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We are often asked to be able to "quote" what the benefits will be for a patient's insurance coverage prior to treatment with a provider. That process has changed dramatically over the years and it is now almost impossible to pin down. Insurance cards sometimes list an office copay benefit but that would only apply to a regular physician's office visit and not any type of specialty, like Psych. On-line access to benefits is an option for some insurances and will usually spell out the regular coverage. Some require a username and password to be set up to be able to go on-line and those also expire every 90-days or so and have to be kept in a secure location for HIPAA requirements. We actually have devoted entire shared, secured documents to just the handling of on-line usernames and passwords.
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As a medical billing/management company, we are given the task to follow up with insurance companies to get the claims paid for any charges turned in to us. Some insurances - like Medicare - make that task easy by having strict regulations in place that we follow and, by doing so, they pay easily and on time. Others will loosely follow guidelines and hold or even deny the same claims, and we are forced to contact them to get that claim paid. Find out how we help get those claims paid.
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