Frequently Asked Questions

  1. Why should we use a medical billing service and yours in particular?
  2. How long have you been in the medical billing business?
  3. Do you have experience in our specialty?
  4. How do we get the process started?
  5. How quickly can we get started and be up and running?
  6. Do you handle practices of all sizes?
  7. Will you provide a list of references?
  8. Will our practice have a dedicated account manager?
  9. Is your billing service wholly based in the USA?
  10. What is the turnover rate of your staff?
  11. Does our practice have to be near your Billing Center?
  12. Will we have real-time access to all our patient accounts?
  13. How will we know how our practice is doing financially?
  14. How will you support us in transitioning to ICD-10?
  15. Do you offer EMR?
  16. We already have EMR; will your billing software interface/talk to our EMR?
  17. Do you offer electronic prescriptions?
  18. How much do you charge for your services?
  19. Why do some billing firms only charge by the claim vs. a percentage of collected revenue?
  20. What services can we expect?
  21. How do we get our existing patient data to you?
  22. Do you transmit claims electronically?
  23. How often are claims processed?
  24. How will we get our patient information and billing sheets to your Billing Center?
  25. How quickly will we be reimbursed?
  26. Where will claim remittances be sent?
  27. Do you bill secondary and tertiary patient insurances?
  28. How can you reduce insurance claim denials?
  29. Will your Billing Center handle appeals for claim rejections?
  30. How do you follow up on delinquent claims?
  31. Do you send patient balance-billing statements
  32. How does your office handle uncollectable accounts?
  33. Does your Billing Center handle all patient billing questions and disputes?
  34. Do you send patient recall letters?
  35. Does your service include provider credentialing?
  36. Will you help us with Tax Identification Number and address changes?
  37. Will you help us stay current with the frequent changes in medical billing laws and regulations?
  38. Are there differences in billing from state to state?
  39. How do we know our patient data is secure?
  40. Is your Billing Center HIPPA compliant?

  

   Answers

  1. Why should we use a medical billing service and yours in particular?
    The main reason for opting to go with a billing service is that you did not endure medical school and subsequent training for 8-10 years to supervise a medical billing operation. You do what you do best. We do what we do best and we have been doing it for more than 21 years.  Speak with our clients and you will soon find the rewards far outweigh the small fee.
     
  2. How long have you been in the medical billing business?
    We have been providing quality medical billing services since 1993.
     
  3. Do you have experience in our specialty?
    AMB has experience in numerous specialties.  Based on our control-oriented methods, thoroughness, experience and teamwork, AMB’s management and employees are capable of successfully managing the revenue cycle of any practice or specialty.
     
  4. How do we get the process started?
    A simple call to Advantage Medical Billing will immediately start the ball rolling for you.
     
  5. How quickly can we get started and be up and running?
    The Medical Billing Service industry is highly regulated and contracted services are subject to Federal, State, and Clearinghouse approvals.  This may take between 1-2 weeks depending on the agency and other factors. However, during this waiting period, we will accept your claims and begin to structure the billing process.
     
  6. Do you handle practices of all sizes?
    Yes, from sole practitioners to large groups.
     
  7. Will you provide a list of references?
    Yes, upon valid request.
     
  8. Will our practice have a dedicated account manager?
    Yes. Dedicated Account Managers will be your first point of contact.  They all have numerous years of experience as do their support staff.
     
  9. Is your billing service wholly based in the USA?
    Yes. Our office and staff are all located in the USA.
     
  10. What is the turnover rate of your staff?
    Our average term of employment is 10 years.
     
  11. Does our practice have to be near your Billing Center?
    Distance is not a relevant factor considering the electronic communication venues available.
     
  12. Will we have real-time access to all our patient accounts?
    Yes, via our online secured portal.
     
  13. How will we know how our practice is doing financially?
    We live by informational transparency. Our Practice Management System has one of the best management reporting modules in the industry.  We provide a monthly report package to give you a relevant snapshot of your practice.  We also review each report with you to ensure you have an understanding of all relevant information. All management reports are available for viewing/printing as needed.
     
  14. How will you support us in transitioning to ICD-10?
    This depends on your current situation including whether you are currently automated and/or have an EMR system.  Our Practice Management Software is fully ready for the transition to ICD-10. We have proprietary billing sheets adapted for ICD-10 and we provide access to coding programs to help you make the transition smoothly and with ease.
     
  15. Do you offer EMR?
    Yes, it is available as a discounted option through our software vendor.
     
  16. We already have EMR; will your billing software interface/talk to our EMR?
    Yes. Our Practice Management Software is HL7 compliant. It will interface with all other HL7 compliant programs.
     
  17. Do you offer electronic prescriptions?
    Yes, it is available as a discounted option through our software vendor.
     
  18. How much do you charge for your services?
    Our fees are a percentage of revenue collected for the monthly period plus postage.  Based on the volume of the practice this percentage may be stratified.  Various other factors can generate discounts for the practice.
     
  19. Why do some billing firms only charge by the claim vs. a percentage of collected revenue?
    The fee per claim usually only includes claim submission with the majority of the difficult medical billing work being done by the practice staff.
     
