1. How do we get our claims out to you? We can have them faxed, mailed (USP priority mail) or submitted to us electronically via your Electronic Medical Records system. If you choose the electronic method, our software includes a Scheduling component, which makes it easy for you to print super bills, maintain patient demographics and get the claims to us immediately on a daily basis.
2. Do you submit claims electronically? Yes, to those companies that have the capabilities and are efficient with Electronic Medical claims. There are certain payors, which require paper claims and to these we continue to do paper claims submissions.
3. How quickly do we get re-imbursed? Our claims are submitted on a daily basis. Many payors vary in how often they re-imburse. However, the average turn around in the Medical billing industry is 15-30 days. Remember that insurance’s require that you are credentialed with them in order for us to be able to submit electronically on your behalf and this does take a few weeks. So the first cycle to get re-imbursement started will be approximately 4-6 weeks. We advise that all paperwork is submitted to insurances for your change over in advance of our starting your billing in order to decrease this lag time.
4. Will you also submit for secondary insurances? Yes, secondary insurances are included in our service at no additional fee.
5. How quickly can we be up and running with my billing account? We prefer to start with 2 weeks notice time in order to get your Advanced MD access key set up as well as requesting changes in Submitter ID and verify clearinghouse and Provider ID numbers. If you are a new practice it may take slightly longer than this in order to be sure credentialing is completed with facilities and insurances.
6. How do I know you will be more effective than our own office staff? Gateway Medical Solutions does more than just billing and processing claims. For those of you who have done in house billing in the past there is the overhead of salaries, benefits, sick leave, vacations, etc. as well as supplies needed. You do not have to worry about any of this with us, it is all included in the monthly percentage of payments received fee. There are NO start up costs or hidden fees. We have increased timeliness because you do not have to worry if your biller is ill. We do daily submissions. We do not send out claims that we are not completely confident will be paid. We make sure that all provider ID, submitter ID and Demographics are correct before submitting them. If a claim is denied we follow up to see if a letter of medical necessity is needed. We also will make personal calls to insurances to determine if further information is needed on all denied claims. We have an in built system in Advanced MD called the Claims scrubber that will double check to be sure all information is correctly sent out. If something does not meet standards it is held with our system until it is corrected THAT SAME DAY. Then it is resent.
7. Will I have a dedicated person to my account? Yes, We use a team approach. Your account will be handled by a Billing Supervisor and at least 3 other personnel (depending upon the size of your practice this may be more) all cross-trained to your account. This will allow for coverage for you as you grow your practice.
8. How often are my claims processed? Within 24 hours of receipt your claims will be submitted for processing to your clearinghouse. If we need to gather more information such as Insurance ID numbers, We will request this information that same day. This submission will be prepared and sent for processing as received the same day upon receipt of that information.
9. Where does my money go? All payments go directly to your office. You then send copies of your EOB’s, (These can be either faxed or scanned and uploaded to us OR done electronically through the clearinghouse and Advanced MD) to our corporate headquarters in Sullivan, Missouri. This way you can track all re-imbursement activity.
10. How do I know that my patient data is secure? We have a secure connection with AdvancedMD that backs up all client data several times per day. Our staff all sign confidentiality agreements and are trained in HIPAA compliance. We also sign business associate agreements with all our physician clients as required by HIPAA. We do not give any information out over the phone to anyone but patients or responsible parties.
11. Which billing software/EMR systems are you familiar with? We are skilled in using Advanced MD as well as E-Clinical Works, ALL MEDS, CPRS, VISTA, Digichart, MDI, Lytec, Practice fusion and Athena. However, with an API connection many systems can be made compatable with Advanced MD.
12. Do you also bill for Physical/Occupational and Speech Therapy? Yes, We also do therapy billing for Medicare Part B and Commercial Insurances.
If you have any question which have not been answered by this list of Frequently asked Questions please feel free to submit them on our "Contact us Page". We will respond to your questions within 24 hours or less.