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Frequently Asked Questions


Choosing a medical billing company is a big decision, and you may have some questions. Here are some of the most common ones; we are always available to speak with you should your question not be on the list.

How does reducing my A/R days outstanding help my bottom line?

According to the Medical Group Management Association (MGMA), there is only a 50% recovery rate of the gross charge when an account has not been paid within 90 days. By reducing your average number of A/R days outstanding, Medcare MSO significantly increases overall receipts.

My practice currently has a lot of problems with rejected claims. What can you do for us?

The average number of rejected claims for a medical practice is 30%, and only 50% of these claims are ever resubmitted. We work these claims like a bulldog. We pursue all disputed and unpaid medical insurance claims with aggressive follow-up until there is a resolution.

Through our interactive tools, we will track the status of each claim, and we can immediately address any issues. Many claims are rejected because of improper coding or lack of supporting material, but these problems are virtually eliminated by working with Medcare MSO.

Do you work with all kinds of specialties or just a select few?

Medcare MSO’s staff is experienced in a wide range of specialty practices and labs. To see some of the many types of medical businesses that we serve, please see our Specialties page.

How quickly can I get up and running?

Our goal is to get the entire process in place for you within one week.

How can you ensure fast carrier payout?

Our daily electronic claims submissions lead to immediate carrier response. We obtain some of the fastest pay-outs in the industry – most within 10 to 14 days.

Do you comply with HIPAA and PHI?

Absolutely! Medcare MSO meets all HIPAA requirements and supports PHI compliance.

What if you’re not able to collect? Do we still have to pay you for your efforts?

Our success is tied to your success. We only charge you a percentage of the collections that result directly from our service. We’ll clearly establish a customized rate for your practice right from the very start.

How about those start-up costs I hear about? What hidden costs should I expect?

Medcare MSO does not charge you for transfer fees, supplies, or other hidden costs associated with our medical billing services.

I am starting a new medical practice and expect to have little volume to start with. Am I going to get the same level of service as established practices?

Every client, regardless of size, works with a dedicated account manager and a dedicated medical billing team. The client and our staff work on the same practice management and billing system, which ensures that every client receives the same quality of service.

We welcome new medical practices because it gives us an opportunity to help you grow your practice, and we hope the relationship we build will translate into a partnership that lasts for many years.

We are extremely busy setting up our new office. How quickly can we start billing through Medcare MSO?

We can set up your account within 2-3 days. Once it is set up, you can start entering visits right away, and we can start submitting them for reimbursement within one week (if your payer credentials are available). We also offer data entry services, in case you don't have an office staff.

Wouldn’t I save money by doing the billing in-house?

That’s a common misconception. Actually, it can end up costing you far more money. Consider all your expenses with an in-house staff: salaries, benefits, taxes, hardware and software technology, continual training to keep up with the latest Medicare and insurance changes, retraining when the person you’ve come to rely on moves on from your practice. In the long run – and even the short run – you can often save more by outsourcing.

I am currently researching medical billing services. What makes yours stand out from the rest?

As a medical billing company, we are dedicated to our customers and their success. After all, our success depends on yours. Here are some facts about Medcare MSO and our services that you might find interesting.

  • We offer complete practice management, CCHIT Certified EHR, Free Credit Card Processing system and a Patient Portal that allows you to monitor our performance 24/7.
  • We are electronically connected to over 4,000 payers, and have some of the best reimbursement time frames in the industry.
  • We assign a dedicated account manager and team to work on your billing.
  • We offer highly competitive rates.

I’ve heard that it’s expensive to outsource. Why not just keep my billing in-house?

Too many practices just look at the bottom line without analyzing all the real costs of keeping billing in-house, as opposed to outsourcing. The reality is, by outsourcing, you should be able to significantly cut costs, while increasing your billing collections.

If you do in-house billing, salary is generally only about 70-75% of your employee costs after you factor in payroll taxes, FICA and insurance. You are also paying for quite a bit of time during which no work is being done during sick days, vacation, and family leave time.

