Will all claims be electronically filed?

With few exceptions, claims are filed electronically.  There are still a handful of small providers that do not offer electronic filing or who require paper submissions.  Rx identifies the appropriate submission format for each claim to ensure that the process moves as efficiently and promptly as possible.

Do I have to buy software?

Absolutely not.  Rx maintains all of the technology required to get the job done right so that you can focus on your practice.

How does Rx receive the patient information needed to submit medical claims for payment?

The delivery method varies depending on the provider or client.  We receive most data via HIPAA compliant websites. However fax, email or FedEx are also options.

How are payments received and posted?

Normally the provider receives payment directly from the insurance companies. In order to apply proper credit and adjustments, Rx requires a copy of the EOB. If there is secondary coverage, Rx bills upon the receipt of the EOB from the provider’s office.

How does patient billing work?

Patient billing is triggered automatically when the EOB is received from the insurance company, assuming there is a balance due from the patient. If the claim is subject to contractual limits, Rx will credit the patient’s account accordingly and bill for the balance. If a co-payment is made at the time of service, Rx will need to be notified in order to credit the account properly. We then follow up on outstanding patient accounts at 30, 60, and 90 days in accordance with standard practice.

Does Rx handle my checks?

No. Rx will file the claims and post EOB’s and payments as needed, but we do not handle checks directly.  Rx will provide monthly statements detailing the amounts received from both insurance and patients, along with the fee for services rendered by Rx.

How often are my claims processed?

Within 72 hours of receipt if not sooner.

What is the turn around time for dictations?

Our standard for turning dictations is 24-48 hours.

Is there an appeals process?

Yes.  All claims unless paid at 100% or per contract are appealed for additional payment.

Our success depends on yours.

The Rx business model is built on a results-driven philosophy and that means our fee is based on net collections, not the time, effort or energy we invest in your account.  Our expert billing staff focuses exclusively on maximum claims reimbursements.