Medical Billing Service Company

How Does 5 Star Billing Services Do It?

Our Proven 5 Star Medical Billing Process is guaranteed to improve your collection percentages. The 5 Star Medical Billing Process includes:

• Efficient, accurate and complete data exchange
• Electronic and paper claims processing
• Aggressive AR follow up and insurance collections, payment postings & EOB analysis
• Patient Statements and balance collections
• Monthly practice analysis & collections reporting meetings

Getting Started With 5 Star Billing Services

Before we can even begin our 5Star Billing Services process, the first step is to determine your needs, learn what is important to you and how we can best help meet your goals.

Efficient, accurate and complete data exchange

Initially we ensure that the overall transition and implementation process is handled smoothly and efficiently. We will seamlessly migrate data from your current billing system or service provider. Then we focus on integrating systems and processes. We work with your staff to ensure that correct information is exchanged in a timely manner. We will work as closely as possible to do things correctly the first time so we can obtain the highest reimbursement possible in the shortest period. We have set up systems to facilitate a very efficient exchange of information. We will train your staff so that we can work as a team. Most Practices prefer a 5 Star team member to enter new patient information directly into our software from the patient intake documents. We double-check the data for accuracy and completeness before generating claims. Accurate and complete patient information is the first step to getting claims paid successfully.

Electronic and Paper Claims Processing

We are passionate about processes, because we know that a well-managed process prevents errors and maximizes the output ensuring that billing errors are corrected before they become problems. We catch incorrect codes, data-entry mistakes, and missing information to avoid costly delays, denials, and resubmissions. Delays are minimized and AR days reduced as we scrub claims before they are submitted. We excel in accurately coding and billing for professional fees and medical equipment and supplies. We keep current with insurance specifications and regulations and ensure the fees are kept at the maximum allowable reimbursement. We also focus on procedure codes so claims are not suspended or rejected. We process Secondary Carrier claims upon receipt of the primary carrier EOB making sure that you receive the maximum amount covered by the insurance companies and minimizing out-of-pocket expenses to your patients.

Most claims are sent electronically on a daily basis. Paper claims are usually mailed weekly.We process claims for Medicare, BC/BS, Medicaid and 1900 other payers. We also handle Workers Comp, Personal Injury, Cash Payments, HMO and PPO claims and payments.

Aggressive AR Follow Up, Insurance Collections, Payment Postings & EOB Analysis

Each EOB is audited for correct payment and/or benefits and credited appropriately. When necessary, immediate steps are taken to process and repair unpaid or reduced claims to ensure that you receive every possible penny. Checks are mailed directly to you.

We continuously track your net collection rate (the actual payment vs. the contracted rate) to ensure you are getting your fair share. 5 Star Billing Services will improve your net collection rate and your average collection per charge, which translates to more money in your pocket. Our goal is to help you get started or to help you improve your existing practice. Remember, if you don't get paid, we don't get paid. It is to our mutual benefit to collect the full reimbursement for services rendered.

Each month we work on the accounts receivable aging report. When a claim is not paid, we research and fix the problem and resubmit the claim. We will reduce your accounts receivable days outstanding, which means less of your money is tied up. We aggressively track, manage, and follow up immediately on all denials

Patient Statements and Balance Collections

We manage all patient billing including printing and mailing all patient statements and follow-up statements, and we handle all patient questions and calls. We audit for accuracy before we send statements to patients. We create clear, concise and informative patient statements to minimize the number of calls from patients needing clarification of their bills - fully customizable (summary or detailed format). We also write and mail patient collection letters.

Monthly Practice Analysis & Collections Reporting to Regain Control of Your Business

5 Star Billing Services helps you unlock the insights and intelligence within your own data to help you run your business better. We offer complete reporting solutions, including customized and on-demand reporting. In addition, we analyzing your data and draw the conclusions required to continually improve your business. We run reports to identify denials or difficult payers and follow-up with calls and appeals. Reports include:

• Instant access to accurate aging to know who is really delinquent
• Collection calls
• Follow-up and documentation
• Appeal insurance carriers on delayed or denied claims
• Medicare/Medicaid Credit balances - run report to catch monthly government credits
• Refunds
• MTD Summary all Visits, New Patients, Charges, Total payments, Cash Payments, Insurance payments and Adjustments.
• Year to Date Report
• Practice Stats Report
• Payment report (by charges or payments)
• Procedural Analysis Indicating Revenue Generated by each Procedure
• Diagnosis Report
• Claims Cost Analysis
• Patient referrals / Referring doctors
• Custom Report Generator: allows you to extract any information you need from the database

Remember, if you don't get paid, we don't get paid. It is to our mutual benefit to collect the full reimbursement for services rendered.

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