Benefits

The East Texas Medical Billing hands-on approach allows us to act as an extension of your staff. This permits you and your personnel to focus on practicing medicine. Our company provides end to end medical billing of services including: demographics entry, coding, charge entry, electronic claims filing, re-filing denial claims, ERA, payment posting from EOBs, follow up on accounts receivable.

Patient Demographics Entry

ETMB enters details of the patient's name, present address, city, state, zip code, social security number, DOB & employer details. We are one of the only independent medical billing companies that has our own secure access to admisssion records through Firstnet, Chartmax, and Dashboard. This access gives us the most up to date information on patients from East Texas Medical Center, Trinity Mother Francis Hospital, local Nursing Homes and Home Health Agencies.  This helps us get your claims paid even faster! We prefer our own staff to enter the patient information because the smallest error can slow down a claim payment.

Charge Entry

ETMB enters the Dates of Service, Referring Physician, Ordering Physician, Place of Service, Type of Service, CPT codes, ICD9 codes, Modifiers, Authorizations or Referral Details.  Having access to the local hospital admission computer systems is a huge asset for us to determine if the patient stay is inpatient or outpatient.  Having access to the hospital software also allows us to find out any extra procedures that the physician might have forgotten to put on the billing sheet.  For example, reviewing a patient's chart is a billable charge of a 99232 or 90862 even if there was not an exam.  Many family practice physicians do not know to add the medication review code in addition to the office visit.
 

 Payment Entry /Cash Posting

ETMB initially enters all the details: Patient Account Number, Patient Control Number, Patient Name, DOS, CPT code, Billed Amount, Allowed Amount, Adjusted Amount, Paid Amont, Deductibles, and Denial Details.  After the initial data is put by our staff, we have a secure module that dials into the insurance company to autoapply each check. This process takes less than 60 seconds and always re-calculates the allowed amount since Congress is constantly changing the pay scale for our physicians/providers.  This eliminates human error and gives us more office time to work on appeals or audits.  An average medicare check is $10-30K.  Several years before ERA, the biller would have to open each patient account to post their individual payment & adjustment on the EOB until the check was completed! It was a pain-staking process and took all day.  It was not cost efficient for the billing company or the doctor. 

24 Hour Claim Processing
When claims are received in our office, they are processed within 24 hours. Whether you use paper to submit your receivables or a unique Palm/PDA electronic billing application, our goal is lightening fast data entry and bill submissions.

Electronic Claims Submissions
ETMB daily submits your claims electronically to Medicare, Medicaid, BCBS and all commercial carriers. Once we receive your data, your account representative checks for errors, makes corrections if necessary, and submits the claims.  ETMB uses Availity as our clearinghouse which catches a lot of the insurances that have invalid policy ID's.  There are now many insurances that accept secondary electronic claim submission.  Our company uses Flashcode to double-check CPT codes & ICD9 codes.  This software will tell us if multiple codes can be used on the same day and which code has the maximum reimbursement.

 Claims Follow-Up
We aggressively follow-up on all claims. In addition to your individual account executive that deals with carriers and patients, ETMB has follow-up specialists that assist in calling patients to deal with outstanding balances. We know that we don’t get paid unless you get paid.

No Recorded Voice Prompts
All calls are answered personally and messages are answered within 24 hrs. Does anyone want to go through the labyrinth of touchtone choices, only to be left on hold, disconnected, or worse, left with an unresolved billing inquiry? We never use electronic voice prompts during regular business hours. When a patient calls they speak directly with an account representative. Questions are answered courteously, and all efforts are made to expedite a settlement. Patient privacy and support are never compromised.

• Pay nothing upfront, and we average at least a 40% cost savings.
• Lower office overhead
• Billing material costs eliminated
• Storage of billing eliminated
• Fewer claim rejection and faster corrections
• Consistent payment on claims
• Eliminate staff time spent on insurance and patient claim follow up
• Increase in accounts receivable
• Improve turn-around time of accounts
• Negativity associated with billing and collections removed from office
• Eliminates need to attend CPT, ICD-9, and billing seminars