How do we get the necessary information to you?
There are several ways for your office to send in your billing, including the following…
- Standard Mail — just place your documents into a secured envelope and mail to our main office.
- Fax — the quickest way to get your billing to us! Just fax each completed document to our office on an as needed basis (after each visit, at the end of each day, once per week, etc).
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 (front and back
- A copy of the patient’s written prescription or authorization (if applicable)
- The patient’s first superbill (treatment or encounter 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:
- Patients name
- Name of insurance carrier
- CPT codes
- ICD-10, HCPCS code(s)
- Referring physician’s name and the referral # (if applicable)
- 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 the Explanation of Benefits (EOBs) that come with the insurance checks, so that we can enter the insurance carrier’s payments and identify which claims remain unpaid and needed follow-up and also 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 fax, an email or a phone call from us indicating that the claim does not contain enough information to be processed by the carrier, listing exactly what is missing. 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 monthly. Payment Plans can be easily accommodated also.
How do you handle non-payments from an insurance carrier? (denials, etc.)
We must first determine if the denial, whether in part or in full, is valid. If the denial is valid it must be written off. If the denial is not valid, as in many of the cases, we will request that the carrier reprocess the claim. Many carriers will require that the claim be resubmitted on paper via snail mail, and we do not charge you for this.
How do you handle non-payments from a patient?
We will send out no more than two statements, and make one follow up phone call. After 120 days we recommend that the account be turned over to collection 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 prefer to bill our own patient’s, but we are interested in obtaining insurance claim processing services only from you. Will you do it?
Yes we will! 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.