àElectronic Claims Submission
àPaper Claim Submission
àUp to Date CPT and ICD-9 Codes
àTop of the Line Billing Software
àSubmission and Status Reports
Weekly and Monthly
àPayment Collections
Insurance and Patient Oriented
Electronic Claims Submission: Software used is a colaboration between Gazelle and ENS Ingenix. This insures that there are minimal errors in claims submission, as well as a tracking system as proof of submission.
Paper Claim Submission: For those insurance companies that do not accept electronic submission of claims, our software is capable of printing physical HICFA/CMS 1500 Claim forms. This is also used for appeals if necessary.
Up to Date CPT and ICD-9 Codes: The American Medical Association releases updates to the medical billing coding system yearly. We have the most updated versions of those codes, as well as update capable software that automatically omits outdated codes. One of the biggest problems in medical billing is incorrect coding, which is nearly eliminated through our work.
Submission and Status Reports: An automatic report generated by the billing software that details the claims submitted, system rejections (if any), and status of submission. In addition we keep and updated list of all bills that were submitted by us on your behalf in a spreadsheet that is accessible to you at your request. This spreadsheet details the date we submitted the claim, all the information on the patients (DOB, Insurance Information, ect) and the most recent status of the claim. This allows for our doctors to ensure that they have not omitted any bills that require submission.
Payment Collections: This divides into two sections. Firstly there is the insurance collections, which is quite self explanatory. We follow the claims until the checks have been received by the doctor and a copy of it and the EOB have been provided to us. Secondly there is patient oriented collections. This is an area that is overlooked much of the time by billing agents. In many cases, claim payments are subject to in and out of network deductibles that are not collected from the physician at the time of service. Typically, once the patient leaves the office it is very difficult for the amount pending to be collected. We provide a service through which we allow ONE month after issuance of decision from the insurance company for the member to pay the balance. If the patient has not payed the balance within the allowed time frame, we automatically forward those claims to a collections department that raises the rate of collections on average by 68%. The majority of the time, the physicians swollow the loss created by the patient balances. Our specialists work hard to ensure that we collect as much as possible from the patients.