ARE YOU TIRED OF HEARING THIS FROM YOUR BILLING COMPANY AND IN HOUSE BILLER???

Dr. Jones I cannot seem to get the insurance company to pay these 15 claims.

Dr. Jones response why not Amanda? Amanda's response well several reasons Dr. Jones. One claim the insurance company states that the claims denied over the file time and they will not reprocess the claim, five of the claims were partially paid and the other part of the claim were suppose to be paid but, now the insurance company states that it is past the appeal time frame, we will just have to write off the claims. Seven of the claims did not have a referral or prior authorization and the insurance company will not back date a referral or prior authorization the claims are not collectible they should be written off and Dr. Jones Two claims were not able to be processed since we were not contracted with the patients carrier, the insurance company stated that since, we are not contracted we are not getting paid, BUT.... They gave us an approval; the referral number is xys98589545 and yet they will not honor the authorization they gave us we should write the claims off.

If you have experienced any of these claim issues STOP!!! do not write them off... Ask

• Amanda did you appeal the claims and what did the insurance company say?
• Amanda how many times did the claims get denied and do you have the original paper work to the denial?
• Amanda do you have the electronic submission records with your appeal?
• Amanda do you know how to appeal to the provider relations department?

There are many ways to obtain payment for claims like these. Training your staff how to do administrative appeals which takes hours, days and many months to appeal, process and keep up with over a period of 6 months to a year depending on the appeal level..

Realistic Solutions MR works with your billing companies, behind your billing companies or replaces your billing companies by cleaning up the aging, specialized collections projects for Hospitals, Home Health Agencies, Nursing Homes and Private Practices. Before you write off your money to the land of hopeless and I just don't have time to do that pile. Call Mary Berard President of Realistic Solutions MR

You can email her at [email protected]. 774-578-2660 DON'T YOU THINK YOU DESERVE TO GET PAID FOR ALL YOUR HARD WORK???