Medical Billing Services
Data Entry - we obtain information from the provider and/or practice and enter this information into our database.
File Claims - the majority of insurance carriers today accept electronic claims; therefore, most of our claims are filed electronically, with the exception of the select few that only process paper claims.
Insurance Follow-Up - is done on a monthly basis. At the end of each month, we review your aging reports and identify any insurance claims that are more than 30 days past due. Fortunately, with electronically filed claims there will be little or no follow-up required. Even so, we like to review and keep on top of this to make sure your accounts receivables don't get out of control.
Statements - are mailed out from our office on behalf of your practice or facility on a monthly basis. We do not send bills to your patients until the insurance carrier has responded, payments, co-pays, deductibles and coinsurance percentages have been applied, and contracted provider adjustments have been made.
Our protocols allow for three billing cycles, with the third statement sent as a final notice. If no response is received from your patient, we prefer to assign the account to Financial Credit Network for further collection activities; however, we are open to your personal specifications regarding this issue.
Payments - are always sent to you by insurance carriers and patients alike. As we receive copies of payments and explanation of benefits (EOBs) from you, we post these into our database. Each EOB will be audited for correct payment and/or benefits.
Appeals - if a payment or denial has been made incorrectly, we challenge the insurance companies to receive the correct reimbursement for you, plus penalties and interest if applicable.
Reports - are done on a monthly basis, and include month end charges, adjustments and collection reports, as well as month end patient and insurance aging reports. Additionally, we will provide you with an updated patient list each month end of all the patients we have previously entered into our system; thereby, allowing your staff to save time and money in duplication costs.
Fee Schedules - it is vital to have fee schedules with the insurance companies and networks that you participate in updated on a yearly basis. We request these fee schedules and update your pricing in our database accordingly in order to make sure you are being reimbursed the maximum allowable by each carrier.
Medical Coding - is a serious business in this day and age and without the knowledge of medical coding and reimbursement methodologies many practices lose revenue. Therefore, we assign the correct ICD-9, CPT and/or HCPCS codes derived from the medical information your office staff provides; thereby, making sure you will be reimbursed without delay.
Medical Coding Audits - we analyze your medical records and previous coding to make sure you are on the right track and understanding of medical coding. If there are any discrepancies, we will identify these and help provide you with training, so that you receive the maximum reimbursement possible.
*Encounter Data Entry - MDMBS is one of the few medical billing services that provides the processisng of capitated/encounter data services.
Encounter data is becoming increasingly mandated and monitored by health plans and IPA's to track quality and initiate disease management programs.
Many IPA contracts require providers submit encounters for capitated services and are instituting bonus programs to encourage compliance.
In addition, Medicare has instituted payment increases for specific diagnosis for Medicare recipients. This is monitored through encounter data submissions.
Are you missing out on additional revenue for your practice? Rates are based on a % of the copayment paid by the patient so the costs match the volume and there are no out of pocket expenses to the physician.
*Please note that we will only be able to provide Encounter Data Entry services to those practices that sign up with us to provide all of their medical billing services. As a business, we are sure you can appreciate that we are unable to assist those offices that only require Encounter Data Entry.