1. How do we get our claims out to you?
Superbills can be faxed, uploaded into our partnered practice management system Advanced MD, or submitted to us electronically via your Electronic Medical Records system. If you choose the electronic method, Advanced MD 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: 98% of insurance companies have the capabilities and are efficient with Electronic Medical claims. There are very few smaller payors which require paper claims and to these we continue to do paper claims submissions.
3. How quickly do we get reimbursed?
All claims are submitted on a daily basis. Many payors vary in pay cycles, however, the average turn around in the Medical billing industry is 15-30 days. We will also designate an employee to work on getting as many payers as possible set up with Electronic Funds Transfer so you receive your money without the paper check delays.
*It is important to note that most insurances typically require that you are at least loaded into their system as a non-Par provider (out of network) in order for us to be able to submit electronically on your behalf and for you to receive payment. If you are currently not in their system or are working on becoming Par (in network), this process can take up to several weeks. Claims will be submitted as soon as an effective date is established.
4. Will you also submit for secondary insurances?
Yes, secondary insurances are included in our service at no additional fee. Secondary claims are billed out the same day we receive the primary payor's Explanation of Benefits.
5. How quickly can we be up and running with my billing account?
We prefer to start with a 1 week notice time in order to get your Advanced MD access key set up as well as requesting changes in Submitter ID and verifying 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 as it is all included in the monthly percentage of payments received fee. There are NO start up costs or hidden fees. We have an increased timeliness because you do not have to worry if your biller is ill. We submit claims daily and 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, our Accounts Receivable team will quickly follow up to ensure swift payment. We also will make personal calls to insurances to determine if further information is needed, such as medical documentation. We have an in built system in Advanced MD called the Claims scrubber that will double check to be sure all information is correct BEFORE any claims get sent out that day. If something does not meet standards, it is held within our system until it is corrected THAT SAME DAY and then sent out.
7. Will I have a dedicated person to my account?
Absolutely. 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 through our 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 upon receipt of that information.
9. Where does my money go?
All payments go EFT directly to your bank so that you can track all re-imbursement activity. For the few insurances that do not offer EFT, the paper checks will go to your designated pay-to address (such as your clinic or PO Box), which you'll then send us copies of any EOBs and letters received. These can be faxed, scanned and uploaded, or via a bank lock box that you create us a login for. For EFT payments, we will work with the clearing house to get electronic remittance set up through Advanced MD so that you don't have to worry about tracking down any EOBs.
10. How do I know that my patient data is secure?
We have a secure connection with Advanced MD 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 of our physician clients as required by HIPAA. We do not give any information out over the phone to anyone but patients or responsible parties who can confirm their identity.
11. Will my EHR/EMR connect with Advanced MD?
With an API connection, many systems beyond the ones listed under "Our Services" can be made compatible with Advanced MD. There is a link to Advanced MD's home page under "Resources." You may contact them for further details about API connections and integrating with Advanced MD.
If you have any questions 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.
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