Monday, November 15, 2010

We are familiar with the challenges that you face as a hospital

We are familiar with the challenges that you face as a hospital: legacy systems, inability to work low dollar balances, self pay accounts not sufficiently worked, aged AR, shortage of qualified and skilled personnel etc. Billing Paradise will help you address all of these challenges very effectively. Our solutions are designed to improve your cash flows, reduce your operating costs and lower your bad debt write offs, while maintaining positive patient and community relations.

Your Pain…

• Not worth keeping Billing clerk in house for the low volume of claims processing work

• Low collections and Huge AR Backlogs?

• Your in-house billing assistants moved to other job and left you in lurch?

• Rising costs for processing services

• Difficult to keep up with ever changing claims processing procedures?

• Lack of trained and qualified resources?

• Distractions from pursuing your core business objectives

• Ever increasing need for IT capital expenditures

• Customer dissatisfaction

• Lack of follow ups with the insurance (Credentials, payments etc..)

• Low dollar value claims are not followed – Time Crunch!

• Payment delay for the visiting physicians.

• Delay in obtaining Authorization number.

Our Solution

• Expert resource with best process

• Better Process

• Faster TAT

• Significant cost savings up to 30-40 %

• 99% Accuracy

• Increased Cash flow - Denial Management and AR Follow-up.

• Experienced staffs with regards to the insurance policies will follow the claims and for credentials.

• Team allotment for the specialty vice follow ups.

• An office manager at your place manages the entire process with our staffs.

What You Get?

We will take care of your entire Healthcare Claims processing activities.

1. We will dedicate a Phone number for your Patients to call our office customer service 24/7.

2. We will get you a Toll Free Fax number .

3. Less than 36 hours TAT upon receiving super bills

4. Save about 40-50% of your existing cost or owning billing staff

5. Follow up with insurance carriers for all submitted claims to ensure proper payment of claims in a timely manner

6. Patient Insurance verification to minimize claims rejection*

7. Weekly production report and monthly AR aging report

8. Free patient billing and invoicing for three times

9. 90 Day payment guarantee for all Primary claims of MCR and other Commercial Carriers MCR Blue cross excludes Medicaid and Trust Funds and Patient balance

* If you signup online Appointment scheduling services with us what we do the eligibility of the Pt before the appointment and will notify your office the status.

How We Do:

1. Super bills will be collected from your office daily thru FTP upload or PC Anywhere access.

2. Patient Demographics and charges will be keyed into Online/ offline Medical claims process software and claims will be submitted electronically.

3. EOB- Explanation of Benefits will be updated into billing software on a daily basis.

4. AR aging reports will be carefully processed and sent to your appraisal.

5. Insurance calling will be done on claims based on the AR report.

6. Reports on the work done will be sent on daily, weekly and monthly basis.

Step 1: Collecting / Checking / Scanning of required documents to Our Office

Step 2: Required data i.e. Patient Demographics, Insurance Information, Super bill, Check copies and EOB copies. Charge Entry will be updated in our software. Expected TAT of this process is 36 Hrs.

Step 3: Payment information’s will be updated to individual claims account on daily basis based on daily document source – Check copies and Explanation of Benefits.

Step 4: Unpaid / Denied / Rejected claims will be Analyzed, Accounted and Act upon by the AR crew which will also call various Insurance Companies for follow-up.

Step 5: Through our Office / Client we will route submission of secondary and tertiary claims, claims with attachments, patient bills and other documents to the Insurance companies

Medical Billing

Medical billing

When you consider the advantages of outsourcing, you'll realize there's a lot to gain by using it as an intrinsic part of your business strategy.

Medical billing service business must boost your reimbursements. In fact, a medical billing service should be more efficient and effective at medical billing than your own office. A medical billing company should allow you and your personnel to focus on practicing medicine.

Billing Paradise medical billing service will allow you to save on overhead expenses such as salaries, payroll taxes, benefits, and printing/office supplies. You will not need to invest in expensive billing software or train your staff every time there is a software update or change. You will eliminate all worries about billing staff turnover.

According to a recent article in Dermatology Medical Billing Times, a claims adjustment rate with a value between 20% and 35% is considered good and acceptable. Our account executives have an average of eight years in medical billing at Preferred Health Resources. Their knowledge, ability, and dedicated follow-up are why at PHR; our adjustment rate is consistently low, as low as 12% with Medicare. At PHR we achieve A/R rates for our practices that are higher than the industry average. Simply put, you and your medical practice will get a higher average return on your processed claims.

