In-House Biller VS. Outsourcing Billing

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Outsourcing can result in:

  • Higher collections and lower rejections!
  • Higher billing production
  • We will be 100% focused on billing and seeing claims paid correctly.
  • We can focus on the data entry and electronic transmission of your claims. Claims can be transmitted to the insurance clearing houses daily if that is your wish.

Front to Back Support!

PATIENT ELIGIBILITY

When our expert insurance verification process starts, we ensure that clean claims are being submitted to the correct and active insurance companies.

CLAIMS REVIEW

Prior to submission, each claim is reviewed for any errors or irregularities.

INSURANCE BENEFITS VERIFICATION

Next is checking eligibility to see if the requested medical or behavioral services are covered and what the patient can expect to pay.

AUTHORIZATIONS

We will contact the insurance companies to obtain authorizations. We understand you and your providers are busy. We will integrate with your team to obtain the necessary information to complete these authorization requests. If needed, we can even help coordinate peer to peer appeals for authorizations.

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Collections

Once we receive notification an insurance company has paid you, we reconcile each claim on the corresponding remit. A monthly report of all payments you were paid is sent to you. This way you don’t have to worry if there are payments missing from your bank account! We will even reconcile your deposits for you and ensure you are getting every penny!

Any underpaid or denied claims are worked immediately. This is done through appeals, gathering updated patient information, and having claims reprocessed. We will contact the insurance companies so you don’t have to wait on hold!

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Follow Up

We will also follow up on the patient balances for you and make sure your front staff is aware of what they should be collecting at the time of each appointment. This includes changes in benefits, when a deductible is met, past balances due, and missing coordination of benefits. Don’t worry if you do not understand these terms; we would love to help explain these to you, your staff, and even your patients when needed!

In the event your staff and ours have exhausted all resources, we are prepared to help connect you with a collections agency and handle the reporting for you as approved.

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What We Can Offer

  • The ability to dedicate enough time to follow up on insurance claim denials
  • We have the time to read and identify the reasons for a denial
  • We have the time to look for denials that may not be sent to your office
  • We have the experience to quickly understand denials and know exactly how to appeal for payment
  • We have the time to sit on hold for as long as it takes to speak to insurance call center representatives regarding denials
  • We have the experience to work with insurance call center representatives for reprocessing and appeals of denied claims
  • We have the time to document each claims denial into to each patient chart for confirmation of claims denial resolution and follow up, if necessary
  • We will work your aging monthly to make sure all denials are worked and resolved as soon as possible. This creates a higher rate of reimbursement for all of your hard work

Relieve Pressure

We will handle ALL patient balance billing phone calls. These calls won’t even ring into your office, saving your staff valuable time to do the work you need them to do.

  1. We can answer clearly and correctly ALL patient billing questions, resolving any indecision or confusion for your staff.
  2. We will work and mitigate with all patient billing issues. We will do this with compassion and understanding! Hey, stuff happens.
  3. No follow up on patient payments processed at your office, only copays, coinsurances, and deductible balances collected by your staff. We can help you know what needs to be collected at the appointment!
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We’ve Got Your Back

We have always tailored our billing approach to each individual provider and staff needs. We are happy to work with you for as long as it takes for your outsourced billing to work seamlessly and without much effort on your part. It would be our privilege to work with you to understand how hard you work and to work just as hard to get you every penny possible!