MD boss

Services

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Insurance follow up

Insurance calling is a key service of MDboss Inc. It is one of the most important processes in the collection cycle whereby we assess the status of the medical claims sent to the insurance company for clearance. And follow it up for prompt reimbursements.

MDboss Insurance follow-up services are designed to focus on increasing cash flow, lower adjustments and reducing the number of days in accounts receivable (AR). We provide aggressive follow up with the insurance companies on all accounts at any stage of the aging bucket. Our Agents utilize variety of tools along with a persistent and aggressive follow-up on the phone each day and on every case including the low value and low margin accounts. We watch your aging buckets and monitor your money moving from one bucket to the next.

We run and analyze a variety of reports like aged trial balance, looking at old accounts, studying by payer and by patients to determine the right issues and address the same and making sure that the accounts that are a high balance or at risk of being lost due to timely filling reasons are addresses proactively.

Our Insurance follow up services are carried out by trained account representatives with extensive experience in all billing functions, thereby adjudicating the claims as quickly and accurately as possible.

Collection Process:

Our Accounts Receivable and Insurance follow up services include:

Aging Analysis.
Payer Follow-Up.
Denial Trend Management and Reporting.

Prioritize insurance company

We implement a pre-determined set of codes and procedures for different insurance plans according to their work nature.

Some of the different insurance plans include:

Federal Insurance:

MDboss Inc. follow-up services focus on ensuring clean, complaint claims were submitted and accepted by various federal /government programs and are always as per the guidelines. Follow-up is carried out using a variety of tools including website, governmental program systems and aggressively calling up to determine status of claims. Most of the primary and secondary claims, if submitted are done electronically, and processing of each claim is tracked in a timely manner, to determine any denials if any, and address the same pro-actively.

Managed Care & Commercial Insurance:

MDboss Inc. has extensive experience and an excellent track record in handling Managed Care and Commercial Insurances. Our skilled staff utilizes the most up to date technology and process available to adjudicate claims in a timely and effective way‚ focusing on accounts which need immediate attention.

We utilize website and online accounts with all the major payers for verification purposes‚ claims status‚ and ERA. All the major procedures are filled with authorizations on behalf of the providers/hospitals and as per the contract conditions. Our teams have thorough experience in all the PPO plans like BCBS‚ Aetna‚ Humana‚ Cigna‚ Great West‚ AARP‚ GHI‚ United Health Care‚ United Medical Resources‚ First Health‚ Mega Health‚ Magna Care‚ Secure Horizon‚ Pacific Care‚ Mutual of Omaha, Inter Plan Health and many more. Due to the tendency of Managed care plans of getting delayed payments‚ for the requirement of detailed documentation‚ authorization requests etc‚ Our experts are well experienced in handling all the documentation issues and in timely processing of claims.

Worker′ s Compensation/ Personal Injury follow up:

Our expertise in Worker′s compensation and Personal Injury receivable services cases is extensive. Our experts know how to get these claims paid‚ and are thorough in documentations‚ filing liens‚ working with attorney′ s and judges‚ no appearance letters‚ negotiations‚ and settlements. The highly trained team is skilled at working directly with employers‚ workers compensation carriers‚ commissions and review boards to successfully expedite claims. We work with you as your partners in dealing with these often complicated and litigious claims.

Implementation of relevant approach

The final step in the process of “insurance calling” is the implementation of the relevant approach or action after the status of claim becomes known. If the claim is not on records‚ then it is sent again. If it is denied for one or other reasons then it is resent after making the adequate modifications. If however it is processed then the claim is closed‚ and in the last case if it shown to be currently pending then the collection call is made after 3-4 days and it is worked upon according to the situation.

Enhanced cash flow.
Increased profitability.
Accelerated revenue cycle.
Improved collection ratios.
Significantly reduced administrative costs
Focus on increasing lower adjustments and reducing the number of days in account receivable (A/R).
Ensures complete confidentiality.
Observe strict Rules and Regulation in making collection calls in order to.
Work with the best utilization resources so as to maximize revenue of the client's companies.