Medical Billing Collections

There’s two types of collections – Patient and insurance.

Patient Billing

Patient billing is the process of charging patients for amounts not covered under their insurance plan. Medicare requires the patient be billed for their responsible coinsurance or deductible amount. There are however Medicare patients who can be exempted due to documented hardships.

Most commercial insurance provider contracts require the patient be billed for deductibles , copay’s, and coinsurance so it’s important the provider understand this.

For our clients we’ll typically print statements and mail to the patients once a month. Most medical billing software programs have a feature for creating and printing these statements.

Sending out patient statements for a large practice with many patients can be very expensive. Many clearinghouses offer services to print and mail statements. All we have to do is print our statements to an electronic file and upload to the clearinghouse for processing.

This is a tremendous time saver. Stuffing hundreds of statements into envelopes is very time consuming and labor intensive. Not to mention the logistics of getting all those envelopes mailed.

Insurance Collections

Also referred to as aging. This is a tedious process which involves a lot of phone calls to insurance companies to determine why a claim was denied. Most insurance companies have an automated phone system that allows you to check status. However entering all those numbers via the phone keypad is tedious for a medical billing specialist. A lot of larger insurance companies may have the ability to check claim status on-line.

A good reason it is so important to get the claim right the first time and avoid all this work. In general the longer a claim goes unpaid, the harder it is to get paid.