What makes Professional Billing & Collections different in our billing of Workers Compensation and No-fault cases is our insurance carrier contacts.
As you are aware workers compensation and no-fault claims are handled by a single claims adjuster. Because collections is the biggest part of medical billing, our collections team stay on the phones with these adjusters. Over time we have built a solid business relationship with many of them. PBC understands they are essential to our clients and our success.
The first step in our billing begins with calling the insurance carrier, to verify a patient’s benefits. From our initial call we find out who the claims adjuster is. Then we proceed to make sure that the billing address and Claim/ Carrier Case numbers are correct. After that we find out if the case is open or closed.
And last and most importantly, we find out what the case is established for. We feel that it is very important because sometimes patients go to the doctor’s office complaining about things that are not on file with the insurance carrier (even though other complications can arise from the accident at a later date). This information gives our clients a heads-up on what treatments will be covered. It also eliminates the claim from being denied for treatments not related to the accident.
If our clients want to do a specific treatment or test that requires an authorization, PBC will get that authorization.
A lot of the claims adjusters that we are familiar with allow us to fax them the original bills. By doing that it speeds up the processing, allowing for faster payment. It also allows us to never get denials for: timely filing.
If a submitted bill is not responded to within 23 business days, we begin our collections process. That starts with us calling the claims adjuster. We will leave a maximum of two messages for an adjuster. If they fail to get back to us we proceed by calling their supervisor. If a claims adjuster is not answering questions to our satisfaction, we will call their supervisor. PBC knows how to make sure all of our requests are answered correctly and in a timely matter.
PBC specializes in getting old workers compensation cases paid. If you have cases lying around your office, give them to us. We will work as hard as necessary to get them paid.
PBC does No-Fault Arbitration. So if you have no-Fault cases under seven years old, we will work those as well.