Frequently Asked Questions

Q: Pricing - How much do you charge?

Pricing is calculated based on the expected total costs from the agreed-upon workflow, spread over the anticipated payments received or the number of encounters billed monthly. This results in either a percentage fee or a cost per claim. Key variables include volume, average reimbursement per encounter, and the specific processes involved.

Q: Are there other services outside of the above-mentioned fees?

Yes, there can be. For example, verification of benefits is charged separately due to the time-intensive nature of the process, especially when sufficient information isn't available through automated systems.

Q: Insurance Networks - Are you in or out of network with the payers in your area? If in network, which payers?

Some practices may choose to be out of network, which can present challenges in attracting patients willing to pay cash rates or those with favorable out-of-network benefits. MCB emphasizes enrolling providers correctly and promptly to ensure they are approved and contracted before seeing patients. They also assist in keeping information up to date with CAQH, NPI Registry, and PECOS (CMS).

Q: What is included in the standard process?

The basic claims process encompasses claim review and submission, addressing rejected claims, payment posting, denial review and resolution, open claims review and cleanup, and patient statements.

Q: Technology - Do you work with our EHR system?

MCB is adaptable to the EHR/EMR system used by a practice. Depending on the system, they will either utilize the associated billing system or create an interface to their preferred Practice Management system. They recommend selecting an EHR system that best fits the practice's needs and workflow and can provide suggestions to develop an efficient process.

Q: How well do you follow HIPAA Compliance regulations?

MCB strictly adheres to HIPAA regulations, ensuring all necessary technical, administrative, and physical measures are in place to provide privacy, security, and confidentiality to protect electronic protected health information (e-PHI).

Q: What services do you offer?

MCB offers a range of services, including: Medical Billing Payment Processing Reporting EHR Integration Compliance Denial Management Consulting Credentialing

Pricing - How much do you charge?

This is often one of the first questions asked from practices looking for a new biller. Pricing for most businesses in competitive markets is based on cost plus margin. In our case, it is a similar math equation where we take the expected total costs from the agreed-upon workflow and spread that cost over the expected payments received or number of encounters billed monthly to come up with a percentage fee or a cost per claim. The key variables are volume, average reimbursement per encounter, and the aforementioned process.

Are there other services outside of the above mentioned fees?

There can be. We charge separately to perform verifications of benefits. Due to the nature of this process, it can involve significant time to complete via phone if the automated systems do not provide enough information necessary.

Insurance Networks - Are you in or out of network with the payers in your area? If In network, which payers?

Some practices can choose to be out of network. The challenge with being out of network is finding enough patients willing to pay your cash rates or with good out of network benefits. We insist on enrolling our providers to ensure it is done correctly and timely. You have to be approved and contracted before seeing patients in order to get paid. And it is critical to revalidate timely. MCB will help you keep your information up to date with CAQH, NPI Registry and PECOS (CMS).

What is included in the standard process?

The basic claims process includes claim review and submission, review and repair of any rejected claims, payment posting, denial review and repair, open claims review and cleanup, and patient statements.

Technology - Do you work with our EHR system?

We are agnostic to the EHR/EMR system you use. Depending on the system, we will either use the associated billing system or build an interface to our preferred Practice Management system. Our recommendation is to use the EHR system that is best suited to your practice, patients, and work style. Pick one that is easy for your staff to manage patients and easy for you to record your notes. We can provide suggestions and work with you to develop an efficient process.

How well do you follow HIPAA Compliance regulations?

We comply with HIPAA regulations very well in everything we do. We know that handling the patients’ personal information is a big responsibility. So, we assure you of all necessary technical, administrative, and physical measures to provide privacy, security, and confidentiality to protect the e-PHI.

What services do you offer?

● Medical Billing
● Payment Processing
● Reporting
● EHR Integration
● Compliance
● Denial Management
● Consulting
● Credentialing

Do you have separate teams for handling rejections, denials, and claims?

Yes, we have separate teams handling denials, rejections, and claim processing.
Every unit is responsible and works according to the given plan and rules. We always try to minimize the chances of mistakes by taking substantial steps to identify and remove those errors through analysis and routine audits.

Do you have any software to help you with practice management?

We are working on the detailed RCM software as per the physicians’ needs, making it easy for them to automate the billing process.

What things to ensure to get accredited ASAP?

The crucial thing to get it all done is to fill out the application form quite vigilantly. If there is wrong information added or a field is left unanswered, the process will take a long time to complete. The rest can go smoothly pretty much.

What about the monthly reports? What’s your take on that?

We make reports monthly, quarterly, or annually according to a healthcare provider’s requirements. At the end of a month, we also generate collection, payer adjustment, denial, aging, and other reports including detailed information about the progress of ongoing claims and accounts receivable of rendered services.

Do you offer Patient Healthcare Plan Verification service?

Yes, we do pre-authorization when required.
• First, we go to the patient’s verification checklist list.
• Get a copy of a patient’s insurance card.
• Contact the insurance provider.
• Make a record of the accurate information.
• Follow up with the patient as needed.

How will you handle our Accounts Receivables?

Our accounts receivable follow-up team is in charge of taking care of denied claims and processes them again to obtain reimbursements from insurance companies.

We follow up on A/R in a systematic manner, usually in three stages:
• Initial Evaluation
• Evaluation and Prioritization
• Collection

What sets you apart from Other Billing Companies?

We focus on our quality of work with a proactive approach that minimizes accounts receivable.

We have an experienced staff. With us, you will have a highly flexible and affordable billing experience with timely MIPS reporting under one roof.

We are an all-in-one solution where we optimize providers’ performance in every way possible, even with some value-added services, such as credentialing services, RPA medical billing, HEDIS reporting, and more.

2022 Patient Reports

Emergency Cases

Please feel welcome to contact our friendly reception staff with any general or medical enquiry call us.

Frequently Asked Questions