OUR SERVICES

     First what we don't do.  We DO NOT do general medical billing, of any kind.  We work ONLY for Acupuncturists and Chiropractors. 

WHAT WE DO

Billing Services

     Verify benefits, during business hours as quickly as possible. If the patient is in the office, or on the way we will make every attempt to verify coverage immediately.  We accept request for verifications via a fax that we receive in the form of electronic submission on a secured computer,  We can also receive requests in the form of email, as well as the occasional call.

     Our offices submit the billing as is convenient for them.  Some like to submit daily, some once a week.  If they submit daily, we request they submit even if they have no insurance claims.  We expect to receive something from them daily.  If we don't receive a billing, we don't know whether we didn't receive it, for what ever reason, or if they just have no insurance patients that day.

   We will verify the billing as necessary.  We'll contact the office before sending a billing if we see something that might possibly need a correction.  We will confirm with the practitioner if a new patient's charges don't show an initial E/M code, or if a Medicare bill doesn't contain the diagnosis codes required..  Naturally these are just confirmations, it's the doctor's decision to confirm or make changes.  We'll look at diagnosis to make sure they contain the highest level of specificity.  For a patient with a specific number of visits, we'll try and notify the office when they are getting close to reaching their limit.  We like our offices to keep track of this also, but we give a call or fax as well.

     Then the billing goes out, within 24 hours of receipt.  Naturally electronic whenever possible.  If the office has never billed a particular carrier before, the initial bill always goes paper, with a letter to the provider relations and accompanied by a signed W9 form. 

      All Explanation of Benefits and accompanying checks, are sent to the provider's office.  The EOBs are then date stamped, and faxed to us with the originals filed at the office.  We scrutinize these  EOBs for errors and any errors are addressed, again as quickly as possible. We insure that the carriers pay exactly what we know they should. Payments are then posted.

    In addition we are constantly working the aging.  We create new aging reports every two weeks.  We know how long a particular carrier's claims should take to process if sent electronically and if a check hasn't arrive in that period, we make a call.  These aging reports are worked daily in addition to the billing.  This requires lots of phone work, but it must be done to keep payments coming in quickly.

     In addition, we will be securing authorizations for state and Federal Workers Compensation patients and negotiate payments with attorneys for PI claims.  We are here to answer any questions a patient might have about their bill, as well as any questions they may have about their insurance in general.

     At the end of the month we provide our offices with a complete list of all charges billed, a list of all payments received and an aging report of all outstanding collectables.  We'll also provide a list of all charges that were applied to deductibles, as well as charges that were denied.  (For example coverage was terminated, etc.)  Upon request we can provide a current list of all patients that the office can use as a call list to reactivate patient's.  Birthday lists for the following month can also be provided.

Collection Services

     We will also work old collections.  This is not nearly as rewarding as billing however. This isn't OUR billing, we didn't secure the authorizations or verify the benefits, we just can't be as confident in the outcome.  Furthermore, carriers have reduced dramatically the deadlines for submission of a claim.  There are statue of limitations with personal injury claims as well as ideal times to secure authorizations, and they are generally not months after treatment.  Time is money, and the older the claim, the less viable.  It's disheartening to see an office do the work, but unable to collect because they submitted the claim improperly or didn't submit it timely.  There is little anyone can do when that happens.  Our greatest sucesses in this area have been with worker's compensation collections. however we'll do our best with any type of outstanding claims.  

Finally

     We try to function as an extension of our client's office.  Unless an office has a dedicated insurance person, with the years of experience billing acupuncture and chiropractic claims  they just aren't able do what we do.  We have taken over for offices that had a dedicated person and have always made the practice more money while providing a  better level of service. Because we know exactly what we are doing, AND we do it well.