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- Are you HIPAA compliant?
- YES. Click here to view our HIPAA
page.
- What exactly is a medical billing service? How does it
work?
- Any healthcare practice, no matter what specialty, must be paid
for its services. Our job is to be your billing department and collect payments
from payers for your services. By outsourcing your billing needs, they are
handled by professionals who specialize in that type of work, just as you
specialize in providing certain healthcare services to your
patients.
How does it work? We either enter your claims information into
our computer system, or download the information from your system. Our software
and billing manager will check the claims for errors and omissions. The
information will be converted into a claim file, and this file will be
transferred (uploaded) to a claims clearinghouse, or directly to certain
insurance carriers.
Claims filed electronically are generally processed
in about two weeks, and the check is sent directly to your practice. We then
post the remittance advice, or EOB, against the patient's account. On a
periodic basis, we generate statements for those patients who owe a coinsurance
balance.
- How much will this cost me?
- Actually, our program is designed to save
you money over the cost you would incur in filing and collecting claims from
your own office. Yes, we do collect a fee, but someone has to collect your
reimbursements, and we can do it for a cost savings to you.
We can
save the average practice 20-25% over what it would cost them
internally. Since we strictly provide billing services, our economies of scale
can provide such services more efficiently.
- What are your fees?
- We normally accept a percentage of the dollar amounts that your
practice receives. This amount will vary based on the level of service that we
provide based on the specific needs of your practice. We keep our
overhead low so our fees are quite competitive.
- What costs do I already incur in collecting insurance
payments?
- Primarily payroll expenses for those employees that perform
billing, including salary, benefits, social security tax, unemployment
insurance, and workers comp insurance. We can free up these employee expenses
so they can spend their time and energy on patient care or helping your
practice run more efficiently.
- How do you get our billing information?
- It depends on your office. We can download the data directly
from your computer system, or we can manually input information from your
paperwork. We continually look for new ways to streamline the process to help
make your job easier.
- What are your qualifications?
- Our owners and employees are experienced in many facets of
healthcare and financial management.
First of all, the billing manager
has a degree in biology and is an adjunct faculty instructor of biological
sciences at a local college. This gives us an edge over billers who have had
only minimal training in anatomy and physiology, as we understand the
terminology and operations of your practice.
Further, the company's
medical director is a practicing doctor of optometry, and the lead service
representative has a degree in accounting and experience in
collections.
- Why should I use a billing service?
- The two main advantages of outsourcing your billing needs
are:
- MONEY Your practice can save an average of 20
to 25% over the costs you incur directly in performing your own billing,
and
- EFFICIENCY When your billing is removed from your
office, you are free to use your time, energy, workspace, and employee time on
providing care to your patients, and not on chasing after your insurance
payments.
- What type of computer system is required in our
office?
- Our system can import data from any type of practice management
software, so there is no requirement for your office to change anything! If you
are not currently using a computerized practice management system, we can
manually input your data as well.
- How do you file claims? What insurance companies can you
work with?
- Most of our claims are sent electronically. This
is sort of a buzzword, but it means that the claim information, rather than
being printed on a claim form, is stored in a data file and transmitted to
another computer system, either through a bulletin board system (BBS) or the
internet.
- We can send this file directly to certain carriers, or to an
intermediary known as a clearinghouse. The two clearinghouses we use are WebMD
and Gateway EDI. These clearinghouses will forward the claim information to the
appropriate insurance carrier.
You can visit the respective
clearinghouses' websites (click on "Links") to see a list of the insurance
companies that they process. If you have a question about a specific carrier,
please feel free to contact us.
- What about data security and patient
confidentiality?
- This topic is addressed specifically by HIPAA. Our existing
compliance plan includes the following activities: We perform daily backups of
all files, plus weekly backups that are stored off-site, to protect against
data loss. All of our employees are trained in the strict private nature of the
data that we handle, and at no time is such data disseminated from our office
beyond the normal course of doing business with the patients' respective
insurance carriers (except for the backups noted above, which are encrypted to
further ensure confidentiality). We adhere to the OIG guidelines regarding
compliance and confidentiality for third-party billing services.
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