Electronic Medical Claims Filing FAQ
- Will my claims really get paid faster?
- How fast will I know if the claims have been accepted?
- Will I be able to know at all times what claims have been filed?
- Will I have to have expensive equipment and software?
- Will my patient charts ever have to leave my office?
- So what exactly does the billing specialist need from our office to file the claims electronically?
- I don't have a formal superbill. Can the billing specialist design one for my needs?
- What happens if the claim is rejected or paid wrong?
- What are the liabilities involved in using an outside service?
- How will the information needed to file a claim get from my office to a billing specialist?
- What would my office staff be responsible for?
Will my claims really get paid faster?
Most definitely. Electronic claims are always processed before paper claims, and because of the electronic tracking methods in place, the insurance companies can't claim they never received your claims.
How fast will I know if the claims have been accepted?
You will know that the insurance companies have accepted your claims within 24 hours.
Will I be able to know at all times what claims have been filed?
You will be given a detailed verification report that will show what claims have been transmitted and when.
Will I have to have expensive equipment and software?
No. In fact, you don't have to have any equipment or software at all, if you choose not to. With the specialized software the billing representative has, all of your data entry of new patients, posting of charges and payments, and statement sending can be totally outsourced.
If you prefer not to outsource the data entry, posting of payments and charges, etc., then you can certainly keep your current software and equipment. Your billing specialist will only need a copy of the superbill and patient registration form to perform the billing. The services are totally tailored to meet your individual needs.
Will my patient charts ever have to leave my office?
Absolutely not! Any information the billing specialist needs, he/she would contact your office manager and request it by either fax or phone. Only information that is pertinent to filing the claim is necessary. All patient information is kept in the strictest of confidentiality and is only used for billing purposes. The billing specialist will only have access to what you give them access to.
So what exactly does the billing specialist need from our office to file the claims electronically?
A copy of the super bill for services performed, a copy of the patient registration form, and a copy of the insurance card front and back. If the billing service is going to perform full accounting of payments as well, then they will need a copy of the EOB so they can properly post payments.
I don't have a formal superbill. Can the billing specialist design one for my needs?
You bet. The billing specialist can even put the form on two part NCR paper, so your office won't have to make copies of them. The same can be done for a patient registration form as well.
What happens if the claim is rejected or paid wrong?
Your billing specialist will challenge any and all rejections and will do prompt follow up on any problems.
What are the liabilities involved in using an outside service?
All data is backed up on a daily basis and is stored off site. With our network of over 1500 billing centers nationwide, there will always be help available if needed for any reason.
How will the information needed to file a claim get from my office to a billing specialist?
Once a week or at any time you would like it arranged, the billing specialist will come by your office to pick up the necessary data to file the claims.
What would my office staff be responsible for?
Your office staff will be able to continually concentrate on increasing patient care and follow up on the status of all the patients who come through your practice. With this kind of care, your patients will become great word of mouth referral sources for you.
