How we Manage your Account
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- If you don't already have them, we create custom forms for your office to provide us with the information we need.
ie. Patient Registration and Superbill
- We use Practisoft Practice Management software.
(We're currently working with a software vendor to provide an Internet based application.)
- We review the insurance companies you are contracted with and provide suggestions as to the ones with the most beneficial fee schedule. Additionally, we assist you in the credentialing process for any insurance you decide to accept.
- We set-up and maintain a dedicated toll-free fax number for your office to send the necessary forms (patient registration, copy of insurance cards, superbill). Fax daily or weekly. Or you can use Fed-Ex, UPS, or USPS.
- We enter patient demographics, insurance carrier information, and charges. If necessary, we provide the diagnosis & procedural coding support to review claims for accuracy. All claims are entered within 24-48 hours.
- All claims are submitted electronically or by paper if necessary.
If we utilize your software, hopefully you're already set-up for electronic claims. If not, we can handle the set-up process too. Utilizing our software will take 4-6 weeks to set you up with a clearinghouse unless you already have one.
- Follow-up has become the key element with insurance billing. We follow every unpaid claim withn 20-30 days after submission by calling the insurance carrier and the rest is OUR secret.
- All EOB's (Explanation of Benefits) are reviewed for denials. If applicable, we request (from you) any supporting documentation necessary to appeal claims.
- All payments are sent directly to your office. It is vital for your office to supply us with a copy of ALL payments and EOB's received so we can apply them to the proper account, appeal denials, and bill patients accordingly.
- Patients are billed once we've exhausted all avenues of collection from their insurance carrier(s). Patients receive 3 statements monthly with a Final Notice on the third statement explaining their account will go to collections if they don't pay within 60 days. Then we follow-up with a final courtesy call, if they don't pay within 15 days their account goes to collections.
- We are not a collection agency and therefore we outsource this service. We can use any collection agency of your choice. The collection agency we use only charges on what they collect. Their fee is 33% or 50% if they have to get legally involved.
Nothing is set in stone. The details above are how a typical account is managed. Although certain areas are crucial, we can work with you to provide the exact service you require.
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