Services
Full Service Claims Processing
Claims processing available for all specialities via clearinghouse. We input all required information into our billing software then send claims out daily according to established preferences.
Practice Analysis
Reviews are performed to identify patterns of claims denials and the coding utilized in those denials. CPT Coding and Qualifier analysis comparisons are performed to identify optimal configurations to increase accounts receivable. Custom reports available to help show who is paying and where is it coming from.
Our staff includes practicing Surgical Assistant that can review some Op Reports if desired to ensure accuracy and the most effective coding for claims submission.
Claims Follow-up
We aggressively follow-up on all claims to ensure we're receiving timely updates. We contact the insurers and patients on your behalf with the knowledge that if you are not paid, we are not paid.
24-48 Hour Claim Processing
We usually process within 24-48 hours of receiving substantiating documentation for the claim, which ensures a faster turnaround on accounts receivable.
Electronic Claims Submissions
Mederi Services, will submit your claims electronically to Medicare, Medicaid, BCBS and all commercial carriers possible. Printed and mailed claims is unreliable and extremely inefficient.
HIPAA Compliant
We comply with HIPAA privacy and security regulations.
New to Practice or Independent Assisting?
If needed, we will help point you in the right direction to get your practice going and being independent as well as obtaining necessary documents to get started. We know this process can be difficult but everyone has to start somewhere. Unfortunately, there is no book to read, this knowledge comes with years of practice and helping hundreds of other people do it already.
WHAT WE DO!
We provide guidance on the initial setup for first time independent assistants or Practices
No setup fees!
We can provide practice optimization reviews for all clients
We document your personal preferences
Claims are filed electronically whenever possible
You can send us the demographics page, op report, and codes via email or fax
All claims are filed within 21 days of DOS
Follow-up is performed on claims within 65 days of electronic filing
All checks, correspondence, and EOBs are sent directly to you
You can fax or email any received documents to us for processing
Aggressive appeals management of any denied or underpaid claims using proprietary automated appeals software
Appeals are customized by applicable regulations, state and type of provider.
Once appeals are exhausted, professional billing statements can be sent as needed
All accounts are reconciled monthly and statements for services are sent by the 5th of every month
Automated reporting sent out 3 times a month to give accurate status of accounts
Monthly statements include 6 detailed reports identifying the current status of all accounts
Accessible for questions and concerns
Live chat online with staff during normal business hours
WHAT OTHERS DO!
No help for the new practice
Charge set up fee
Only bill for certain credentials
Only bill for certain states
Only bill certain procedures
You are required to input your own data and codes
30-60 day delays to process initial claims
No electronic filing
No initial follow-up for 60-90 days
No transparency into account activity
Checks are sent to you only every other week from the billing company
Generic appeals content
Appeals only on request
Write off claims that has paid anything
Send you a bill at the end of the month with some reports that give limited information about your account
Closed when you need them and have time to ask questions
Their Process! (Co example 1)
You submit (via USPS, e-mail, or fax) relevant documentation (face sheets) about the patient and procedure
They process and send the claim between 30 to 60 days of the date of service
They wait 60 to 90 days for a response from payers
If there is no response from the payer within 90 days, they will begin a follow-up process
If a claim is denied, they will appeal if applicable
Once they receive payment from primary payers, secondary payers will be billed if necessary or available
They will invoice the patient if applicable (individual client to client basis only.)
Reimbursement checks are sent to you directly
You will receive from them and an invoice for all collections for the prior month accompanied by 3 monthly reports
Other report styles are available by request.
Their Process! (Co Example 2)
You submit all the patient demographics and all related documentation to be able to submit the claim
They process and send the claim within 72 hours of received complete documentation
They wait 60-90 days for response from payors
Any documentation request or request to settle will be handled appropriately
If no response from payor within 90 days, they will begin the follow up process with the payor
Any denial that deems an appeal will be appealed appropriately and in a timely fashion. (Not all appeals are appealable)
Once they receive payment from primary payors, secondary payors will be billed if necessary.
If no secondary payor is on file, they will close the account. (Patient billing will be on a client by client basis)
Reimbursement checks received will be mailed to you via Priority Mail with signature confirmation. Once a week if amount is $1000.00 or more, bimonthly if amount is less than $1000.00
Because they submit your claims with your information and your W9, all checks will come to your name, to their billing company but their billing company does not have access to your funds whatsoever
At the end of the month they will invoice you for the fee, payable on the 10th of each month.