Administrative Services

Broadway Ventures delivers a full suite of administrative services designed to support Medicare and Medicaid operations, ensuring efficiency, compliance, and accuracy in claims review, provider enrollment, and customer service.

Medicare and Medicaid Claims Review

• Claims Processing: We assist in the review and management of over 500,000 Medicare claims annually, providing detailed analysis and ensuring compliance with CMS standards.
• MAC Subcontracting: As a subcontractor for multiple CMS Medicare Administrative Contractors (MACs), Broadway Ventures offers claims review services for Medicare Part A and B, Home Health Hospice, Railroad Retirement Board, and the Review Choice Demonstration (RCD) for Inpatient Rehabilitation Facilities (IRF).
• Quality Control & Training: We provide quality control and training services for MAC Jurisdictions J and M (JJ/JM) to maintain the highest standards of claims processing.

Provider Enrollment

• Comprehensive Enrollment Support: · Comprehensive Enrollment Support: Broadway Ventures offers comprehensive support in Medicare provider enrollment, handling initial provider enrollment processing, revalidations, changes, updates, reassignments, and corrections. Our services ensure compliance with CMS enrollment standards and timely processing of applications.

Call Center and Help Desk Operations

• Medicare Beneficiary Support: Our highly trained call center agents provide accurate and effective support for Medicare beneficiaries. With advanced technology and customer service training, we efficiently handle customer inquiries related to Medicare claims, benefits, and provider services.
• RSNAT Prior Authorization Model: We support the CMS Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) model by providing monitoring, reporting, and communication services. Our team tracks and reports key metrics while connecting beneficiaries with appropriate transportation resources when prior authorization for ambulance transport is not affirmed.

Transaction Processing

• Billing & Accounting: We offer extensive transaction processing services, including billing, payer relations, and accounting. Our teams ensure accurate and timely financial transactions, managing the end-to-end processing of healthcare payments for Medicare and Medicaid providers.

Account Resolution

• CMS MAC Business Support: Our specialists support CMS MAC business initiatives by performing in-depth systems analysis and evaluating business requirements. We assist in the resolution of complex account issues, ensuring that business objectives are met efficiently and effectively.

Reimbursement Services

• Provider Reimbursement Management: Broadway Ventures ensures proper reimbursement for Medicare providers through comprehensive management, analysis, and accuracy of Medicare cost reports. Our team manages tentative and straight-to-final settlements, Medicare interim rates, and applicable limits for all providers in the Fiscal Intermediary Shared Systems (FISS).
• Audit & Compliance: We support providers in meeting CMS reimbursement standards by performing compliance checks, ensuring timely report submissions, and managing interim and final payments.