Billing Service Fees and Program

Our Program

  • Process all insurance claims either by paper or electronically.
  • Evaluate ICD-9 codes and CPT codes to assure maximum payment.
  • Posting all EOB's and going after all incorrectly paid claims at no extra charge.
  • Following up by PHONE on all claims filed, whether electronically or by paper.

Program Cost

  • Less that 200 claims per month: $4.35 per hicfa 1500
  • More that 200 claims per month: $3.95 per hicfa 1500 (see minimum bill below)
  • Attorney cases where we call the attorney's office is a flat rate of $100 per case, until the case is paid.
  • Filing of secondary insurance when necessary: cost is 50% of claim charge ($3.95 - $4.35). So fee would be either 50% of 3.95 or 50% of 4.35
  • We charge the normal per claim rate to handle old uncollected insurance money.

Minimum Bill: Most office invoices, depending on volume, will exceed a $600 monthly bill. If for any reason a bill is less than $600, a minimum bill of $600 will be sent out. The reason for this is that it takes roughly the same time to process 30 claims weekly as it does 60 claims weekly and it becomes non-profitable for us to process claims for less than the minimum. In other words, you pay $150 a week for an insurance expert!

Minimum Billing Exemption: New practices please see this page for minimum billing.

Other Information

  • A claim is defined as a HICFA 1500 all six lines filled out but we do bill weekly so some HICFA's depending on patient visits will not be a full HICFA.
  • We modem in or you modem to us to pick up all billing information and normally most doctors systems are set up to do this function, and we also receive via the Internet. NO, you will NOT have to buy new software.
  • It is the offices responsibility to make sure that we have EOB's promptly, remember it is YOUR money being delayed. If we are having problems getting EOB's we will contact the doctor and work out a solution.
  • We work for the DOCTOR and we will notify the doctor whenever we feel that our work is being compromised in any way or if we are having problems getting billing weekly.
  • We file claims weekly so for most doctors' who see patients more than once a week it would be one claim, NOT a fee for each procedure!
  • In some cases our fee evaluation has given the doctor the ability to charge more and collect more. Thus our fee is sometimes free because of the increased collections.
  • In some states PIP cases must be sent to the insurance company by certified mail. We charge for the certified mail expense.