Frequently Asked Questions
How do we get our claims to you?
That’s easy we use USPS – Priority Mail. We will provide to you self-addressed, pre-stamped envelopes so your staff can easily send the work.
Do you transmit claims electronically?
Yes, to those companies that have the capability of accepting an electronic claim. We currently submit our claims to ClaimMD. Please note that most insurance companies require that you are credentialed with them for us to be able to submit electronically on your behalf.
How quickly do we get reimbursed?
This varies by payers. The average turnaround in the industry is 30-45 days. Although in some cases your commercial insurances companies may have a turnaround of less time. Regarding claims sent to Medicare they are required to hold the claims for 13 days on electronic claims and 23 on paper submissions.
Will you be resubmitting for secondary and tertiary insurances?
Secondary claims submission is part of our service. However tertiary processing is not. Unfortunately the process of submitting a tertiary claim is quite lengthy and usually the amount of the claim is not worth it for the provider.
How quickly can you start billing for my Practice?
We our prepared to start billing for your practice in 1 day if necessary. However, we would prefer 2 weeks to ensure a smooth transition process. The easiest transition would be for us to start billing at the beginning of the month.
What is your average collection rate?
This is defined as payments divided by gross charges, minus adjustments. Our collection rate is 93% of allowed amounts.
How often are my claims going to be processed?
Within 24 hours of receipt we input and print or electronically submit all insurance claims.
Where does my money go?
All payments will go directly to your office. You then send us the EOBs (or a copy) along with your daily super bill forms. By doing this we can appropriately track all reimbursement activity.
What type of software are you using?
We use Medisoft Network Professional.
Why do some billing services charge by the claims vs. a percentage of revenue collected?
Most billing firms will charge you a percentage of what they collect. They are more compelled to work harder, follow through with claim denials, process secondary claims and work to get you the highest reimbursement possible. When a billing service bills a flat per claim fee the billing service may not be as compelled to do a lot of follow up.
What is an acceptable accounts receivable amount?
We use this formula. Multiply your gross average monthly charges by 2.5% to 3%.
Example - $40,000 x 2.5% = $100,000. If you are above this number there should be a greater focus on your outstanding accounts receivable.
How do I set my fees?
We recommend using the Medicare allowed fee structure and multiply by 130% or 1.3. After your initial setup you can continually monitor your reimbursement rate to make sure that you are maximizing the amount collected.
How do we get our existing patient data to you?
There are 2 Options – 1) A complete printout from your existing system 2) Provide us the most current patient information as you see the patient. This also gives us the opportunity to start fresh with your data.
Should we continue to work on our previous billing/collections accounts once you take over?
Yes, we prefer you to continue to work post payments and rebill your existing accounts receivable. If this is not possible we can handle that process as well.
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