Due to insurance policies, before patient appointment, authorization or referrals has to be taken from insurance companies to render the services, which includes below works:-
- Eligibility verification: Health insurance policy verification by calling insurance company to verify if respective benefits are covered under policy as per provider’s specialty and if referrals or authorization is required.
- PCP Referrals: Requesting Primary care physician to send referral to specialist in order to get payment from insurance for specialist.
- Insurance prior-authorizations: Calling insurance or faxing appointment information to insurance company so they can authorize the appointment in order to pay for rendered health service.
Before any patient visits the clinic or the place of practice, it needs a structure in place to independently validate & frame a financial clearance policy to determine the amount each patient owes for co-pays and outstanding balances.
At Findmedicalbillers.com Below are the Services offered as part of the Pre-visit policy requirements at our end
- Maintenance and Verification of Patient Information
- Checking of Insurance Eligibility and Tracking Authorizations
- Sending Balance- Outstanding reminders to Patients
- Co-insurance & Development of Payer Guide
- Any issues with the patient’s plan, i.e.: COB analysis
- Pre-existing condition, etc.
- Details of the treatment type & plan to be administered and other related areas like diagnosis & testing procedures, prescription etc as it pertains to practice specialty, examples include:
- In case of physical therapy, Medicare has a Cap on the overall amount per year, we will notify you the total amount met and remaining If you are a specialist’s office, we will notify you if authorization is required for procedures any other details that either you or your office thinks is pertinent, we will check
The ‘Follow-up requirements’ post treatment or post-therapy creates the need to undertake billing activities for patients after the treatment of services have been rendered, So here the degree of follow-up procedures varies depending on the treatment/procedure type along with the type of ailment or disease for which treatment was given or going on.
At findmedicalbillers.com Below are the Services offered as part of the Post-visit requirements at our end
- Insurance eClaims Submission and Frequent eClaims Status Updates
- Secondary Claim Processing (if any)
- Compliance with Carriers Claim Format Requirements
- Assignment of appropriate ICD-9 diagnosis and CPT treatment codes and CPT modifiers if necessary.
- Multi-tiered Claims Edit Checks
- Audit Staff Collections Actions
- An Easy Rebill or Corrected Claim Process
- Analysis of Delay Times in Billing Process Cycle Billing
- A/R processing
- Clear and Concise Statements
- Notes on Patient Statements
- Automated Holds on Statements
- Final Notices
- Denial Management
- Collection Letters
- Payment Plans
- Pre-appointment Balance Review
- Account Types Management
- Analysis of Productivity of Collectors
- Fee Schedules
- Payor Management
Our practice management services range across and beyond medical billing services. In fact, we can serve as your trusted consultant and Mentor, supporting you to consider the many ways to improve cost-effectiveness in your practice to make it more profitable.
At findmedicalbillers.com, we’re happy to educate our subjects by sharing case studies, client references, testimonials, and more, and that will show our commitment that we have for all our clients and business associates when it comes fulfilling the billing requirements so as to increase the profitability and make it a win win situation for all.