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Billing & Revenue Questions  

M.E.D.I.C., Inc. :
Let us answer your medical billing questions


Billing/Revenue Cycle Management:

What is full-service billing?
M.E.D.I.C., Inc.'s “full service billing” includes every task needed to ensure payment after the patient leaves your office: demographics & charge entry, paper or electronic claim submission, claim follow up with payers, payment posting, patient billing and follow up, monthly reporting, denial follow-up, credit balance analysis, and other services.

Sample list of services:
Practice Management Services
• Paper and Electronic Claim Submission
• Secondary Claim Submission
• Charge Posting
• Payment Posting and Adjustments
• Review of Clearinghouse Reports
• Daily and Monthly Patient Statements
• Claim Follow Up and Appeals
• Monthly Financial Reports
• AR Analysis and Clean Up
Consultation/Other Services
• Insurance Benefits Verification
• Appointment Reminder Calls
• In and Out Patient Pre-authorization
• Employee Handbook Development
• Insurance Fee Schedule Analysis
• Front Desk Staff Training
• Birthday/Holiday Card Mailings
• Marketing Your Practice
• Introducing In-Office Cosmetic Procedures
• Analysis of Current Office Procedures
• Form Design/Review of Current Forms

Do I need to purchase software to use your services?
No. You are not required to purchase any software to use our services. We use the Allscripts Professional PM solution (formerly known as A4 Healthmatics Ntierprise), a HIPAA compliant practice managed software. For more information about Allscripts, you can visit their website at www.allscripts.com

How does M.E.D.I.C., Inc. charge for its services?
Our full service billing fees vary by specialty, the size of the group, and services requested since the resources necessary to perform medical billing vary widely depending on those factors. If you would like a firm quote from us for your particular practice, we would be happy to schedule a meeting to discuss M.E.D.I.C., Inc.’s services and the specific needs and dynamics of your practice.

If I become a client, can M.E.D.I.C., Inc. take over my existing accounts?
Yes, if you like. We can convert your outstanding accounts receivable to our medical billing system and provide all follow up services. Some new clients choose to keep their old accounts receivable and work them themselves (or allow a predecessor medical billing service to wrap up those accounts). Please note that we charge an additional fee for working outstanding accounts receivable; that fee varies depending on the amount and age of claims outstanding, among other factors.

Once I become a client, how long does it take for M.E.D.I.C., Inc. to start providing full-service billing?
While in theory M.E.D.I.C., Inc. can begin provision of medical billing services almost instantly, it does take approximately 4-6 weeks for all administrative functions to be addressed (such as changing contacts for all ERAs, getting any necessary VPNs established, etc…).

How does my office provide you with the information you need to do our billing?
You have the option of mailing, faxing, or scanning your charge and payment information on a daily or weekly basis.

Can M.E.D.I.C., Inc. submit claims to insurance companies with which our physicians do not participate?
Yes. We can submit to all insurance carriers regardless of participation status (however, please note that often insurance companies with which a provider does not participate will remit payments directly to the patient/subscriber, who in turn is tasked with compensating the physician).

As a client, can I access my practice’s billing data from my office?
Some clients choose to have direct access to our billing system from their location. Such access allows for some enhanced efficiencies, in that those clients can schedule patients directly into the practice management system, create superbills from the system, know if a patient being seen that day has an account balance, etc…. M.E.D.I.C., Inc. is happy to discuss this access with you!

We are not located in Virginia. Can you still do our billing?
Yes! With the help of modern technology, we can still do your billing with faxing, mailing, or remote access.

Whom should a patient call with questions?
M.E.D.I.C., Inc.'s Customer Service number is listed on all of its clients’ patient statements. This ensures that a patient with questions relating to a statement will contact our office with any billing questions rather than the providers’. At times, patients do call the provider’s office directly. In such instances, M.E.D.I.C., Inc. advises its clients’ staffs to direct such calls to M.E.D.I.C., Inc. , where patient inquiries are handled by a dedicated group of staff members which assists your patients with any questions they might have.

