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Standard Services

  • Posting of all patient procedures (IN/OUTPATIENT)

  • Posting of all payments--cash, checks, credit/debit transactions

  • Eligibility Verification (limited)

  • Match computer balances to bank deposit. Report any discrepancies to the business office

  • Update and/or verify insurance and patient demographics.

  • Insurance billing (included, but not limited to):  Private, HMO (Including Capitated/Managed Care Plans), Medicare/Medicare Risk Plans; Medi-Cal/Medicaid Plans; Workers' Compensation; Personal Injury

  • Capitation Payment Posting and Adjustments (If applicable)

  • Denials and re-submissions (includes ‘TRACER’ claims, insurance correspondence, and appeals)

  • Aging (A/R analysis) with billing support by our Claims Research & Recovery Specialist.

  • Secondary payer billing

  • Print and mail patient’s monthly statements, including Collections System [friendly reminder, past due, final notice]  POSTAGE INCLUDED

  • Refunds

  • Daily and Monthly Close

  • Daily software backup (if support is needed)

  • Receive patient phone calls/inquiries regarding billing issues

  • Monthly/as needed meetings with Office Manager and/or Provider(s)

  • Standard Reporting: Aging Summary (Request for Review and Aging Detail for Billing Office  use); System Summary;  Production Report; Period Totals per provider; YTD totals per provider/practice; Tracking of Aged Percentage and Days In A/R. 

  • “Best Practice” Standards: (Days in AR: <35; Aging - Current: 55%; 31-60: 24%; 61-90: 10%; 91-120: 7.0%; 120>: 4.0%)







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