I am a Medical Claims Specialist and owner of Healthcare Billing, Inc. I have been processing claims for 15 years for multiple clients.
I currently process claims for a Mental Health Practitioner based in Vermont, in addition to multi-specialty (Medical), Group of Providers whose practice is based on home visits for homebound patients, Physical Therapy, Pain Management and Mental Health groups.
The rate I charge is 5% of the total amount on collected (paid) claims only, or $4.50 per claim (including rejected claims – meaning front end of the billing cycle issues such us no coverage,pre-authorization, plan c issues for Medicare, etc) I work from my own office utilizing my own resources, and cover the costs of the billing software, government payor’s network service, the clearinghouse and all necessary expenses to submit the claims electronically.
Once an agreement is reached – I give my clients options on how to work together. For example, if you prefer to have us utilize your existing EMR Software in order to process your claims, you would simply provide us with a report from your EMR on charts that are ready for billing and the log in information. We would then review your patients’ charts and assign the corresponding level of Evaluation and Management CPT codes, in accordance with the E/M Guideline and CPT codes for other procedures and discipline. This includes assigning the ICD 10 diagnosis codes. Alternatively, I can provide a superbill for your Practice to fill out and send to me via e-mail/fax. Once the claims are processed, I send a detailed report for your records. Please note – for Payors that do not require EDI enrollment – claims will be processed as soon as possible. For local clients, I could also work in your office location.
Most importantly, my turnover is 24 to 48 hours, depending on the number of claims. For example, if I receive 50 claims today, the claims will be submitted by the next business day. For over 100 claims, usually my turnover is 48 hours.
As for credentialing – I charge $250 per Provider, per insurance panel.
However, for maintenance purposes (revalidation-re-attestation) of already credentialed Providers – this service is free.
Choosing to outsource your billing or switch to a new billing company is an IMPORTANT investment decision. We know that this decision can be very difficult. What separates us from our competition is our flexibility to meet your billing need and our commitment to pursue every claim for our clients. After all, we only get paid if our clients get paid. I do understand how busy your schedule can be. But, if you find any free time, please do not hesitate to call me at any time
Samples of my work are available upon request
Website: http://www.hc-billing.com