PMP Frequently asked questions

What makes accurate medical billing so important for behavioral health specialists?

Medical billing is an essential part of any medical practice. However, the task of billing for your services can be a time-consuming and tedious activity. Most practitioners desire to spend their time on their area of expertise versus learning a new set of skills to ensure payment for their services. Practice Management Professionals assist behavioral health professions by improving billing accuracy and efficiency; allowing for your revenue streams to flow freely and expand quickly.

What does a medical billing account manager do for me?

Medical billing is a complex system that ensures that behavioral health professionals get paid for their work. Your Practice Management Professional’s account manager focuses on consumers, the healthcare providers, and the insured’s insurance company. Their job is to make sure each service is correctly applied, entered into the appropriate billing system, and paid for through the insurance carrier, the client, or a combination of both in a timely and efficient manner.

How does the billing process work?

The behavioral health specialist sees a client for a session or evaluation. This service is equated with a Current Procedural Terminology (CPT) code. This code is used to report medical and diagnostic procedures and services to the client’s insurance carrier. This code is sent to your billing account specialist or outlined in our electronic health record system.
The billing specialist then contacts that client’s insurance carrier and verifies that the insurance policy is currently active, ensures that the client is seen for services is covered by the policy, and determines if the insurance carrier covers the services outlined via the CPT codes provided by the practitioner. The biller then outlines the CPT procedures and services codes that are covered by the insurance carrier and enters them on a specialized form (CMS 1500 Form; 2/2012 ), along with the other required client information, and sends them either electronically, or traditional mail, to the third party insurance carrier for processing and payment.
The turn around time in receiving payment for most third party carriers is about three (3) weeks. However, on occasion, there can be a delay in payment for services sent to the insurance carrier. If this occurs, the billing specialist will communicate with the insurance company and reconcile the claim until it is paid to the fullest extent.
Our billing specialists send out bills for providers within forty-eight (48) hours of receiving the information from the provider (excluding weekends and holidays). This allows our customers to obtain payment for services quickly.

What are the benefits of outsourcing my medical billing?

  • It increases the time a behavioral health professional can spend on the things they enjoy doing! Outsourcing your medical billing frees up your resources for healing your clients and for creating programming materials. Let our medical billing professionals spend time on the phone with insurance carriers, figuring out denied claims, and creating monthly statements.
  • It decreases funds towards human resourcing activities (e.g., hiring an administrative staff member, payroll taxes, etc.).
  • It can improve overall cash flow for your business. Have a skilled billing professional overseeing your claims and service fee payments could ensure more expeditious payment from third-party payors and clients alike.
  • It could decrease overall costs for office space to house an administrative staff person for billing.
  • It affords clinicians to be free of having to enter into the role of “bill collector” with their patients.

What systems do you use for billing and electronic health record systems?

Practice Management Professionals (PMP) uses Office Ally as its billing clearinghouse and electronic health records system. Depending on the level of electronic record support you desire, PMP can direct you towards the best plan and services for your size practice and professional needs.

Do I need to sign a contract?

We keep our contracts to a minimum of six (6) months to ensure continuity and accuracy of services for both the client and PMP staff. The client will be asked to pay a one-time startup fee of $249.99 (two hundred forty-nine dollars and ninety-nine cents US currency) to ensure proper establishment of the Client’s consumer’s records to provide ongoing accuracy of medical billing and accounting ledgers. Client’s pay $4.99 (four dollars and ninety-nine cents US currency) per claim; with a $199.60 (one hundred ninety-nine dollars and sixty cents US currency) monthly minimum. This is paid monthly via credit card directly to PMP.