Us
Others
Coverage Validation
Patient Demographic Validation
Charge Posting
Claim Scrubbing (Level I and II)
Secondary Claims Management
Clearing House Follow Up & Other Troubleshooting
Payments Posting
Patient Funds Posting
Patient Statements Management
Refunds Processing
The Fee for Service is pre-paid. It is based the average number of patients seen and not to exceed
the maximum number of authorizations allowed per day. The rate is then multiplied by the number of staff corresponding to the number of appointments then multiplied by an 8 hour day, then multiplied by a 5 day work week, then multiplied by 52 weeks in a year, then divided 12 months in a year. This will become the monthly amount due.
The invoice is issued on the 16th of each month. It is due upon receipt.
Client will authorize BA to prepare, process and submit claims to commercial and government payors. BA will apply its best efforts to obtain reimbursement for Client’s charges for all clinical procedures and medical services provided to patients. All such claims shall be submitted by BA in the Client’s name and utilize provider numbers assigned to the Client by the respective insurance payor. Claims will be submitted by electronic, facsimile, or paper means. Payment of all claims filed on behalf of Client shall be directed to such accounts to which Client has control. BA shall post payments received from the insurance companies to the patient's record.
It is the responsibility of the Client to contact the patient directly, when necessary, to secure full payment for the Client. Client is the only party to this Agreement to negotiate a repayment plan with patients.
Client will authorize BA to medically code any services performed by client for which a superbill is not used. This can be for services performed at a facility other than the Client’s office (i.e., hospital, clinic, other practices, etc.) The coding fee is $2.00 per chart.
Credentialing process typically takes 30 to 180 days to complete, covering federal, state, and private health insurance payers. To ensure a seamless and timely credentialing experience for new physicians, we assign dedicated resources who manage the process with precision and attention to detail. For this we charge a fee of $300 per new hire. For existing physicians we maintain the credentialing requirements for all physicians as a part of our service.
BA may be responsible for the collection of claims and submissions both after and before the effective date of this contract dependent on the option selected in the contract. For claims, whose date of service, is posted after the effective date there is no fee on collected funds. For claims, whose date of service, is posted before the effective date the fee on collected funds shall be 15%. For claims posted before the effective date, BA will review each outstanding claim and assess whether it should be written off, needs to be resubmitted, or any other actions that would work towards the collection on such claims.