FAQ’s

Frequently Asked Questions

General

If I’m not located in your area, can you still do my billing?
Certainly! We already bill for psychiatrists in several states. We can do your billing unless there’s a state law that requires your billing be done in-state. Note: Regretfully, we can’t offer our services in Arizona, Oregon, or Washington State because state requirements say billing services must also be licensed collection agencies.

How much does it cost?
Please check our Rates page.

Do you specialize in mental health?
Yes. Mental health billing is very different from other medical billing. Many times, the mental health payer isn’t the same as the medical payer. Third parties may handle the authorizations for mental health treatment. Even in this age of ‘parity’, co-payments listed on your patients’ insurance cards may not apply to mental health. When we talk with colleagues at conferences, others in medical billing tell us they don’t handle mental health because practices are ‘too small’ or ‘it’s too much work’ or ‘there’s not enough money involved’. Specializing in mental health billing is our expertise and passion. You don’t want to be squeezed into the mold of a larger medical/surgical practice. You want and deserve a billing service that understands your needs. That’s us!

How does it work?
Simple. You send us patient information, we verify benefits. You fill out a daily day sheet, we bill charges. Once you receive payment, fax or scan the EOB for to us. We do the rest!

I don’t participate with insurance or managed care companies, but patients want me to submit claims. Can you do that for me?
Your network status with insurance companies doesn’t matter. You can use our services.

Can you do patient statements?
Always. Patient statements are a central part of our services, included as part of your total cost for our billing services. When needed, we also can send statements to your patients’ attorneys, churches, or any third party payer.

I lose money on sessions not being authorized or because patients use more than their yearly maximum. Do you keep track of authorizations?
Of course! You can’t expect to get paid if we don’t. Some billing services don’t keep track of authorizations, but for mental health, that’s just not acceptable. Every time we submit claims, we send you an Authorization Report with dates through the last day you billed. This report lists patient name, insurance company name, number of authorized visits, number of visits used, start and end dates, and a comments field containing at least number of visits per year. You can keep your authorizations current with this report.

Can my patients call you directly if they have questions about their insurance?
We encourage your patients to call us directly on our toll-free number if they need to. The number is on all patient statements. We allow this so you don’t have to spend time discussing money issues.

Are you able to check benefits ahead of time so that I know how much to charge my patient when s/he comes in for the first time?
You get us the patient information in a timely manner, and we can do this. Complete benefit verification is an absolute MUST which we provide for you. No need for you to wait a month or more for the first claim to be paid before you know how much to charge your patient. Over the years, we’ve found by then your patient may be gone, making it a lot harder to collect co-pay/coinsurance/deductibles than if you collected them in the beginning. Sometimes, if your patient is still seeing you by then, they may have built up a large enough balance that it becomes a therapeutic issue or a barrier to treatment. Getting you as much information about insurance as possible so you can collect as much as possible at the time of service is our goal. After all, good practice management is about increase revenue and decreasing cost as much as possible.

What are your hours? Will I be able to reach you when I need to?
Usually, someone is in the office from 9 a.m. to 6 p.m. Eastern time, Monday through Friday. You can fax to our office 24 hours a day, 7 days a week.

How do I tell you when claims are paid?
Fax or scan the EOB statement coming with the insurance check. Or, we can arrange for the EOBs to be received by us electronically.

Do I retain control over my money?
You keep complete, total control of your money. We don’t get the checks, you do. All moneys are payable to you and come to your address, just like they do now. Other billing services require your money go to a lockbox or an account to which they have access. The idea is they’re doing this for your convenience, so you don’t have to fax or scan EOBs. Maybe that’s a benefit; really there’s a mistrust on their parts that you won’t tell them about all your collections. Our belief is we are your practice management PARTNERS. If we don’t have trust, why bother? Not reporting doesn’t serve a purpose.First, you cheat yourself of the full benefit of our services by under-reporting. Second,patients or insurance companies usually let us know there has been a payment. From our experience, our customers are so happy with our services, they don’t even think about under-reporting.

I am not able to keep track of which claims aren’t paid, and then I lose money because things aren’t submitted ‘Timely’. Will I have to keep track of which claims are paid, or do you do that?
We’ll do that! After all, that’s part of why you hire us. A ‘Claims Aging Report’ is generated weekly for us to see all your outstanding claims so we can follow up on them. Also, on a daily basis, we check our clearinghouse to see about rejections. In case we have to resubmit, being ‘Timely’ isn’t an issue. With electronic filing the clearinghouse can provide proof of ‘Timely’ submissions. Because of this, insurance companies don’t tend to ‘lose’ claims submitted electronically. For paper claims or EAPs, we follow up in plenty of time to resubmit, if necessary.

