DECIDING IF YOU NEED A BILLING SERVICE
Q: How much do you charge?
A: Because we customize our services to serve the direct needs of each practice, rates differ depending on the needs of a given practice. Upon request, we will analyze your practice's needs and quote you a price, free of charge.
Q: I have an in-house billing agent because I can't afford to hire an outsourcing service.
A: The costs associated with hiring an in-house billing agent far exceed the costs of hiring a billing service. Discounting the time consumed with perennial training, the costs associated with an in-house billing staff include paying for vacation time, sick leave, maternity leave, as well as unemployment insurance, social security, health insurance, along with the possibility of paying Worker's Compensation claims. Add to those costs the purchase and maintenance of computer equipment, expensive software updates, and soft costs like postage, paper, toner cartridges, etc., and it quickly becomes apparent that in-house billing staffs cost more than imagined.
Q: My office is small and therefore generates a small amount of claims.
A: MCD handles practices of all sizes and while our fees are practice sensitive, we commit the same resources and expertise to each practice, regardless of how many claims are generated.
Q: Processing our claims outside of the office makes me uncomfortable.
A: MCD is HIPPA compliant and therefore all information received from your office is kept in the strictest confidence. Any professional billing service is merely an extension of their client's office and MCD encourages our client's staff to openly communicate with us about matters relating to the filing of claims.
Q: What about patient information leaving our office?
A: Again, MedClaims Direct is HIPPA compliant, which means all information received from your office is locked away in password protected electronic files. You retain all originals. This paperless system eliminates the possibility that sensitive information will end up somewhere it shouldn't.
Q: How will I get paid?
A: You will retain control over insurance company payments and private payments made by patients as a result of receiving a statement from MCD. Your office will simply provide MCD with accurate copies of any insurance checks, private payment invoices, and EOBs so that our office can update your accounts receivable, keeping your account accurate and up-to-date.
BECOMING A MEDCLAIMS DIRECT CLIENT
Q: How do I get started?
A: Since communication is the key to success, a consultation with you (and your office staff, if you so choose) will be scheduled to identify your billing needs and to troubleshoot potential problems in the billing process. Any necessary paperwork (contract, welcome packet, fee schedule, copies of sample superbill(s), patient registration forms, clearinghouse forms, etc., etc.) will be exchanged at this meeting (or at a time mutually agreed upon).
Q: How long does it take to get started with MCD?
A: Once we have all the relevant information for your account, we will begin billing immediately. While it can take up to four or five weeks for your account to be set up with our clearinghouse, we will submit your claims on paper so that your income will not be disrupted.
Q: Do you charge a registration or set up fee?
A: MedClaims Direct does not charge you for becoming a client. We only accept payment for performance, i.e., the agreed upon percentage of what we generate for you and your office.
ONCE YOU ARE A MEDCLAIMS DIRECT CLIENT
Q: What kinds of information will you require from our office?
A: To be able to efficiently and accurately bill for you and your office, we require copies of all superbills, patient registration, insurance cards, and EOBs. (If mailing, please do not send originals.)
Q: How will we transmit information to you?
A: There are several different methods for transmitting your information to our office: Standard Mail, Fax, and Courier. Depending upon your contract, you will either mail or fax the information to our office. ( Phoenix area only: We can also coordinate a courier run between our office and yours, the specifics of the pick-up to be determined by MCD.) We suggest you assign someone from your staff as a liaison between your office and MCD whose responsibility it will be to ensure that we receive all relevant information in a timely manner.
Q: How often will we send information to MCD?
A: In order to maintain the flow of revenue, we ask that information be sent to us on a daily basis, regardless of whether you are mailing or faxing the information. ( Phoenix area only: the frequency of the courier run will be determined by consultation.)
BILLNG ON YOUR BEHALF
Q: How often will MCD process the information we send?
A: Because maintaining your revenue flow is our primary goal, we have a 24-48 hour turnaround on all accurate and complete information sent to our office.
Q: Can all claims be billed electronically?
A: MCD will submit claims electronically whenever possible. Many commercial insurance companies accept electronic claims, but some do not. Because payments are generated much faster from claims that are submitted electronically, we will endeavor to take advantage of every insurance carrier—commercial or government—that will allow us to transmit electronic claims.
Q: How are payments received and applied?
A: All payments will be sent by the insurance carrier to your office. You will simply provide us a copy of the EOB so that we can accurately post any payments and make any necessary adjustments to a patient's account. If the patient has secondary coverage, this coverage will be billed upon receipt of the EOB from your office.
Q: How does MCD handle denials?
A: Upon receipt of the EOB from your office, we will promptly investigate any denied or rejected claim to ascertain the reason for denial or rejection. In some cases, the claim may require additional documentation from your office, in which case we will contact you or your designate for such information. If an unsatisfactory reason for denial is given by the insurance carrier, MCD will write a letter of appeal and pursue the insurance carrier until payment is received or a satisfactory explanation of denial is tendered.
Q: How does MCD handle account balances?
A: After all insurance payments (both primary and secondary) are applied to the patient's account, MCD will bill the patient for any outstanding amount.
Q: How often and with what frequency will MCD bill patients for outstanding balances?
A: We will send patient statements monthly until we receive payment or until we receive further instructions.
Q: How are private payments processed?
A: Simply provide MCD with a copy of the check, money order, or credit card receipt for any outstanding balance and MCD will apply the payment.
Q: How does MCD handle patient non-payment?
A: MCD is not a collection agency; however, we can send friendly reminders to patients with outstanding balances. With your permission, we can set up payment plans as well. We will often recommend seriously delinquent accounts be handed over to a certified collection agency.
MISCELLANY
Q: What reports do you provide?
A: MCD can provide monthly reports on a variety of information pertaining to your account, including, but not limited to, Practice Analysis, Activity Report, Aging Report, etc., etc. Specific reports to suit your needs can be designed upon consultation.
Q: Will I need to purchase any hardware or software in order to do business with MCD?
A: No. The only piece of hardware required is a standard fax machine.
Q: Can MCD help me design forms for my office?
A: Yes. We can help you tailor your superbill and patient registration forms to meet your needs.
Q: Can MCD code my superbills?
A: No. All coding should be done by a certified coder or by the provider. Any uncoded superbills will be returned to the provider for completion.
Q: How often does MCD invoice its clients?
A: Monthly.
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