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 Take Advantage of Me in 2004!!! There is more to ClaimTek than Medical Billing. As a ClaimTek client you can take advantage of the other vital services and resources offered by ClaimTek. ClaimTek offers a variety of solutions that medical practices in your area will be interested in. For the next two months we will highlight some of features of the Collection Letter Service and the need for this service. The ClaimTek Collection Letter Service - As a billing service, you submit claims electronically to insurance companies and mail statements out to patients to collect their portion. While most claims get paid within a few weeks, a small percentage of claims does not get resolved and can be difficult to conclude. You typically file tracers and even make phone calls to the insurance companies but, unfortunately receive marginal if any response. Since your billing service is not setup as collection agency to deal with these unpaid accounts, your client, the doctor, is usually faced with two difficult choices. Either write off the unpaid accounts or refer them to a hard-core collection agency; in which case the medical practice looses 30 to 50 percent of the value of the claim. In addition to this high percentage fee, the practice will most likely loose the patient as client. Harsh collection measures usually result in the loss of patient goodwill. The insurance industry is very highly regulated. Given the current climate in the medical field, it is extremely difficult for almost any practice to enforce these regulations upon the industry. Virtually all states have legislation in place requiring insurance companies to pay or deny claims within 30, 45 or 60 days. Yet, billions of dollars in claims are not paid or denied within these legal requirements. Our company has developed a program specifically designed to utilize the states' insurance laws and regulations to force insurance companies to meet the legal requirements governing them. Insurance resolution: Persuading an answer from the insurance company that either closes a claim or provides the practice better information from the payer to close the claim. There are four types of resolution:
2. Denial from the payer (which allows the provider to bill secondary insurance, re-bill the primary with different coding or information, or convert to self-pay) 3. Information from payer that no claim is on file (which allows provider to resubmit the claim, attaching the correspondence from our collection agency to achieve maximum efficiency) 4. Suspension of action on the claim for whatever other reason the payer might have. The major point to all of these is that NOTHING happens without some kind of response from the insurance company. It is the lack of a response, not the response itself, which is the problem. Therefore, response generation is exactly what our collection program provides.
B) Because of the changes in the mix of payers (HMOs, Managed Care, etc.), Our Collections division has designed specific communications for insurance companies that have all the necessary information for them to process the claim. We have the ability to "touch every claim" every 10 days, for a fixed fee, that is impossible for the provider or your billing service to match. We will contact the payer up to five times requesting payment or denial. ClaimTek offers the most comprehensive software system for the billing service that wants to gain the most out of this growing industry. With our Extended Services Program you can offer advanced solutions and unique services unmatched by any of your potential competitors. |
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