App
FAQ
Frequently Asked Questions
Q. How are aging A/R days determined?
A. This is a formula based upon your production and outstanding A/R balance.
Q. How do I determine my payor mix?
A. Most systems have reports that you can run by clinic counts and show your payors. You can use this information to determine the percentage of each payor by the number of visits average in whatever time period you select based upon those counts.
Q. How do I calculate my percentage of reimbursement of my charges?
A. This is a formula based upon your billing receipts and your total production for any time period you want to view.
Q. How long does credentialing take in Nevada and why?
A. Credentialing typically ranges 3 to 6 months due to education and licensure verification and hospital and/or insurance company board review meetings.
Q. How can I verify that I am getting paid what my contracts state I should get paid?
A. Any business owners should always understand that “monetary value” of contracts signed. Most software systems have the capability to enter your insurance reimbursements by CPT code.
Q. Can insurance contracts be re-negotiated?
A. Yes. You can always submit in writing to an insurance company the request to renegotiate rates. Worst case scenario is they say ‘no’ but you don’t know unless you try.
Q. What are the benefits of having an EMR system and doing electronic billing?
A. Using EMR speeds up the ability to bill claims to the payer and have tracking of these claims as reports are generated of the submission; rejections are received within 24 hours and can be turned around faster for processing. Also, with EMR, the turnaround time for payment from the payer is faster by an average of five days which in turn reduces the aging time of a claim on you’re a/r.
Q. Who is responsible for coding charges?
The physician is responsible for coding his/her charges as they know exactly what services they provided whether in the office or in the operating room. All dictation should match the services provided to maximize the reimbursement value of the services provided.
Q. Are there options for ‘shopping around’ if I feel my expenses are high and want to reduce them?
A. Yes. You should always reach out and get price comparisons. Your existing vendors may even try to match the pricing if it’s lower so they can keep your business.