Find answers to questions around medical billing & collections
Medical Billing Frequently Asked Questions
How can you improve our collection rate?
Our dedicated billing service is focused on accurate and timely filing. Follow up is key to ensure claims are processing correctly and set to pay on time. We use our revenue cycle management tools built into our billing software to track and follow up on claims status daily. Our software includes cycle management automation which greatly reduces the risk that a secondary or tertiary claim will be missed in the filing process and increases the potential to receive maximum reimbursements for all claims processed. Since our billing percentage is based off what is collected, not what’s charged, we have a vested interest in collecting maximum reimbursement for each claim.
Patient statements are sent out each month or more frequent upon the doctor’s request. The sooner you bill the patient after their visit, the more likely they are to pay.
Recommend the practice to collect all copays at time of visit to avoid chasing this money later.
Payment solutions such as EFT should be used as a proactive approach to maximizing patient portions and soft collection letter campaigns are used for those that have an outstanding balance.
How do you provide transparency?
We provide a wide variety of reports related to your practice financials on a monthly basis.
Another way is by allowing users access to our billing and practice management software. Where you will be able to view patients charts, view claims, view balances, and run reports when needed.
How HIPAA compliant is your company?
Our HIPAA compliance is an ongoing process and effort that we continue to ensuew it safeguards and remain effective with our staff. We perform regualr risk analyses to identify any new risks to confidentiality, integrity, and availiability of PHI. We document our complaince efforts as it will need to be inspected by regulators in the event of an audit.
How much does your service cost?
Please give us a call for you FREE CONSULTATION!
How do we send my billing information to your office and how often?
We are very malleable to accommodate an avenue of exchange your practice is comfortable with. Some preferred methods are secure eFax, secure email, regular fax, office pickup (if local), or a secure shared folder method. We can also offer access to our software for use within your practice.
Our policy is to acquire new claims from the practice every day. We like to submit well within the timely filing limits of each health plan just in case there are any issues with the claims data, we can resolve and get it paid within the current adjudication period.
Do you check eligibility and benefits of our patients?
This is a separate services we can offer. If you’d like us to handle these administrative tasks, we will need your appointment schedule 1 week prior to the visit to ensure enough time for the authorization request to be processed and issued from the health plans for that visit. There will be a fee of $2.50 per eligibility and benefits checks requests. If there are any prerequisites to the claim such as prior authorization, this will need to be obtained before services are rendered to the patient. The authorization number is part of the claims data that will be provided.
There will be a fee of $15 per authorization request.
How should our claims be submitted?
If your office has a set superbill, intake sheet, face sheet, fee ticket, patient encounter documentation, etc., we can use this to generate claims for you. We understand each office might have their own term for this document.
The claims data always required for a claim is the following:
Patient name, DOB, address, sex, insurance plan and ID, date of service, CPTs and matching ICDs, as well as any other supplemental information required such as authorization numbers, CLIA numbers, referring providers, rendering providers, and facility locations.
We would be happy to take a look at a sample document you would provide us to perform the billing so we can make sure all information needed for claim generation is present.
If you would like to give us access to your EHR software, we can export the superbills from your patient encounters and use these to generate claims in our MedOffice software.
We prefer to bill our own patients and handle our patient statements in-house.
“No problem! Please keep in mind, patient billing is BEST performed by the biller, who already has access to all account balances and other additinal information.
If we are already handling the insurance end of things, it only makes sense to let our system automatically generate patient statements. However, we can provide you with remote access/viewing software, which is update regularly, for a minimal fee. This will enable your staff a view patient balances and generate their own statments, among other things.
Do we need to report any insurance and payments received in our office to you?
YES! It is vital to your practice that any payments pertaining to any patient account in our possession be reported for accuracy of that account to include necessary adjustment and account closure.
How do you handle non-payments from an insurance carrier? (denials, etc.)?
We must first research as to why the denial was received, whether in part or in full. If the denial is valid, we review your write off policy and procedure, then, move forward from there.
If the denial is not valid, as in many cases, we will request necessary documentation from your office and request the insurance carrier reprocess the claim with documentation if that is the case.
What other services do you provide besides billing that can help my practice?
Our goal is to improve the overall health of your practice.
Multi-Specialty Billing including Dental
Patient Access Specialist Training
Patient Assessment Screening
Electronic Funds Transfer