File Claims
Most claims are filed electronically and we will work with clearinghouses to ensure claims are transmitted per payer specifications. We will implement a process for sending secondary claims and review payer response reports to ensure claims are received by the payer. Billing and, LLC will file claims electronically or paper and ensure accurate and timely filing of secondary claims therefore increase your cash flow by maximizing first time acceptance of claims.

Send Statements
Statements or collection letters are sent on behalf of your practice or facility. The protocols of statements and collections are performed per your specifications. You can customize statements and collection letters.

Electronically Post Payments
At Billing and Collections.Com we will provide payment posting with automated feature that requires very little manual labor. We coordinate set-up with payers to ensure receipt of electronic remittances, retrieve electronic EOBs and set-up reason rules and payment guidelines to improve AR denial tracking, balancing each remit and provide an auditing process to ensure accuracy.

Verification of Benefits
Automation is key and therefore we will put the automated verification of benefits performed prior to appointment in conjunction with facility schedule. We will create registration and health history forms as well as coordinate online features for pre-registration process.

Your liaison will provide an evaluation of payer payment patterns and identify root causes. AR reports can be produced in a wide variety of ways to create the best snapshots of what is happening and where things need to be modified to achieve maximum results. A detailed and specific report outlining days in AR, what trends are discovered as well as what can be done to collect maximum dollars.

Denial Management
Billing and Collections.Com will help assess denial patterns and trends in your practice and quantify the actual impact of denials. We will provide a detailed list of codes or procedures being denied and provide education as to how to resolve future denials.

Decrease AR Days/Reduce Bad Debt
One of our services help to increase collections by identifying payer specific reimbursement guidelines with highly experienced insurance representatives and review prior guidelines (if any) and recommend new guideline. At your request, your liaison will arrange and be part of insurance representative meetings.

Increase Payer Reimbursements
Your team will establish systems to assist personnel in the day to day collection of deductibles and co-payments. We provide education and system guides to personnel and train when appropriate to increase payer reimbursement and provide scripts as needed.

Because each practice is different customized reports as per your request will be furnished. Financial and operational reporting including interpretation of data and implementation strategies to improve financial and operational performance.

EOB Storage
We electronically store and scan EOBS from payer.

Intake / Data Entry
We obtain the patient demographic data from the provider and input it in our system.

Medical Coding
Our Medical Coders have vast experience in all specialties, including: Radiology, Emergency Medicine, Pathology, Cardiology, Otolaryngology and Dermatology to name a few. We are experienced with CPT, ICD-10, and HCPCS coding across all specialties, insurance and governmental requirements, and payer-specific coding requirements in the region.

Coding Benchmarks
At Billing and we know how important benchmarks are and therefore we will generate reports based on coding trends and compare data to other providers to determine if you are compliant with others.

Coding Questions
Unsure of the correct CPT code to use? Can't find the right modifier? Submit us your coding question via email and we'll get you the answer. Train all aspects of CPT, ICD-10 and HCPCS codes, provide claim appeal letters claims with supporting documentation.

Document Review
We review medical records to ensure that the documentation supports the service that was billed, ensuring that there has not been up or down coding.

Educational Feedback
To ensure that all that we discover can be corrected prior to claims going out we will provide education and training material specific to your specialty.

Charge Capture/Lost Revenue
Our goal is to ensure that all services that are performed are billed and make every visit a reimbursable service. We review encounter forms and documentation to ensure that you are capturing all office charges, as well as set up access to hospital records to ensure capturing of all hospital charges.

Billing and Collections