How often do you bill to insurance?
As often as possible! Daily, if we can. This frequent billing brings a steady cash flow for you!

What is the expertise of your staff?
Please check our About Us page.

Will I have someone personally overseeing my billing?
Completely! We don’t use an ‘assembly line’ approach to billing, as some other billing services do. In a large billing service, there may be one person who verifies benefits, another one who enters charges and submits claims, yet another who posts payments, and still another who sends out patient statements. That’s not us. We’re small enough to give you personalized attention.

Can you process patient credit card payment?
Absolutely. We partner with Authorize.net for this service. Patients have a choice of either calling our office with their credit card numbers or going to a secure online site to pay. You don’t have to buy or rent any equipment … and you don’t have to lose money because your patients don’t carry a checkbook! Note: This service is at an additional charge.

Technology

I’m hopeless with computers! Do I have to know a lot about computers?
Not at all! You only have to know how to operate a web browser or email.

Do I have to buy expensive software?
No! You don’t have to buy any software. All you need is a web browser.

Do you bill electronically?
Yes. Our clearinghouse is Gateway. Keep in mind some mental health insurance carriers (mostly EAPs) don’t accept claims submitted electronically. For the most part, our claims are submitted electronically.

Are you HIPAA compliant?
Completely. We’re a ‘business associate’, and once you hire us, you’ll get a ‘business associate’ contract to add to your HIPAA compliance plan.

Are you submitting NPI compliant claims?
Beginning May 9, 2007, 100% of our claims are submitted in an NPI format.

Are you submitting ANSE-5010 claims?
Yes, as of January 1, 2012.

Will you be able to convert to ICD-10 when it is required?
Yes. We’ll offer you full support for the conversion.

Insurers/Medicare is forcing me to accept electronic deposits & remittances. Can you do that?
Of course. We can electronically post your 835 remittance files. In most cases, this is preferable, because it leads to faster patient invoicing.

Special Billing Concerns

Can you bill for employee-assistance (EAP) visits?
Yes, we routinely bill for EAP visits. There are unique challenges in EAP billing; we understand this. Billing isn’t standard, codes may vary, and often you can’t use a HCFA/CMS-1500 form. We’ll take care of everything except reporting clinical information.

Other Services

Can you extend authorization end dates?
Yes, we can do this for an additional charge; it’s not included in our standard billing package. If you’re not as organized as you’d like, it might be worth the additional cost to be sure your claims get paid. We’ll work with you to see what your needs are and how you might organize yourself to be sure as many of your claims as possible get paid.

I would like to negotiate with insurance or EAP eompanies to try to get better rates. Can you help me with this?
We can do that. Some companies are willing to negotiate, others are not. Your success often depends on things we can’t control, i.e., network needs, location, your specialties, company policy, etc. If you’re interested in this service, we’ll consult with you first to determine the feasibility of successful negotiation.

I am so tired of filling out credentialing & re-credentialing applications! Can you do this for me?
Yes. We can do paper credentialing, CAQH, or online at payer sites, as needed. Usually, an average of 1-2 hours per document is required after we gather all the information about you and your practice.

Can you help me find managed care panels to apply to?
Yes. This is separate from our billing package. We have a lot of experience in helping clinicians find the right blend of managed care participation and non-participation.

Can you review my managed care contracts?
Yes. This is a separate service from our billing package. After reading hundreds of managed care contracts, we can explain the pros/cons of signing them. We’re familiar with the terms and conditions frequently used in managed care contracts.

Can you handle past-due accounts and outstanding claims I currently have?
Yes. Our fee for handling these accounts or claims from dates of service prior to our start date will be separate and distinct from our regular billing package. Also, it will be significantly higher. This is because of the difficulty in getting claims paid that might have been incorrectly billed, not timely, not authorized, and so forth, and patient accounts that might have been allowed to age without prompt billing, bad addresses, etc.

Are you a collection agency? Will you work with collection agencies?
We are not a licensed collection agency. We can’t report delinquent debt to credit reporting agencies nor do we ever contact patients by phone or mail about past due balances. If you choose to employ a collection agency, we can provide information or reports to them.