In the compliance arena, Medclaims Billing Services’ management leads by example. Therefore, a culture of compliance exists in every activity undertaken by management, consultants and employees. The compliance program has been crafted in the spirit of the Compliance Program Guidance for Third Party Medical Billing Companies, published by the Office of the Inspector General. To this end, a strict code of conduct is adhered-to in discharging all business responsibilities with employees, clients, patients, insurance carriers and other business partners. While striving to collect what clients are legally and ethically entitled to, our efforts will always be within all applicable regulations and guidelines.

Clients see immediate improvement in cash flow. This is because our total focus is billing. Unlike office billers, we are compensated based on what we collect. Therefore, we work very hard to maximize collections. We also have state-of-the-art tools and we are experts in medical billing. This means that the job gets done correct the first time. We have also fostered good relationships with our business partners. So, when problems arise, we take care of them fast and seamlessly.

This question is best answered with another question: Why do you pay an accountant to do your taxes? Professional billers know the industry inside out and have the right tools to get the job done. In addition, office billing-costs (salary, Workman Compensation insurance, etc.) can be eliminated or substantially reduced. You no longer have to worry about the billing getting done, when your biller calls in sick. In summary, cash flow will improve while certain costs will be reduced or eliminated.

The vast majority of claims, except to some very small carriers, go out electronically. This is the case for primary and secondary claims. Medicare and Blue Cross claims go directly, while other commercial claims go out via Change Healthcare and Office Ally. Therefore, most claims are adjudicated within 7 to 10 days. Medicare Explanation of Benefits (EOBs) are received electronically and are automatically posted in our system. Secondary carriers or patients billing are automatically triggered at this point.

None!

Our office and resources are a natural extension to your practice. Capturing patient demographics and insurance information. Posting charges. Editing claims. Claims submission. Carrier billing. Insurance and patient follow up. Patient billing. Appeals. Professional consultation. Assistance with Medicare and other insurances certification. And much more…