Mediclaim is a full service medical billing company. But to truly understand everything we do, a step-by-step description is in order. From the time you decide to use us for billing until the last dollar is collected for you, we are involved in every step along the way.
Setting up service with Mediclaim is easy. You provide us with your practice information and a few signatures for EDI enrollments, and we take it from there. The process to get your office up and running takes about 5 business days. Once the EDI forms are processed by payers we are ready to bill for you.
Next, we just need your billing. It doesn’t matter to us what kind of form you use, as long as we know who you treated, why you treated them, and what services you provided. You can use your own superbill or we can design one for you, as long as it has the basic information needed for billing. We will also need patient demographic information for at least the first visit. After that we would only need any updated information. There are occasions where we can extract the demographic data from your system, but this is determined on a case-by-case basis.
There are a few ways you can get the billing to us: fax, email, mail, pickup, or fedex. Pickup is available for any offices located around the Philadelphia area. Our driver will work with you to schedule a weekly pickup that is convenient for you. Pickup is the most preferred method. It provides a secure and convenient way for us to receive your billing. Fedex is probably the next best method. We provide you with the fedex supplies and our account number, so you are not charged. It is best to send a package once a week, preferably on the same day every week.
Once we receive your billing, we enter all data into our system. Most billing is entered within 24 hours of receipt. Any superbills that are lacking the information needed to bill are sent back to the office for clarification and billed the following week. Keep in mind we rarely send billing back. Currently less than one half of one percent of the billing we receive is sent back to the offices. Once entered, the billing is transmitted to each payer that evening.
Within 24 hours of transmitting your claims we receive confirmation reports from each of the payers. If any claim is rejected, we work on it immediately. Whether it is an invalid insurance or a data entry issue, we fix it and resubmit the affected claims.
Depending on the payer, most payments are received by your office within a few weeks. We do not receive the payments on your behalf. Whatever method you currently have in place will continue even if you use Mediclaim to do the billing. We can, of course, help set up any EFT arrangements you would like, but they would be set up to your bank. Payments and EOB’s will continue to be sent to your office.
Any EOB’s received by the office should be sent along with the billing, so we can post the payments and fix any denials. It is not necessary for your office to copy checks or deposit slips, as the EOB’s are all we need. EOB’s often contain information on both sides so sending originals is best. We can return them to you if you wish but we generally hold everything for a year before it's shredded.
Any denials noted on the EOB’s are worked immediately and resubmitted. Occasionally we will need to contact your office for clarification but generally we prefer to do everything with as little disruption to you and your office as possible. Any claims for which we received no answer are followed up on after 45 days.
Any remaining balances are either billed to the patient or any additional insurances. Patient bills are sent out every week on a six week cycle. The payment stub contains your name and address but our phone number. We prefer your patients call us if they have any questions. We can help them understand any balances due or help them fix any insurance issues. We are not a collection agency and will always treat your patients with respect.
Mediclaim will bill you on a monthly basis based on the revenue you received from the billing we did. If you receive capitation payments we do not charge you on those. There are also no added fees of any kind. Our percentage rates start at 3% and contain no hidden fees. Plus, there is also no binding contract. If you are unhappy for any reason you can transition to a different system and we will help in any way we can.
In addition to all of this, Mediclaim gives you full access to all your data through its online portal. Patient demographics, claim history, patient balances, cpt reimbursements, and payer mix are just a few of the things available. You can view a demo HERE.