After receiving your charges and patient information, we either code them, or review them to be certain that we'll be billing for every procedure you performed.  Guidelines change every year, and surgeons, in particular, don't know what they're allowed to bill.

We enter your charges and create a day sheet, showing everything that has been billed.  This report, along with regular deposit reports will be sent to you, usually in the same way we received your work.  We then transmit every claim that can be transmitted, print HCFA's for the rest and put them in the mail.

With electronic transmission, a check can be printed within five days of when you gave your patient treatment.  Then, depending on the current financial condition of the insurance company, your check can then sit on a shelf and wait to be mailed for weeks at a time.  This is still progress for the industry; checks written from paper claims will sit on that shelf just as long.

Some billing companies deposit your checks into their own bank and write you regular checks, as if you were their employee.  These are called trust accounts.  They offer the advantage of guaranteeing that you receive exactly what you think you should earn on a monthly basis.  I think of them as Payday Loans for the wealthy and well educated.  At AMB, we retain our clients because they like our service, not because they can't afford to pay off an accumulated debt.  If you want us to handle your checks, which is a big convenience on both ends, we deposit them directly into your own account.

This brings us to the subject of denials.  It is not unusual for a claim to be denied without legitimate cause.  Refiling that claim will result in a computer denying your claim for exactly the same illegitimate cause.  This is not illegal.  Insurance company employees are human and make mistakes.  They make them with increasing frequency at the end of quarters, when P&L statements are being prepared for insurance company stockholders

Insurance companies also work hard developing new ways to legitimately deny claims.  For example, if a patient has a compound surname, and anything, even a hyphen is omitted during data entry, many companies will deny payment, even though the patient is clearly identified by her Social Security number, or her insurance ID number.  But you have not reached the heart of mail return hell until your claims are denied as being not medically necessary by a someone on the far side of the world, who is undoubtedly a fine human being, but has no medical knowledge.

At Arizona Medical Billing we are tenacious, albeit slightly cynical after twenty years.  We have staff that does nothing except call insurance companies inquiring on the status of unpaid claims.  We write countless appeals for standard denials, and yes, we are qualified to argue medical necessity with anyone.  Sometimes this requires the input of the physician, but much more often only requires your review and a signature.

At the end of each month, we will bill you for a percentage of what we collected for you.  Your percentage is determined by your specialty, the amount of coding your account regularly requires, the insurance companies with which you are contracted, and by the level of organization of the work we receive from your office.  If we cannot profitably work your account for less than 10%, your office has internal problems on which we can advise, but cannot compell you to resolve.  That is the other half of the reason we make it easy to terminate contracts from either end.