Billing Procedures

Our business procedures are as follows:

• Electronic Claims Processing – we currently submit claims electronically using an established national clearinghouse or submitting directly to the carriers, claims are paid within approximately 7 to 14 days.

• Our billing software has a claims editing feature that is capable of analyzing claims before they leave our office and alerts us as to any errors before transmitting to insurance carrier. This claims editor was designed to establish control to improve cash flow by reducing the collection cycle and to avoid Medicare and Medicaid audits.

• We have a back up system to ensure the integrity of data and no mission critical information is lost.

• Our systems include regularly scheduled virus checks as well as a firewall to protect from any unauthorized access or disclosure.

• Our Drop-Chute or HICS communication software enables us to have a completely paperless environment. We install it at your office and allows for you to electronically send the required information. Totally encrypted for your security.

• We have a Linux Red Hat secure server along with our web sever that allows us to send and receive encrypted files over the internet, as well as allow our clients complete access to their data 24/7

• If your claim cannot be filed electronically we will drop them to paper (HCFA-1500) and send them first class mail.

• We have in place a compliance plan that meets all HIPAA guidelines, including a business associate contract.

• We must receive a complete superbill (treatment form), which has been signed by the physician rendering the services. This form must contain the following:
  1. Complete patient information

  2. Name of insurance carrier (primary and secondary)

  3. CPT codes any / all modifiers

  4. ICD-9 codes

  5. Referring physician name and referral # (when applicable)

• We recommend that our clients send us their new billing on a daily, bi-weekly, or weekly basis depending on their volume.

• All claims are submitted to the payer’s with-in 24 hours.

• A daily report of all transaction is provided.

• It is vital to your practice that we receive a copy of (EOB’s) payment received so that we can enter the insurance payment into our system for account reconciliation and invoicing. They can be included in you weekly billing envelope or sent through encrypted software.

We look forward to serving you and your practice, medical group, or facility!

Thanks for your support, please visit us soon!