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Home
> Post-Billing
System
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I. Batch Payment
Posting
Dmbi uses a batch system
in order to prevent the problems of over-posting
and under-posting payments from the insurance companies.
All EOB batch totals are matched with the billing
system's own payment report at the time of posting.
This guarantees that any amount posted in the doctor's
system matches “penny to penny” the
checks cashed by the physician. Any amounts due
to the physician from uncollected deductibles, co-pays,
and coinsurance are eventually noted on patient
statements which are promptly mailed out. |
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II. Denied
Claims Tagging
All denied claims are identified
directly from the EOBs and duly tagged according
to the reason for their denial. In essence all denials
are extrapolated from the other outstanding claims
in the system in order to take a directed approach
in resolving them. A dedicated team is set aside
to fix all denials and resend them prior to their
timely filing limit. In addition all denied claims
requiring telephone correspondence with patients
are done with an evening customer service team.
Proactive efforts are taken to resolve claim denials
to prevent sending patient statements which are
routinely ignored and or discarded. |
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III. Aging
Analysis
Once claims are sent
to the insurance company a process of analyzing
their payment status is begun. Through the use of
insurance company website and automated phone systems
all claims are noted as either being denied, capitated,
not on file, or set to pay in the billing program.
By analyzing outstanding claims all claims which
are not on file are quickly identified and resent
in a three fold manner: electronic re-submission
through the billing system and websites, HCFA-1500
mailing, and fax to insurance companies directly. |
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