Some staff turnover is inevitable as people move on, and by doing billing in-house, you must pay for training every time you add or replace someone. When your office staff is under pressure during busy times, you could also lose money to inadvertent medical billing and coding errors that cause your practice to lose revenue.

Medcare MSO provides a dedicated team of experts and we charge a small percentage only for what we collect on your behalf. When you add up the numbers, outsourcing to Medcare MSO makes a lot of sense.

I’m happy with my current staff. Will I need to let them go in order to work with you?

 

You can keep your staff and allow them to focus on supporting your practice in other ways. Our analysis often reveals areas where staff can be most effectively utilized to increase revenue.

We already have a system in place for billing. Can you transfer my patient data to your system?

Yes! We have transferred data from existing systems many times and for most of our clients there is little or no start-up fee. We will take care of your EDI setups, and perform the entire process with no revenue interruption. Our clients see a revenue increase after they’ve switched billing to Medcare MSO based on the speed and accuracy of our process.

What is the start-up cost to switch billing from in-house to you?

To make the transition easy for our new clients, we have absolutely no start-up fees. We also take care of your EDI setup. We’ve performed the EDI set-up many times and know exactly what information is needed. Medcare MSO takes care of the entire process and makes certain there is no revenue interruption. In fact, the vast majority of our clients quickly see a revenue increase after they’ve switched over, thanks to the speed and accuracy of our process.

Right now, if I have a billing question, I just go out to my front desk and ask my staff. What if I can’t reach you?

That’s a common concern, of course. The fact is, thanks to our interactive patient management tools, you can get the answer you’re looking for in seconds. With our system, you can verify your new patient’s insurance, set up new visits with comprehensive supplemental information, view insurance payer, see which claims have been denied and why, and much more. There’s no need for one of your staff members to sort through files and make phone calls on your behalf – everything’s right at your fingertips.

I’ve been working with another medical billing service for years. I’m not 100% satisfied, but is it really worth it to switch?

That’s up to you to decide, of course, but we believe the answer is an emphatic “Yes!” Ask yourself these questions: Do you know when your claims are sent and even if they’ve been sent? Can you check on the status of your claims online day or night, or do you need to wait for a monthly report? Do they handle patient invoicing and collections? Are they communicating effectively with you? How fast are their collection times?

With our cutting-edge software, Medcare MSO’s highly-trained medical billing specialists are experts at aggressively fighting denials and getting your claims paid quickly. At a time when insurance carriers are using data mining to create millions of edits to reduce payments and deny claims, it is critical that your collections solution is state-of-the-art. A very brief transition period can end up saving you tens of thousands of dollars over time.

Won’t it be confusing for some claims to be processed by our current firm and others by you? What can you do to alleviate this concern?

We’ve rarely had difficulty navigating the transition; in fact, our system is set up to ensure that you continue to bill quickly and get paid. First, we set up your account in our system and file an ERA form to switch ERAs to us. This could take a month or two, so during that time, we use paper EOBs to enter payments.

Our practice management system assigns a specific number to each new claim, and we take great care to select and follow through only on claims processed by us during the transition period so there’s no confusion.

What about our Medicare and Medicaid payments? How does that work during the switch?

First, we file an EDI application, which usually takes two to three weeks to process. In the meantime, you can enter charges into our system right away. Once we receive a confirmation of the EDI setup, we release all the accumulated claims at once to the payer for fast payment.

We already have a system in place with our current medical billing firm. Is there an easy way to just transfer patient data?

A lot depends on what system your current biller is using, and if that system allows export of data. In many cases, you should be able to at least get the information in a spreadsheet. Once you have the patient data, we will work with your practice to come up with the best way of transferring data to our system quickly and accurately.

What is the start-up cost to switch billing from them to you?

For most of our clients there is little or no start-up fee.

We’ve performed the EDI set-up many times and know exactly what information is needed. We take care of the entire process and make certain there is no revenue interruption. On the contrary, the vast majority of our clients see a revenue increase after they’ve switched billing to Medcare MSO because of the speed and accuracy of our process.