Medical Contracting Services

We will act as your liaison with the insurance carrier. Many commercial insurance carriers will negotiate reimbursement fee schedules with providers. We will attempt to negotiate the contract on your behalf. We will review the contracts and provide you with all the information regarding the contract.

Ultimately, you are responsible for the insurance contract and you will need to approve and sign them, but our services will provide you with some piece of mind and remove much of the stress and time involved in negotiating.

Medical Credentialing Services

The credentialing process is combination of acquiring detailed information from each physician and the group practice (if necessary). The physician will be asked to provide us with all the essential information from his/her Curriculum Vitae (CV) as well as any previous practice affiliations and provider numbers. If we are credentialing a group practice the following information will be required: corporation information (FEIN, Date of Incorporation, etc), ownership, specialty(s), service locations, etc.

The physician/corporation information is entered into a database that will store and allow us to update it at any time. This database will automatically fill out many of government and commercial insurance contracts.

From start to finish the process will take from 60 to 180 days. Obviously this is dependent on the insurance carrier. One thing to keep in mind is that some carriers do not back date their application for participation in their network. Generally, the date they receive your application will be the date that you will become effective in their plan. For a new physician joining a group, it is imperative that this process start at least 90 days before the physician starts seeing patients to ensure that reimbursement will not be a problem.

If you would like help getting insurance contracts or getting your physician’s properly credentialed please use our RFB form to contact us.

Insurance Billing

One of the benefits of outsourcing your medical billing is having the ability to submit more of your claims electronically. Submitting your claims to insurance companies electronically allows your claims to be processed faster, to receive acknowledgements on them faster, and to resubmit your claims faster. Meaning your accounts receivable time will be reduced and you will get paid sooner.

Custom Data Services Insurance Services

We bill all major insurance companies and submit your claims electronically.

Our office uses a national clearing house to send patient claims daily. The clearing house will report back to us within 48 hours on the status of the claim; Accepted, Pending, Denied or Invalid. If the claim is denied or invalid, we will check the patient’s insurance information for accuracy by reviewing our records, contacting the physician’s office or contacting the patient/guarantor.

Many insurance carriers accept claims electronically. Unfortunately, there are some carriers that do not. These carriers will have their claims printed and mailed to them by our clearing house. And we will process the accepted, pending, denied, and invalid claims in the same manner that we process the claims that are sent electronically.

We submit all of our claims securely via a SSH certified file transfer protocol. This means that you don’t have to worry about how your claims reach their destination. All of our transfers are secure and encrypted which means your data is safe and HIPAA compliant.

To find out more about our insurance services or any of our services Contact Us to make a request for bid or to ask a specific question.

About Pre-Collections

Building relationships with your patients is part of our job. We believe that your patient’s visit hasn’t ended until their claim is successfully adjudicated and they are 100% happy with their service. Maintaining that relationship during difficult processes such as collecting on delinquent accounts is also part of our job, and can be a more delicate process. Our experience has allowed us to create a very unique and customized service that will allow you to implement a pre-collection letter package and plan that you feel will best suit your patients, and help maintain that positive relationship.

With our pre-collection service you will be provided with the flexibility to decide the number of letters a patient will receive explaining what will happen to their account if it remains unpaid. You will have the authority to decide what action will be taken on which accounts.

How do we do this?

Custom Data Services Pre-Collection Services

Our pre-collection services allow you to use a customized approach in sending your patients a variety of letters explaining to them what will happen if their account remains unpaid. You will choose the number of letters a patient will receive, and the contents of that letter from an assortment of pre-made letters that we currently have available.

Every month we will also provide you with a list of patients whose balances are overdue so that you can make a determination of placing the account in collection or suspending the patient’s account from further correspondence.

The flexibility offered with our pre-collection service is what helps build strong relationships, because you know your patient and their situation better than we do, and you can help us make their entire experience better.

To find out more about our services Contact Us to make a request for bid or to ask a specific question.

In a previous post I wrote about how you can make money using your medical billing company’s collection service. So today I would like to take a moment to introduce you to our sister company Custom Collection Services, Incorporated; a medical collection specialist.

Custom Collection Services, Inc.

CCSI has a long history of providing Northwest Indiana with exceptional service in the field of medical collections. CCSI was originally founded under the name Medical Dental Hospital Bureau of Lake County, Inc. in 1957 by Donald G Bradshaw and Elizabeth J Bradshaw. In 1990 The company was sold to Larry Mlynarcik and Juan Arroyo, the current owners of Custom Data Services, Inc. and began operating under the came Custom Collection Services Inc.

CCSI Collection Representatives

Custom Collection Services, Inc. is a fully licensed and bonded collection agency that has representatives with over 85 years of combined collection experience. All of their account representatives are fully trained in the Fair Debt Collection Practices and HIPAA Privacy Acts.

Collections as we know can be a tough business, but we realize that building a feeling of goodwill and maintaining positive relationships with the debtor and you is the best way to collect effectively and to insure the equity of your brand.

CCSI Collection Services

CCSI has a fully computerized system featuring the lasted collection software. Initial notices are sent to debters within 48 hours of arriving at CCSI . Follow up notices are subsequently sent every 30 days after the initial notice is mailed. CCSI uses a variety of multicolored collection letters to help debtors recognize the status of their accounts.

CCSI ‘s daily efforts in collecting your bad debt are assisted by the records available from Custom Data Services, credit reports, and other consumer data to locate and secure pyaments.

CCSI does not require you to have a minimum number of accounts or balance. And they understand that the sooner you accounts are turned over to them the better they can maximize your recovery percentage.

After 90 days, unpaid balances of a value greater that $50.00 are reported to the credit bureau.

CCSI Collection Fees

Custom Collection Services works on a very competitive fee schedule. All accounts placed with CCSI are collected on a contingency fee basis. If they do not collect money on an account, they do not charge you any fees. If you approve legal action on an account, they pay all court costs and attorney fees.

All collections due you are remitted following the end of each month. A statement is included listing each individual account payment and the fee due to CCSI .

Custom Data Services, Inc. Credit Balance Refunding

During the process of payment retrieval in is inevitable that some accounts will need to be adjusted. In order to assure the accuracy of our collection process we audit our accounts monthly to reconcile unidentified and duplicate payments by providing you with a credit balance refunding service.

Our Credit Balance Refunding Services Include

Unidentified Payments

Patients and insurance companies will send payments without proper documentation making it impossible to identify the account for which the payment needs to be posted too. During our payment retrieval process we mark all payments that are unidentified with a “U”. Any payments marked with a “U” are then processed by your customer service representative where they will attempt to contact the insurance company or payer to help identify the payment. If we are unable to successfully identify where the payment belongs and the payer has no current open accounts for services rendered by you will we refund the payment to them.

Duplicate Payments

Another common occurrence during the payment retrieval process is the collection of duplicate payments. Patient’s will occasionally pay their balances before their insurance company has applied benefits creating either a duplicate payment or overpayment on their account. During our audit process we identify accounts with duplicate payments or overpayments and refund the balance to the patient.