  20. What services can we expect?
    See “Services” Tab.
     
  21. How do we get our existing patient data to you?
    One option calls for a comprehensive data conversion process that includes a one time programming fee. We recommend a piecemeal option that calls for absorbing patient demographic data as patients come into the practice.  The latter is cost effective and allows for weeding out inactive patients and updating all others.
     
  22. Do you transmit claims electronically?
    Yes. Our clearinghouse accepts a vast majority of commercial primary carrier claims and an increasing number of secondary carrier claims.  Medicare is 100% electronic with automatic crossover to scores of secondary carriers.  CMS 1500 paper claims are generated as needed.
     
  23. How often are claims processed?
    Claims are processed on a daily basis, and submitted 3 times weekly. This allows for the quality control that we value so much.
     
  24. How will we get our patient information and billing sheets to your Billing Center?
    We provide prepaid mailing envelopes.  Encrypted scanning and emailing of billing data to AMB is also possible.
     
  25. How quickly will we be reimbursed?
    Most major insurance companies will reimburse clean claims in 7-14 days. Setting up EFT with carrier can shave 1-2 days over paper payments.
     
  26. Where will claim remittances be sent?
    You will continue to receive your checks and EFTs at your office and/or bank.  We do not accept any claim reimbursements or patient payments at our Billing Center.  Doing so would negate the Accounting principle calling for separation of duties.
     
  27. Do you bill secondary and tertiary patient insurances?
    Yes. We cascade to each insurance carrier on file.
     
  28. How can you reduce insurance claim denials?
    We carefully review and scrub (diagnosis specificity, appropriate modifiers usage, CCI conflicts, code obsolescence, quantity check, each claim prior to submission.  We verify demographic and insurance information for completeness and accuracy. We also immediately resolve all clearinghouse pre-submission exceptions. 
     
  29. Will your Billing Center handle appeals for claim rejections?
    Yes. We will consult with the provider and will handle the appeal process.
     
  30. How do you follow up on delinquent claims?
    We generate Account Receivable Aging Reports on a regular basis to pursue outstanding claims and patient balances.
     
  31. Do you send patient balance-billing statements?
    Yes, we mail three balance-billing statements to patients and attempt to contact patients by phone. Final Notice letters with a due date are issued and the provider is advised of the situation.
     
  32. How does your office handle uncollectable accounts?
    If we are unable to obtain payment from the insurance carrier(s) and the patient, we promptly advise the provider and request the guidance on how they wish to handle the account.  This may involve brokering a deal with the patient, setting up budget payments for the patient or starting collection proceedings.
  33. Does your Billing Center handle all patient billing questions and disputes?
    Yes. Patient statements list our telephone number and our expert staff is happy to handle all patient inquiries and problems.
  34. Do you send patient recall letters?
    Yes, we generate and mail recall letters.  We encourage this activity to help provide quality healthcare and retain/enlarge your patient base.
  35. Does your service include provider credentialing?
    Yes, for direct Federal and State agencies.  For commercial carriers we will utilize the CAQH Universal Provider Datasource service.
  36. Will you help us with Tax Identification Number and address changes?
    Yes. Whether you are a new, established practice or if you have left/joined a group, we will help you with these issues.
  37. Will you help us stay current with the frequent changes in medical billing laws and regulations?
    Yes. As we become aware of regulatory changes, we pass the information to you and explain the impact to you.
  38. Are there differences in billing from state to state?
    Generally, the medical billing process is quite fluid on an interstate level.  For commercial claims, the process is seamless. For Federal and State Agencies, we secure specific approvals from the respective agencies before claim submission can proceed.
     
  39. How do we know our patient data is secure?
    Our data servers are redundant, have layered firewalls, continuously updated virus protection and use VPN tunnels for secure data transfer.  We do data backups on a nightly basis and store the backup medium offsite.  Restore procedures are tested frequently. We secure network access with layered login protocols using complex and expiring passwords.  Workstations have security screens with timed inactivity logoff. Billing Center access is limited to employees and protected with monitored security systems. All PHI documentation is carefully shredded. Employees are well versed in HIPPA Privacy Compliance.
     
  40. Is your Billing Center HIPPA compliant?
    Yes. See “How do I know my patient data is secure?”
Call Adsvantage Medical Billing today


“I have been very satisfied with Advantage Medical Billing. Our Account Manager and the supporting staff are always very thorough, pleasant, and helpful.”

Colorectal Surgery Practice – Summit, NJ

“After Medicare computerized, we tried for
2 years to keep up with manual billing and
spent 8 years doing our own computerized billing.  It was nearly impossible for our office staff to maintain the computer skills necessary to use the software – even after trying 3 different software packages. At that point,
we decided to hire Advantage Medical Billing. 
It is one less headache for us and we have
never been sorry for that decision.  They are highly recommended!”

Orthopedic Practice – Rahway, NJ

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1020 Springfield Ave., Mountainside, NJ 07092 | Email: info@AdvantageMB.com