As a client, what reports will I receive and how often?
M.E.D.I.C., Inc. tailors our reporting to the specific needs and requests of our clients. Typically we provide a menu of standard monthly reports. But, as mentioned, we also developed unique reports specific to our clients’ requests. M.E.D.I.C., Inc. can provide you with sample reports for review.

Practice Management Consulting [go back]

What are practice management services?
"Practice Management" is a broad term encompassing many different services available for provision by M.E.D.I.C., Inc. services. It can mean operational assessments to evaluate the business health of practices, internal coding review/audits, educational services/training programs for physicians and staff, among other services. M.E.D.I.C., Inc.'s practice management consultants come from many backgrounds: practice administration, law, coding and billing.

What are M.E.D.I.C., Inc.'s fees for consulting services?
Practice management service fees are highly variable, depending on the type and size of the project. Rates can be hourly, monthly or project-based, depending on a client's needs and objectives. If you would like a firm quote from us for your particular project, we would be happy to meet with you to learn more about your needs.

What are the terms of M.E.D.I.C., Inc.'s practice management contracts?
We structure every contract to meet that particular client's needs. Some contracts are indefinite retainers for our services, while others contain a specific project completion date.

Compliance/HIPAA[go back]

What is "Compliance"?
In the healthcare industry, "compliance" usually refers to the requirement that doctors, hospitals, and payers follow certain federal and state laws and regulations. Many of the laws and regulations address financial issues such as coding and billing. In the past several years, the federal government has stepped up efforts to investigate and prosecute doctors and hospitals suspected of falsely billing the Medicare program, either intentionally or by mistake. Following the advice of CMS (Medicare/Medicaid), many groups have enacted "Compliance Plans" to ensure that their billing and other practices do not run afoul of any federal or state requirements.

What is "HIPAA"?
HIPAA is the acronym for the Health Insurance Portability and Accountability Act of 1996, and the term is also frequently used to mean the many regulations which have been published since 1996 under that law. The HIPAA regulations, including the much-publicized Patient Privacy and Security regulations, are the latest in a long series of government efforts to regulate the healthcare industry. See "Compliance", above. For more information about the HIPAA regulations, please see the official government HIPAA website.

What compliance services does M.E.D.I.C., Inc. offer?
Our practice management staff is highly knowledgeable about healthcare compliance, including HIPAA regulations. We can assist groups with assessing their practices, developing a compliance plan, and implementing policies and procedures, among many other services.

Does M.E.D.I.C., Inc. have its own internal compliance program?
Yes we do. As a third party medical billing and practice management company we are also required to comply with many of the same federal and state requirements as physicians. We have a corporate compliance officer and a privacy officer, who work with our compliance committee to ensure that we stay on the cutting edge of compliance. We also have a detailed written compliance plan and engage in regular employee education regarding compliance issues. All clients of M.E.D.I.C., Inc. are welcome to review our compliance program as part of their own compliance initiatives.


Credentialing Services[go back]

What is credentialing?
Every health insurance payer, including Medicare and Medicaid, requires certain documentation from physicians before they will grant 'participating' status and remit payments for that providers services. This process is called 'credentialing' or 'enrollment'. Physicians (and some non-physician providers) are required to become enrolled at the outset of their relationship with the payer, and then to re-enroll periodically.

How long does credentialing usually take?
Even under the best circumstances the enrollment process can be very long. The time frame varies depending on the payer, but typically would be approximately 1-4 months.

Why should I outsource credentialing?
Many providers find the enrollment process overwhelmingly burdensome and time consuming. Coupled with this, however, is the absolute necessity of proper enrollment to the business health of the practice. Without proper enrollment, payment can be delayed or refused by payers, even if the physician is otherwise ready and able to provide services. Many practices feel it makes sense to outsource this burdensome task to professionals who focus on enrollment and can provide the service as quickly and efficiently as possible. For more information on our enrollment services, please see our enrollment page.

 

 

 

About Practice Management Consulting
About Compliance & HIPAA
Credentialing | Pricing
Questions
     
     
   
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