ACCOUNT REPRESENTATIVE SPECIFIC TO YOUR PRACTICE
All staff members are trained for each account but we assign a specific representative that communicates with your patients so they always talk to the same person, when possible.
ELECTRONIC / PAPER CLAIM SUBMISSION
Claims will have a faster turnaround when submitted electronically, however secondary and even tertiary claims will sometimes need to be mailed. We will handle this in a timely, professional manner in order to get you paid as quickly as possible. Claims are reviewed for coding errors/omissions at the time we enter the charges. If there are any corrections needed, we will return to the provider for handling prior to the claim being billed to the insurance company.
FOLLOW-UP ON OUTSTANDING INSURANCE CLAIMS
We handle the follow up on all claims. This includes patient accounts as well as insurance claims. We will work hard to get you every dollar that you are owed
POSTING OF PATIENT AND INSURANCE PAYMENTS
We post patient and insurance payments daily. Where possible, we will facilitate setting up ACH/EFT payments directly to your bank account from the insurance companies. This will result in quicker payments and a reduction in the amount of mail handled by office staff.
APPEAL OF DENIED OR INCORRECTLY PAID CLAIMS
Unfortunately, there is no avoiding denied claims completely. For those claims that are denied or underpaid (less than contracted rates), our team will effectively and promptly appeal for the additional payment owed.
GENERATE MONTHLY FINANCIAL REPORTS
We will provide you with monthly financial reports tailored to your individual needs. These reports are designed to keep you informed of your account receivables and monthly charges generated by your practice.
PROCESS AND MAIL MONTHLY PATIENT STATEMENTS
We will mail statements to your patients every 30 days. We handle all payment arrangements in accordance with your practices Financial policy and procedures (i.e. balance paid in 90 days, service charges, interest, etc). If patients do not keep their promise to pay, any collection action will be submitted to your office for approval before it is assigned to a collection agency for further processing.
EXPEDITIOUS TURNAROUND ON PAYMENTS
By filing claims electronically, we cut your payment turnaround time. We will also follow up on secondary, tertiary and patient payments as quickly as possible. ACH/EFT payments will be set up for faster deposit times.
HIPAA RULE AND SECURITY COMPLIANCE
The HIPAA Privacy Rule establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically. The Rule requires appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. The Rule also gives patients rights over their health information, including rights to examine and obtain a copy of their health records, and to request corrections.
– The HIPAA Security Rule establishes national standards to protect individuals’ electronic personal health information that is created, received, used, or maintained by a covered entity. The Security Rule requires appropriate administrative, physical and technical safeguards to ensure the confidentiality, integrity, and security of electronic protected health information.
ICD-10 – CPT – HCPCS CERTIFIED
We have CPC certified coders on staff which allows us to be confident that we will accurately code services. Our staff recently passed the necessary test to show ICD-10 proficiency in order to be up-to-date for the change that happened on 10/1/2015
It is ideal for providers to code their services. However, we can code services using ICD–10, current CPT and HCPCS codes for an additional fee. It is required that we are given electronic access to your EHR/EMR.
We will handle your credentialing/re-credentialing, including adding other physicians to your group/practice.
– On-site training
– Assess problems
– Offer solutions
– Auditing by certified coding specialist