| A. All the monies go directly to your office and after you receive payment the EOB's are either faxed or mailed to us. After we receive the EOB we will post the payment on our end and then go after incorrect payment if there is any.
NOTE: Insurance companies are making millions by incorrectly paying claims. It is actually shocking what insurance companies try to get away with and what some doctors offices let them get away with.
B. We challenge every UCR cut or "procedure not covered" as to its legitimacy.
We estimate (conservatively) that insurance companies incorrectly pay 30% of all claims filed and that only 2% are corrected by the providers. How many incorrectly paid EOB's do you have? Do you as the provider know how to evaluate if an EOB is paid directly?
We have seen everything from continuously changing UCR, taking too much co-pay, not paying for all the procedures (leaving out a code), changing the code we filed, saying the procedure is not covered when they paid for the same procedure on the last EOB, saying the patient met their max when they didn't. The list of screw-ups by insurance companies goes on and on so does the list of doctors being paid incorrectly.
NOTE: One of our most important functions is seeing the EOB and evaluating whether the claim was paid correctly or not.
Doctor, to use our service you must make sure that all EOB's are sent to us as soon as you receive them or you will be losing money. | |
