Services

Claims Submission

We submit your medical claims within two working days of receiving your charge form (Superbill), we also receive and process your superbills directly from your EHR. We submit electronic claims to over 4,200 payers nationwide including Medicare, Medicaid, BlueCross & BlueShield, as well as Commercial payers; for those few payers that still do not accept electronic claims, we submit the claims on paper. We use both CMS 1500 (HCFA 1500), professional and CMS 1450 (UB 92), institutional; forms to submit your claims to payers.

We check your claims against LCD (Local Coverage Determinations) in order to make sure that procedures are justified by the diagnosis included in the claims; we also add the required modifiers according with the requirements of each payer. Claim errors can be significantly reduced by using our system, they are checked for consistency before being saved including: ICD9-CM and ICD10-CM codes, CPT-4 codes, DOS, POS and much more; they are later checked by the Clearinghouse for payer ID and insurance ID formats and much more. As a result we achieve a very high percentage of clean claims reaching more that 97% on average.

Track Payments

We track all payments, from third parties and patients, being able to provide you with accurate aging reports of your account receivables. We understand that having an effective tracking system is paramount in order to obtain acceptable collection rates.

Our tracking system gets started the day after the claims are submitted with the acceptance and exclusion reports from the Clearinghouse, those claims that were excluded by the Clearinghouse are fixed and resubmitted immediately. In the following days (usually 2 or 3), with the acceptance reports from the payers, we continue tracking the claims. For those claims that are rejected by the payers, we act immediately by gathering the required information from the insured party or the providers' office. These reports may become very useful in order to proof timely filing in an appeals process.

The next step in tracking claims is once EOB (Explanation of Benefits) are received. We act immediately (within the same day) on denied claims; either by fixing the problem, calling the payer in case is their error, by calling the insured party if the issue is eligibility, COB etc.. We keep track of the resolution of these issues using a spreadsheet and are also documented in the Practice Management Software. The tracking information is available for our customers to see and audit.

Patient Statements

We print and send patients' monthly statements on your behalf with different customized messages depending on the aging state of the account receivable, customized specifically for your practice. These statements are professionally printed on a daily basis with a detachable portion including the account information, the "Pay to" address, etc.; we also include an envelope for the patient to mail the payment. We provide your patients with a toll free number to for them to inquire about their statements.

Since our customers have access to our billing service, at the patients' registration, they can see if there is an outstanding balance for that patient and collect it before the patient sees the doctor. For delinquent accounts, we can work with your collection agency or we can propose one to you.

Integrated Payments Processing and Patient's Portal

Ensures hassle-free credit card processing that will easily reduce follow up on co-pays, deductibles, and co-insurance balances, which will translate into improved A/R. By entering your patient's credit card payments within CollaborateMD, you will increase business efficiency and accuracy. The payment portal offers patients more control of their payments and reduces A/R days, resulting in improved cash flow. The payment portal utilizes the highest form of security and protection to secure the patient’s information. By giving patients a secure online payment portal, offices are reducing patient calls, increasing billing accuracy, and accelerating patient payments.

Eligibility Verification

We offer you an eligibility verification tool that checks eligibility of the patients electronically with one click of the mouse, covering must insurance companies in a central location. The results are stored in the system for future references. Eligibility of the patients can also be checked in batches when you are using the Scheduler.

Scheduler

We offer you a professional Scheduler included in CollaborateMD for each one of the providers, resources and locations of your practice. Insurance eligibility of the patient can be verified from the scheduler's window. There are activity reports that can be obtained from the scheduler in order to search for appointments per provider and resources in different status like: scheduled, cancelled, confirmed, checked-in, in room, checked out and no show. We have the ability to send customized appointments reminders either text message and or voice.

Accessibility to the System

We provide you access to the system for as many users as you need, the users do not need to be in one location, all they need is a computer that meets the minimum requirements and an internet connection to access the system. The user's access could be restricted according to the functions they perform and the information they need to know from different sections of the system and several reports, it can also be restricted by time of day and day of the week.

EMR

CollaborateMD has built standard and customized HL7 interfaces for several "best of breed" EHR / EMR applications supporting numerous specialties. It has also developed strategic relationships with select partners to provide a seamless Practice Management, Medical Billing, and EMR solution, some of those systems are Practice Fusion and Sevocity, for a complete list of EHR/EMR partners and details, visit CollaborateMD/EHR.

Data Backup

The system's information is backed up several times a day in real time in a tier 1 datacenter facility; it is also backed up once a day to a datacenter across the country for disaster recovery purposes. An individual backup/snapshot of all of all your data could be available as well.