FAQs

YES! Simply put, we do not get paid unless you do! Our knowledgeable staff knows exactly how to get claims paid correctly to optimize your cash flow.

It depends on your practice size. Our billing services can replace your billing staff, but you may still need administrative help for tasks like scheduling, insurance verification, and obtaining authorizations. With less time spent on billing, your staff can focus on these other essential tasks.

No need to worry! Many of our clients are solo practitioners with limited or no office staff. In such cases, we coordinate directly with you for billing while you handle scheduling.

Absolutely! We provide monthly financial and statistical reports summarizing your practice. You can also request additional information at any time via phone or email, and we will respond promptly.

If you use our in-house billing software, there is a $99 setup fee. If you have your own software, there are no additional setup fees. Our monthly fee is a percentage of collections in states that allow it or based on a volume-based fee schedule in other states. Fees are negotiated based on your practice's needs and billing volume.

We provide all the necessary forms for your practice, including patient information sheets, Assignments of Benefits (AOBs), privacy policies, cash logs, and super bills/charge sheets. We can customize these forms to fit the specific needs of your practice.

Your office can submit billing information in several ways:

• Billing software: We can integrate with your existing billing software, just provide us with the login credentials.
• Electronic Medical Records (EMR): We can access your EMR directly.
• Ebridge: This is the quickest option! Ebridge is a new HIPAA-compliant shared document service. You can securely send all your documents to us through this portal.

We recommend sending your new billing information consistently, either daily or weekly, through the method that best suits your practice.

To create a claim, we require the following:

• A New Patient Information Form and Assignment of Benefits/Release of Information.
• A copy of the patient’s insurance card (front and back).
• The daily diary/super bill/treatment form/schedule.
• Access to your EMR and/or billing system.

We must receive a completed diary/schedule/super bill/treatment form that has been signed by the physician providing the service. This form must include the following information:

• Patient full legal name
• CPT codes 
• ICD-10 codes (diagnosis codes)

Yes! It is crucial for us to receive this information to accurately enter insurance carrier’s payments and generate the necessary patient statements for accounts that still may have a balance due.

You will receive an email listing the missing information needed to bill the claim. This is done as a courtesy to help you gather the necessary details quickly and avoid any issues with timely filing deadlines set by insurance carriers.

You can easily report co-payments made at the time of service using the cash log we provide, which can be used daily or weekly. For payments received by mail, simply make a copy of the check and send it to us.

Patients in our system will receive a bill for any outstanding balance between the 1st and 5th of each month.

First, we assess whether the denial - whether partial or full - is valid. If it is valid, charges will either be billed to the patient or written off, depending on the reason. If the denial is invalid, we will request that the insurance carrier reprocess the claim. Denials are typically addressed as soon as they are received.

We will send up to four statements to patients unless they are making payments. If necessary, we will recommend turning accounts over to collections. If you need assistance finding a collection agency, please let us know.

Absolutely! Failing to collect co-payments can be considered fraud or abuse and may violate your contract with the insurance carrier.

We do not offer coding services. The healthcare professional responsible for the patient should handle coding. However, we can provide descriptions for specific codes and assist you, but please note that we are not certified coders.

Since 1997, Priority Medical Billing has worked with a wide range of medical specialties. Our team consists of professional experts in medical billing, and we can manage billing for any specialty.

No, all fees are transparent and clearly outlined in our contract. There are no hidden costs.

Yes, we adhere to HIPAA guidelines for protecting patient information. Our staff, software vendor, and clearinghouse for billing electronic claims are also certified HIPAA compliant.

We recommend setting up direct deposit for efficiency. If paper checks are preferred, they will be sent to the address you specify. We ask that you send us copies of all EFT deposit lists, checks, and EOBs you receive.

Yes, we are committed to being available during business hours to address your questions promptly. You can reach us via phone, email, or fax.

Initially, a one-year contract is required to sign up. After the first year, the contract automatically renews unless we receive a 60-day written notice of cancellation.

We can begin immediately! The full setup process typically takes between one week and four months, depending on your specific needs and circumstances. We can give you a more accurate timeline after analyzing your practice.