary significantly by case.
Is credentialing included in Payer Desk plans?
No. Provider Credentialing & Payer Enrollment is a separately priced service.
Does Ellery Health Partners provide medical billing?
No. Ellery Health Partners provides defined payer-administration services. Claims Follow-Up does not include coding, charge entry, collections, or full-service medical billing.
Do you guarantee approvals or payment?
No. Authorization, appeal, enrollment, credentialing, and payment decisions are made by the applicable payer or organization.
Do we have to hire or manage a Ellery Health Partners employee?
No. Practices engage Ellery Health Partners for a defined managed service. Ellery Health Partners is responsible for staffing and managing the internal resources used to deliver the contracted workflow.
Does Ellery Health Partners handle pharmacy-benefit authorizations?
No. Ellery Health Partners handles medical-benefit authorizations: procedures, injections, surgeries, office-administered therapies, and the imaging your physicians order. Pharmacy-benefit prior authorizations, the kind filled at a retail or mail-order pharmacy, are not in our current offer.
Does Ellery Health Partners make clinical or coding decisions?
No. Clinical decisions, medical necessity determinations, selection or alteration of diagnosis and procedure codes, peer-to-peer reviews, provider signatures, and clinical answers to payer questions stay with your practice and your licensed clinicians. Ellery Health Partners does not speak as the treating provider.
Who is Ellery Health Partners designed for?
Independent specialty practices with recurring payer-administration workload and limited internal capacity to own it. We support outpatient specialties including orthopedics, spine, pain management, dermatology, oncology, and infusion practices, and we are not limited to that list.
How does Ellery Health Partners access the practice’s system?
As a provisioned user, under accounts your practice creates and can revoke, after a Business Associate Agreement is executed and the security, training, device, and access requirements in your scope are complete. Work is performed inside your systems. Ellery Health Partners does not maintain a separate patient database.
How is Ellery Health Partners different from software or a virtual assistant service?
Ellery Health Partners is a managed service rather than a software platform. We perform the administrative work included in the contracted scope through practice-approved systems and payer workflows. The practice is purchasing defined operating capacity and workflow ownership, not a software license. Ellery Health Partners is not a staffing placement or open-ended virtual assistant service. Ellery Health Partners is responsible for managing delivery of the contracted payer-administration scope.
Get started with Ellery Health Partners
Tell us about your practice, your approximate monthly volume, and the support you need. We review your workflow, confirm the scope, and send the agreement and onboarding documents. No patient information is requested or accepted.