Medical Billing FAQ –

What types of Medical Providers can you bill for?

All Physicians and Allied Health professionals to include those listed below:

·         OPA-C - Orthopaedic Physician's Assistant - Certified

·         LSA - Licensed Surgical Assistant 

·         CRFNA - Certified Registered Nurse First Assistant

·         RNFA - Registered Nurse First Assistant

·         NP - Nurse Practitioners

·         PA-C - Physician Assistants Certified 

·         CSA - Certified Surgical Assistants

·         SA-C - Surgical Assistants-Certified

·         CFA - Certified First Assistants

·         OAP- Orthopaedic Allied Professional Certified

If you assist in the operating room then you should be attempting to collect for your services.  Each state and insurance carrier will have different requirements related to billing.  Please inquire about the regulations that pertain to your state.

In what states are you able to provide medical billing services?

We are able to provide billing services in all states depending on your credentials.

Do you employ medical billing specialists? What are their specific qualifications?

Our medical billing personnel are trained and certified billing specialists.  Claims are reviewed by a  first assistant for new clients to ensure CPT coding accuracy, so we understand the methodologies applied by the insurance carriers to claims filed for non-MD First Assistants.

Do you have the latest software and technology?

We currently utilize the latest computers, backups and medical billing software to ensure dependability, availability, and fast recovery of your claims.

Are all claims filed electronically?

Yes, whenever possible and FREE of charge to active providers.  However, some claims must be filed manually depending on the carrier or because the claim requires attachments. 

How does your electronic billing system work?

Our claims are submitted to the Clearinghouse, which performs basic validations on the claims and then provides us delivery confirmation to the carrier.

What is the claim recovery turnaround time?

The normal turnaround for electronic claims is 10 – 14 days when filed electronically.  Manual claims take longer but are generally returned within 4-6 weeks.

How long will it take for me to receive payments?

If Mederi Services is able to file electronically, you should see your check within 3 weeks.  Paper filing typically ranges from 4 to 6 weeks.  If you enroll for electronic funds transfer (EFT) with the insurance carriers then the payments can come as soon as the day after the claim is accepted (BCBS).  Our preference would be for all checks to be direct deposited to the bank of your choice and you provide us with the EOBs so that we can post payments to your accounts accordingly.

Will you resubmit or recover old claims that have previously been denied or not filed.

Yes, Mederi Services can re-files old receivables and we have great success collecting from previously denied claims depending on the insurance carrier guidelines.  If the claim has been previously submitted the appeal window can be much longer.  If an un-submitted claim is older than 60 days it may not be elgible for filing depending on the insurance company's guidelines.

Do you aggressively pursue overdue accounts? Do you have staff specifically trained in this area?

We will work with you to identify your needs regarding collections and overdue accounts, as this is generally specific to the Provider we support.  We ask that you complete the new client questionnaire to better identify your preferences.

What kinds of reports will you provide me with?  How will I check the status of my accounts receivables?

Report frequency is dependent on volume of patient claims and your individual needs.  The higher the volume, the increased frequency that we will provide reports/updates on accounts receivable.  

Do you provide customer service to my patients?

Yes, if collections are a component of the services you require, we will work with your patients to answer questions about their bill and provide fair payment options.

Are you a collection agency?

Mederi Services, LLC is not a collection agency.  We can, however, mail statements to the patient and assist in arranging for payment.  Our reports will indicate which patients are in default, how long they have been in default, and how much they owe.  You can then determine the level of pursuit and if a collection agency is necessary.  We can arrange payment plans with your patients if you desire.

How do you ensure confidentiality?  Is my patient data secure?

Mederi Services, LLC is HIPAA compliant in accessing, transmitting, and storing patient data.  We utilize password and fingerprint technologies to ensure security of your data and your patients privacy.  All employees have confidentiality statements on file.

How much do your services cost?

Individuals: Includes initial filing, appeals and follow up until payment has been received or payment is non-recoverable. : The fee structure we charge is between 6% - 9% of the actual amount collected and is billable by the 5th day of each month. 

Corporate service: Includes initial filing, appeals and follow up until payment has been received or payment is non-recoverable for corporate entities such as groups, surgical assistant firms, staffing agencies, etc. The fee is 3%-6% of actual collected revenue.

The company or corporation has to be established or incorporated with a minimum of 4 surgical assistants under their employment.

 Partial service: This option includes only the appeal process for claims that have been denied or where unsatisfactory payment has been received.
This service is not available if you have received partial payment, have cashed the check, and the EOB specifically states that cashing the check is your acceptance of the claim paid in full or where the EOB from the insurance company states that they paid the facility or surgeon for your services in the bundled or global fee.  The fee for this service is 15 % of actual collected revenue or a minimum of 10$ per claim if the claim is not payable.

IMPORTANT: This service is only available to clients that have decided to switch their accounts to Mederi Services, LLC and want us to appeal any outstanding claims.

Per Claim: This includes only the initial filing, you take care of the appeals and follow-up process. The fee for this service is $7.50 per claim, not per code.  (minimum of 150-200 claims per month)

What if I am located outside of Texas?

You can fax, scan, email or mail the required information and  we will file the claim appropriately.

Our recommendation

If you already are working with a billing company and are presently satisfied with their results, pricing, and ethical practices, we recommend that you keep that relationship, as these companies are extremely hard to find.

However, if you are not satisfied with the results that you are receiving, their pricing structure, and/or have questions about their ethical practices, then contact us.

OK – I’m ready to get started, now what?

Contact us at info@mederiservices.com so we can discuss your specific needs and give you a customized quote.  Or fill out the form for a Quote.  We will work to earn and keep your business.