We verify benefits, during business hours as quickly as possible. If needed immediately we will make every attempt to verify coverage on the spot. All verifications are done via phone, they are recorded with name of representative and a reference number of our call.

    Our offices submit the billing as is convenient for them. Some submit daily, some weekly. We receive electronically through our secure website or via mail. Once received we review before submitting claims. We will confirm 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 it's the doctor's decision to make changes. We review diagnosis for highest level of specificity. For specific number of visits, we will notify the office when they are getting close. Then the billing goes out, within 24 hours of receipt. It's sent electronic whenever possible. For brand new offices the initial bill goes paper, accompanied by a W9.

   All Explanation of Benefits and checks are sent to the provider. The EOBs are then faxed/mailed to us. We scrutinize these EOBs for errors and errors again as quickly as possible. We insure the carriers pay exactly what they should. Payments are then posted.

The 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. We will also be securing authorizations for state and Federal Workers Compensation patients and negotiate payments with attorneys for PI claims.  

  At the end of the month we provide a complete list of all charges billed, a list of all payments received and an a/r report. We'll provide a list of charges 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 patients to use as a call list to reactivate patients. Birthday lists for the following month can also be provided.

   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 can't be confident in the outcome. Furthermore, carriers have reduced dramatically the deadlines for submission of a claim. There are statutes 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 the claim was submitted improperly or not timely. There is little anyone can do when that happens. Our greatest successes in this area have been with worker's compensation collections. However we'll do our best with any type of outstanding claims.

     We try to function as an extension of our client's office. Unless your office has a dedicated insurance person, with the years of experience billing acupuncture and chiropractic claims you can't 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.