Frequently Asked Questions

how much do you charge? 

This depends on how large your practice is, how much patient turnover you have, and how much support you want for non-billing activities like contracting and demographic updates. In general, my fees are 4-8% of the income generated by my billing. Please see the Pricing and Services page. 

how do i get my billing information to you?

Secure email, fax, mail,  phone and/or through your online patient/billing portal. 

How do you know if insurance has paid for all claims?

Depending on the kind of account you want, one of the below scenarios is how I will know what insurance has paid or denied. 

• You will send me copies of the insurance companies Explanations of Benefits (EOBs).
• I will download them for you from the insurance company website.
•  I will receive them electronically through my software system.
• Your online practice management program will receive the Electronic Remittance Advices (ERAs). 

Do you follow-up on denied or underpaid claims?

Yes, as soon as I see a claim had denied or been paid incorrectly, I begin following up with the insurance company. Most claim issues are resolved within a month. 

It is rare, but if  a claim is truly denied correctly by insurance, then I let you know so that we can decide whether it should be paid by the patient or adjusted out. 

What if we don't receive an EOB or Payment for a claim? How will you know to resubmit or follow-up with insurance?

Weekly or monthly, depending on your account's needs, I run an Aging Report to identify the claims that haven't received any payment or insurance correspondence.  

DO you provide Patient services? 

Yes, you can put my name, number and email address on your new patient intake information. I'm happy to talk to your clients and answer questions about their benefits, claims, and balances.  

Do you have a HIPAA compliance plan? 

Yes, and part of my compliance plan includes sending out a monthly HIPAA tip so you can come along with me on the journey of refining and developing compliance in our offices. HIPAA compliance is not a one and done kind of thing. It is an on-going practice that supports and protects you and your patients. 

WIll you sign a Business associate agreement (BAA)? 

Yes, this will be one of the first things I will send you when we begin working together. The BAA states that I will protect your client's privacy. 

DO you have a Contract? 

Yes, my professional organization, American Medical Billing Association, uses lawyer, Robert Liles, JD, MBA, MS,  for consultation, education, and writing contracts. He has been in the healthcare industry for decades. He wrote the contract that I use.  It is a standard industry contract and we will go over it together. 

Do you keep track of what my insurance contracted rates are? DO you HANDLE request to INSURANCE companies to raise rates?

Yes, I keep track of which insurance companies you are in-network with and your rates. I am frequently able to get providers raises from insurance companies. 

What if I want to get off insurance panels? 

I can help you terminate insurance contracts and supply your patients with superbills so they can submit their own out-of-network claims and receive reimbursement directly from their insurance company.