Medical Billing Service

Along with Medical Coding, AE & Associates offers solutions for your Medical Billing needs. Led by our Medical Billing Director, Christine Groves, our team of experienced Billers will make sure your billing is handled with the upmost skill and professionalism our company can offer. We can effectively maximize revenue for our clients, while being very proficient in our billing process. Let us be the ones that will give you a financial boost by using our Billing Service.

Medical Billing Process

Claims Submission
  • Claims are submitted electronically within 24 hours of receipt. Almost all unquestioned claims are paid within 30 days, and in some cases even earlier.
  • Or we will process paper claims for those payers who do not have the capability of processing claims electronically.
  • Provide a monthly report to include: Charges, Net Revenue, and all Pending ARs of: 30+ days, 60+ days, 90+ days and 120+ days
  • Establish goals such as strategies for improving revenue for services provided
Patient Statements
  • Monthly statements are mailed out for each account with a deductible or patient responsibility balance.
  • Payments and Posting
  • Each EOB is analyzed and appropriate payments are posted to the proper claim. At the end of each month you will receive comprehensive reports reflecting all transactions
We Also Provide
  • Follow up on unpaid insurance claims, denials and outstanding patient balances
  • We will consistently and proactively review, correct and resubmit any unpaid claims, denials and outstanding patient balances.
  • Process Appeals to Insurance Carriers
  • Phone calls and mailing letters for soft collections

Medical Practice Billing Analysis

Dynamic Medical Practice Impact Analysis
  • Offers you a complete and powerful perspective on the business side of your medical practice. It gives you the information and insight to make important decisions to increase your bottom line.
  • Comprehensive reports and analysis
  • Practical information about your productivity
  • Efficient procedures to ensure maximum reimbursement
  • Establish realistic expectations for practice revenue based on services offered and actual payer reimbursement
Reimbursement Review and Analysis
  • Implementing efficient processes to handle and manage reimbursements are vital to ensuring all the revenue generated in your office is captured.
  • Assess current coding and billing protocols identifying opportunities to increase revenue and profitability.
  • Recommendations regarding methods for coding and revenue audits to maximize reimbursement, claim submission, and payment facilitation
  • Recommendations to optimize clean claims submission
  • Evaluate denial rate and recommend processes to reduce those rates in order to maximize revenue
Payer Analysis
  • Knowing which services payers actual pay for, how much they pay and when they pay is essential for sound practice planning. Our payer analysis gives you this information and more.
  • Analyze payer mix and profitability derived from that mix
  • Establish reimbursement comparisons between payers for all services offered by the practice
  • Provide realistic reimbursement expectations and timelines for all payers and services
  • Analyze contracted payer fees for purposes of internal benchmarking and contract negotiations with payers
  • Provide recommendations on patient mix to maximize actual payer reimbursement
  • Provide recommendations on which patient services should be offered based on actual reimbursement
  • Analyze impact of new payer contract developments on practice revenue

Additional Services

Denial Management
  • Denial Management and Benchmarking is a dynamic way of enhancing your practice revenue cycle. Your denial EOB will be proactively reviewed to identify errors and missed revenue opportunities
  • Identify significant denial patterns and payer payment variances.
  • Reports will summarize the total dollar amount of denied claims along with the reason for denial.
  • Detailed information of each denial and potential reimbursement issues.
  • Provide recommendations to avoid the same denials in the future
Provider Credentialing
  • Credentialing requirements and guidelines are ever changing. They are time and labor intensive. We provide credentialing and credentialing maintenance for both new and established providers.
  • Process and file documents for
  • Hospital privileges
  • Government plan enrollment
  • Third party payers
  • CAQH and expired licenses
Comprehensive, easy to read, monthly reports
  • At the end of every month we will provide you with essential monthly reports that gives you vital information about your monthly revenue/collections
  • Snapshot report summarizing your monthly collections, accounts receivables, and denials.
  • Denial Report, detailing the reason for the denial
  • Feedback and Recommendation report
  • Access to customizable reporting feature
Monthly Feedback and Recommendations to maximize your collections
  • At the end of every month we will provide you with a Feedback and Recommendations report for your internal office to use to make changes regarding patient files (ie updating insurance information), and internal office processes (ie change in codes).
Training and Education
  • AE can train Physician staff in identifying and verifying Pts for proper Eligibility screening and Registration to guarantee maximum probability of payment for services rendered.
  • AE can train Providers in regards to proper coding to optimize revenue based on their contracts with Payers.
  • Our team provides a variety of consulting services.
  • Review contracts for clauses, accuracy and expiration.
  • Provide assistance to Client Corporations in negotiating new Contract terms at renewal
  • Help identify any potential Community and/or State Programs available which are not currently being accessed and help in the application process
  • Assist in the recruiting and hiring of Medical Billers, or front office staff