Our clients decrease their back office expenses by using our Practice Management Software package. All you need is a PC and access to the Internet to get to your management information. Our Practice Management Software is all-inclusive, even our Palm/PDA billing application is part of our standard service. There are no costly software updates or training fees and even hidden costs or additional charges to get access to information about your medical claims.


Practices lose thousands of dollars each year due to untimely filing and inexperienced staff. Our focus is to provide you with maximum reimbursement for your services by making sure that your insurance claims are billed correctly, the first time itself. Our staff will work like an extension of your staff, that is, they will work with your staff to achieve maximum reimbursement for you.

Billing Paradise Medical Billing Service offers you:

• Maximum reimbursement of your claims.

• Collection on your aged accounts receivable.

• Electronic processing of medical claims.

• Significant reduction in your practice cost and dramatic improvement of your cash flow.

• Guaranteed satisfaction.

In addition to processing your claims, our staff will be alert at spotting any problems in your office with regards to proper preparation and delivery of billing information. This extra care assures you that no matter how hectic your office becomes there is someone watching the financial end of your practice.

With rapidly changing billing needs and regulations, our staff provides security and confidence that, at all times your financial interests are being given full attention they deserve, so that you can focus on what you do best i.e. providing quality healthcare.

Billing Paradise Medical Billing Service strives to develop long-term relationships by earning trust through dedication and results. We hope that we have the opportunity to provide our services to you.

Sunday, November 14, 2010

Claim Processing


Printing paper claims and submitting electronic claims

Sending clean and accurate claims is the key to full insurance reimbursement. That's why Billing Paradise helps you send electronic claims to thousands of payers, print national and state-specific paper claims, and receive electronic claim processing reports. It helps you maximize insurance reimbursement while safeguarding your physicians' cash flow against any disruptions.

Submit Electronic Claims

You can use Billing Paradise to send primary and secondary electronic claims to more than 2,500 government payers and commercial insurance carriers nationwide. We help you set up connections to thousands of commercial insurance companies and closely manage the enrollment process for government and Blue Cross / Blue Shield payers. Once you set up your master insurance list, you can submit claims immediately.


Print Paper Claims

Some insurance claims, such as those that require additional paper attachments, must need to be submitted on paper claim forms. You can configure different claim forms for primary and secondary billing scenarios. For most insurance companies, you'll use our standard CMS 1500 Form or our newer CMS 1500 Form with support for the new National Provider Identifier (NPI) numbers. For certain payers, you can also tap into our library of state-specific and workers' compensation claim forms. Finally, you can customize the provider and group numbers that appear on your forms using advanced settings.

Receive Claim Processing Reports

Billing Paradise provides multiple levels of reporting as your claims make their way through the medical insurance billing companies and adjudication process. Once you submit your claims, our systems automatically review all of your claims and return internal validation reports to highlight claims with missing information, such as missing provider or group numbers, missing patient information, or incorrect policy numbers. Once your claims pass our internal validation, we forward your claims through one of several clearinghouse partners who also review your claims and return daily reports that highlight claims that have been rejected for various payer-specific reasons. Once your claims are delivered to payers, the payer may respond with reports highlighting claims that have been rejected for various reasons prior to the adjudication process. Finally, you may receive electronic remittance advice (ERA) reports once payers process your claims and issue payment.

Set up Advanced Business Rules

You can take advantage of our advanced claim printing rules engine to handle attachments, workers' compensation billing scenarios, or other unique situations. You can configure different claim forms per state, billing scenario (e.g. Medicare, workers' comp, etc), and/or procedure code. You can set up rules to print and pre-collate attachments, send copies of claims to multiple recipients, and even print envelope labels.

Saturday, November 13, 2010

Billing Paradise offers best medical billing service to practices across the United States, we endeavour to maximise revenue collections for the practices in a quickest possible time. The technical division from our company establishes VPN connectivity with the practice’s Kareo Medical Billing Software enabling the coders and billers from our company to log into the application.

We have a coding and billing team that is dedicated and dependable, our insight of coding intricacies and regulations remains updated through ongoing education, and combined with our tenacity of completing assigned tasks, the practices are able to accord top priority to patient care.