How do we get the necessary information to you?
There are a few ways for your office to send in your billing, including the following:
- HIPAA Compliant Email
- HIPAA Compliant Fax
The choice is yours. We want this process to be as easy as possible for you.
How often should we send our new billing to you?
As often as you choose to! We personally recommend, however, that our clients send us their new billing consistently on either a daily or weekly basis.
What information is needed in order for your office to generate a claim on our behalf?
- We require the following:
- New Patient Information Form
- A copy of the patient's insurance card or WC ID card (front and back)
- A copy of the patient's written prescription (if applicable)
- The patient's first superbill (treatment form)
How do we report when treatments are rendered, so that you are able to generate a claim on our behalf?
We must receive a completed superbill (treatment form), which has been signed by the physician rendering the services.
This form must contain:
- Patient's name
- Name of insurance carrier
- CPT codes
- ICD-10 code(s)
- Referring physician's name and the referral number
- Any/all applicable modifiers
Do we have to report the insurance payments received in our office to you?
Yes! It is vital to your practice that we receive this information so that we can enter the insurance carrier's payments and generate the necessary patient statements for those accounts which still may have a balance due.
What happens if we accidentally omitted any of the information contained on the required forms, and we already sent them to your office?
You will receive a report indicating that the claim does not contain enough information to be processed by the carrier, listing exactly what is missing, which is normally faxed to your office immediately. We do this as a courtesy to you and your staff, to assist in gathering the information quickly, and to avoid timely filing deadlines that are imposed by many insurance carriers.
How do we report payments received from our patients, for both co-payments and patient billing?
You can easily report a patient's co-payment, made at the time of service, on their superbill (treatment form) for that day's treatments.
You can also report all of the patient's payments, received in the mail, by keeping a Payment Log. A payment log enables you to report all payments received in your office, using one simple form. If you do not already use this type of form in your practice, we can custom design one for you.
You can also report all of the patient's payments, received in the mail by making a copy of the check and attaching it to their patient statement remittance (if returned).
How often will our patients be billed?
Any patient in our system will receive a bill for any balance due, once a payment has been received by their insurance carrier if you have contracted for this service. Patients are billed bi-monthly. Payment Plans can be easily accommodated also.
How do you handle non-payments from an insurance carrier? (denials, etc.)
By utilizing our Dynamic Error Mitigation to first determine if the denial is valid. If the denial is valid it must be written off. If the denial is not valid we will assertively reprocess the claim with that insurance carrier. Some carriers may require that the claim be resubmitted on paper via standard mail, so additional charges may be invoiced to your account as a result.
How do you handle non-payments from a patient?
We will send out no more than four statements, and make follow up phone calls. After 120 days we recommend that the account be turned over to a collection agency and that the patient be denied future treatments until their account has been paid. If you are not already affiliated with a collection agency near you, please let us know.
We strongly recommend that an additional fee be applied to each account which has not received a payment within a 30 day period.
We prefer to bill our own patient's, but we are interested in obtaining insurance claim processing services from you. Does your company offer this service?
We sure do! Please keep in mind, however, patient billing is best performed by your biller, who already has access to all account balances and other additional information. If we are already handling the insurance end of things, it only makes common sense to let our system automatically generate the claims on an as-needed basis!
We can provide you with our Remote Access/Viewing software, which is updated regularly, for an additional fee. This will enable your staff to view patient balances and generate their own statements, among other things.