Frequently Asked Questions:

  • Is there a minimum amount in revenue that I must generate to qualify for your billing service?
  • No there is no minimum amount in revenue required to qualify for our billing service. However we do have a minimum monthly fee depending on your speciality.
  • I feel like I would lose control over my billings if I outsource. How can you assure me the billing service is doing a good job?
  • The first response to this question is other questions:

    • -How much control do you have now?
    • -How accountable is your in-office staff to you now?
    • -How do you know your in-house staff is doing a good job?

    Chances may be that you really don't have the control or accountability you think you have. Providers can get a false sense of security when they see somebody sitting at a desk in their immediate office space. However, many providers have no formal audit processes in place. Does your staff simply write off rejected balances? Or do they ask you for permission to write off balances rejected by insurances because your staff doesn't know how to unbundle procedures with the correct modifiers? Do you have a mechanism in place to check if all services provided were billed to the insurance within 24 hours? Do you balance your system daily regarding copays and CC payments in the office? Do you balance your bank deposits versus total amount posted in your system? Are you sure your patients are getting a regular statement?

    Unless the provider or a reliable designated staff member is actively reviewing all aspects of your billing staff's work, you have no real idea how effective your staff is, the money you are losing, and the cost-benefit of having in-house staff versus outsourcing.

    Our quality billing service, allows our providers real-time access to their accounts so that they can see what dates of service are being entered, the turn-around time from date of service to date of posting, no write-offs without your specific approval, status of the aging; basically any level of accountability they want.

    Lastly, a quality billing service will provide some basic benchmarks that they hope to achieve for your practice. Depending on your fee schedule and contracts, you should collect an average of 65 to 75% of your gross charges. At here at Peak Medical Billing it is our goal to keep your aging over 90 days below 5%.

  • What benchmarks should I be looking for from a billing service?
  • The Healthcare Billing and Management Association, the only professional association for billing services, has established the following benchmarks of excellence.
     
    • Turnaround time from date of service to date of posting should be no longer than 45 days with the exception of WC claims with a turn around time no longer than 60 days. This assumes a clean claim. With the increase of electronic remittance, the turn around time for many of the larger carriers, including Medicare, has been reduced to 2 to 3 weeks, or less, in some cases. Obviously, there will always be denials by carriers so if there is a problem with a claim, reviews, redeterminations and hearings can add 30 to 90 or more days to the cycle.
    • Over 90-day outstanding insurance claims should not regularly exceed 10% of the entire gross charges. Exceptions are only practices with more than 50% WC claims.
  • What about patient owed-balances? Will the billing services contact patients who do not pay their bills or do not follow the payment plans that the patient agreed to?
  • That depends on the billing service you contract with. Peak Medical Billing LLC has a soft-collection procedure implemented. We usually call the patients when mailing the 2nd statement to verify the correctness of the mailing address. Patients with a balance over 90 days due will receive a phone call and a letter notifying them about collection action if we received the doctor's approval to send the patient to a collection agency of his/her choice.
  • Do you help in the credentialing process?
  • Yes we can assist you with the credentialing however this will be billed by the hour as a separate task.
  • Why trust your billing company?
    • We are specialty focused and we know your specialty inside and out and are better trained to recognize problems and trends that could be detrimental to your practice's income.
    • Our company has been established for over 10 years statewide in California and our billing experience covers many different specialties. Don't trust an inexperienced home based company that just owns a computer and some HCFAs.
    • Fact is, that we can bill for less! The average physician spends 15% of their overhead on billing. The costs for medical billing easily add up considering costs of recruiting, training loyal staff, high salaries for good office managers, keeping software and hardware updated, office supplies and office space.
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