Frequently
Asked Questions & Answers
25 of the most commonly asked questions!
Q. How do we get the necessary information to you?
A. 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.
Courier - you can take advantage of our courier
services and don't worry about it! Our courier will pick up your
billing, at pre-scheduled dates and times of your own preference)
and deliver it to our office for you! SAME DAY SERVICE!
Federal Express Services - offers many different
deals to small business owners, establish your own account quickly
and easily today! For more info just go to www.fedex.com.
Q. How often should we send our new billing to you?
A. 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.
Q. What do information is needed in order for your office
to generate a claim on our behalf?
A. We normally require the following (may vary):New Patient Information
Form
A copy of the patient's insurance card or WC ID card (front and
back)A copy of each of the patient's superbills (treatment form)
Q. How do we report when treatments are rendered, so
that you are able to generate a claim on our behalf?
A. We must receive all applicable superbills (treatment forms),
which have been completed. This form must contain the following
(may vary):
Patients name
Name of insurance carrier
CPT codes
ICD-9 code(s)Referring physician's name and the referral #
Any/all applicable modifiers If your practice does not currently
use this type of form, we can custom design one for you.
Q. Do we have to report the insurance payments received
in our office to you?
A. Yes! It is vital to your practice that we receive this information,
so that we can enter the insurance carrier's payments and generate
the necessary patient statements for those accounts which still
may have a balance due. You can copy and mail these remittances,
send them via fax, or have our free courier service pick them
up with the other information.
Q. What happens if we accidentally omitted any of the
information contained on the required forms, and we already sent
them to your office?
A. You will receive a report indicating that the claim is does
not contain enough information to be processed by the carrier,
listing exactly what is missing, which is normally faxed to your
office immediately. 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.
Q. How do we report payments received from our patients,
for both co-payments and patient billing?
A. 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).
Q. How often will our patients be billed?
A. 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 on
a monthly basis usually. Payment Plans can be easily accommodated
also.
Q. How do you handle non-payments from an insurance carrier?
(denials, etc.)
A. 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. Unfortunately, many carriers
will require that the claim be resubmitted on paper via snail
mail, and additional charges may be invoiced to your account as
a result.
Q. How do you handle non-payments from a patient?
A. We will send out no more than four statements, and make follow
up phone calls (if patient support services have been included).
After 120 days we recommend that the account be turned over to
a collection agency, 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 strongly recommend that an additional fee be applied to each
account which has not received a payment within a 30 day period.
Q. Do we have to collect every co-payment?
A. YES, YES, YES! Not doing so is considered to be fraud and/or
abuse, and it is also a possible violation of the contract entered
between the patient and their insurance carrier...and even the
provider and their own contract with the insurance carrier!
Q. We are having trouble tracking authorizations, can
you help?
A. Authorization Tracking is best done in-house, by the person
who handles the scheduling. For an additional charge, we can track
your authorizations as we receive the information from your office,
and provide you with reports that warn of expirations on an as
needed basis.
Q. We prefer to bill our own patient's, but we are interested
in obtaining insurance claim processing services from you. Does
your company offer this service?
A. We sure do! 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. If we are already handling
the insurance end of things, it only makes common sense to let
our system automatically generate the claims on an as needed basis!
Q. How many clients are you equipped to handle?
A. Our staff size is accommodated to meet the needs and volume
of our own business. We will consider any practice, regardless
of their size, and ensure that we will be prepared to handle all
of our clients needs in that process.
Q. We've never outsourced our billing before, and we
are leaning towards taking on the responsibility of handling this
area ourselves. What services can you offer to assist us in this
process?
A. Our consulting services would be a perfect solution! We can
assist you with software selections, staff training, organization,
office policy & procedures, compliance, and more!
Q. Why will you not accept a superbill that is missing
information,instead of just looking up the patient's history in
the system?
A. This is considered fraud and abuse! All of the required information
must be included on the superbill, we cannot "guess"
or "assume" on your behalf exactly what services you
provided, etc.
Q. We are receiving many denials which cite that the
patient was not covered at the time of service, resulting in many
write offs, how can we prevent this from happening in the future?
A. Immediately start performing Verification of the patient's
Benefits! If your staff is not already performing this necessary
evil, they should be! This is another valuable service that we
offer, even if you are not contracted for our full billing services!
Q. We just do not have the staff to keep up with the
old accounts receivable. Do you offer A/R Recovery services?
A. We sure do!
Q. Can you code our superbills for us?
A. We provide coding services, providing
that the documentation provided to our staff support the coding
requirements.
Q. What specialties do you currently handle?
A. At the present time we specialize in
Orthopaedic's, Family Practice, General Surgery, ENT, Urology,
Radiology and Podiatry. However, because we are a claims processing
specialist we can accommodate most any specialty.
Q. How much are your services and what methods of payment
do you accept?
A. At the present time we only accept cash, checks, or money
orders. However, we are in the process of establishing a merchant
account and will be accepting Mastercard, Visa, or American Express
very soon!
Q. How fast can you get us up and running?
A. We can start immediately! From start to finish it can take
an average time of one day to 1 week, depending on the individual
circumstances surrounding each client. We can give you a more
specific time period once we have had the opportunity to analyze
your individual practice.
Q. We just lost our biller and desperately need someone
to help us out until we are able to replace her, can you help?
A. It may be possible for us to assist you in replacing a staff
member. Alpha networks with other billing centers and healthcare
professionals across the United States!
Q. I'm thinking about starting my own practice, can you
help me?
A. Yes! Starting a new practice is an exciting experience, and
often a little scary too. Our services are designed to keep it
an exciting experience for you, and to do everything in our power
to ensure it will be a profitable one for you too! We offer a
variety services, which can benefit most any practice, in a variety
of different ways!