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.
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Copyright Acuclaims 2006, All rights reserved.
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