What Exactly Is A Virtual Chiropractic Billing Team?
The word “virtual” can scare many doctors. They believe virtual implies machines doing a man’s job… this could not be further from the truth. The only thing virtual about a virtual billing team is the portal in which information is transferred between the clinic, the clearinghouse, the payers, and the billing team. Information transferred in a virtual portal is transferred instantaneous and in real time.
How Does Virtual Billing Work in a Chiropractor’s Office?
Communication is key when outsourcing billing. First off, an account manager will be assigned to your practice. This account manager will be the main contact for billing inquiries. They can be reached via phone or email 24/7, if you have chosen a high quality billing team that is. Make sure this account manager can provide the necessary reports and availability that your practice needs. Your account manager manages the team assembled of chiropractic billing professionals. Usually each person on the team has their own specialty (charge entry, claim submission, collections, payment posting, etc).
The billing professional responsible for entering charges will sit in the billing module of the chosen software waiting for new billing charges to appear. As soon as the doctor finishes a clinical note and saves it as complete, all the information necessary to bill is transferred in real time to the billing team on the back end through the virtual portal. At this point, the charge entry team will see the new charges and take the necessary action. They act as the doctor’s very own billing team; they are just not physically in the office.
Claim Batch and Submission
Once new charges are entered and saved throughout the work day, the claim submission team will be the next unit to spring into action. A typical practice sends a daily batch of claims out. The saved charges are used to create the corresponding claims. These claims are batched and ready to be sent. The batch or batches will be sent to the clearinghouse electronically at the end of the day. The clearinghouse will receive the batch or batches of claims in real time and scrub them. Once the clearinghouse has scrubbed the entire batch, successful claims will be forwarded on to the payers in hopes of maximum reimbursement. Denied claims will be sent back to the billing team to be corrected and resubmitted.
Denied Claim Process/Collections
Perhaps the most important aspect of chiropractic billing is the denied claims process. A billing team that excels in this area will drive your revenue to new levels. Insurance carriers and new state regulations are driving chiropractor’s nuts making follow up harder than ever. A highly experienced billing team will make as many follow up calls/emails as necessary to work and correct the denial. The corrected claims are then resubmitted in hopes of the largest reimbursement possible. Resubmitting denied claims and getting paid larger reimbursements at a higher rate has the potential to double a chiropractor’s collections. CloudChiro billing excels in this area.
After claims have been paid, some billing teams simply move on… this can be disastrous to a chiropractor! A chiropractor will have money coming in and likely not notice that his/her AR is off for some time. A few months down the road, there is a huge knot to untangle (can require outside help to untangle this knot). Electronic remits (ERAs) and paper EOBs will be sent back to the billing team after claims have been paid/partially paid/denied/etc from the insurance carriers. This information MUST be recorded to maintain practice efficiency. The billing team will post these payments and forward outstanding balances to patients or write them off depending on the scenario.