Surprise Medical Billing Services

Our expertise lies on offering unexpected medical billing solutions, which tackle the challenges that patients encounter when they get unexpected bills from providers outside of their network. Our committed approach guarantees fair and transparent billing procedures with the goal of reducing unexpected costs for patients.
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    Our Process for Full Recovery of Billed Charges

    Coverage Assessment

    We start by confirming the patient's insurance plan and benefits, clearly communicating their financial responsibilities and expectations to avoid any unexpected billing surprises.

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    Claim Management

    Our expert billers ensure HIPAA-compliant electronic submission of out-of-network claims, streamlining operations for smooth and efficient processing.

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    Follow Up Services

    We proactively track claims, leveraging patient benefit details and negotiating effectively to secure the highest possible insurance reimbursement.

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    Appeals Management

    We specialize in creating detailed appeals, demonstrating medical necessity, and recovering unpaid balances for thorough claim resolution.

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    Payment Posting

    We ensure timely and accurate payment posting for all claims, keeping you informed of claim statuses and promptly addressing any payment discrepancies.

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    Reporting & Analytics

    Our robust reporting provide clear insights into OON billing performance, helping you track claim statuses, identify trends, and optimize revenue strategies.

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    What is Out-of-Network Billing?

    In the world of healthcare finance, out-of-network billing, sometimes known as "surprise medical bills," happens when consumers receive unanticipated bills that include copays and deductibles and show the difference between what their insurance covers and what is charged by out-of-network providers. Knowing the nuances of out-of-network (OON) billing can be quite profitable for individual clinical practitioners in the complicated insurance market of today.
    Getting the hang of this technique is essential to sustaining steady income flow and averting any insurance provider reimbursement issues. By utilizing this substantial revenue potential, skillfully managing OON billing improves both the financial stability and patient satisfaction of your clinic.

    Call to ask any question : (347) 502-6465

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    MBHP's Out of Network Negotiation Strategy

    Expert negotiation skills are necessary to navigate the complicated world of out-of-network billing, especially for hospitals and standalone emergency rooms. MediBill Health Partners (MBHP) is a leading organization with a specialist staff focused on settlement negotiations and a wealth of experience. Our decades-long expertise in medical billing, coding, and revenue cycle management is adapted to the particular requirements of different clinical practitioners, hospitals, and emergency rooms.

    There are several benefits for individual clinical practitioners when they collaborate with MBHP’s knowledgeable medical bill negotiators. It might be difficult to handle conversations with insurance companies since they frequently try to reduce payouts by limiting benefits. As your advocate, our staff makes sure you get the most money possible so you can concentrate on running your clinical business.

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    Our Medical Billing Negotiation
    • We ensure comprehensive collection of essential information during initial contact, focusing on patient history and benefits.
    • Our team reviews your current practices and policies to ensure compliance with state and federal laws, safeguarding you against audits and potential litigation.
    • Trained personnel meticulously track each patient payment, ensuring accurate collection of the patient's portion.
    • We craft clear messaging to help patients understand their responsibilities and expectations, facilitating smoother negotiations and appeals with insurance companies.
    Medi Bill Health Partners
    MediBill Health Partners

    Pre- and Post-Claims Process

    The number of out-of-network (OON) claims is rising, even for those with insurance. If clinicians do not have the relevant procedure codes or the medically necessary diagnoses for the treatments they conduct, they risk losing revenue. Although it is against the law for insurance companies to underpay or withhold reimbursements, they frequently use a variety of roadblocks to postpone payments in the hopes that providers will give in and accept lower amounts.

    How Does MBHP Manage the Above?
    We review code selections, remarks, and reports. We also make sure you utilize the best techniques for coding claims by keeping you updated on changes to codes and coding tactics from various payers. Proactively following each claim through aggressive follow-ups, we pursue each one in turn. Our experience reduces processing time and guarantees on-time payment.

    Our Advanced Negotiation Strategies

    At MediBill Health Partners, we use a systematic, data-driven approach to put patient protection first. Our knowledgeable staff carefully examines past data from the area to successfully negotiate claims, guaranteeing just results that reduce your patients’ out-of-pocket costs.

    Our expertise in dealing with insurance companies and their vendors, both prior to and following claim reimbursement, dates back more than ten years. Our in-house out-of-network (OON) database improves our capacity to locate and correct claims that have been underpaid. Recognizing benefit restrictions and employer preferences, our adept negotiators creatively restructure invoices to optimize reimbursements.

    Pre-Payment: To ensure that you receive the best possible compensation, we aggressively negotiate on your behalf with negotiating vendors who represent insurance companies.

    Post-Payment: We reevaluate claims to bargain further in order to optimize your reimbursement after they have been reimbursed based on vendor pricing or negotiation.

    Negotiations and Appeals Filling

    Being successful with OON billing consistently requires being on top of your game when dealing with insurance carriers. Furthermore, you must constantly challenge not just denials due to OON billing, but insurance firms will try to postpone everything from treatment or claim denials to response times.

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    How does MBHP Address This?

    • Ensuring comprehensive patient information (benefits, insurance, etc.) is gathered before negotiations commence.
    • Vigorously and strategically advocating for maximum reimbursement.
    • Consistently implementing the most effective approach.
    • Systematically appealing all delays.
    • When appeals prove insufficient, collaborating with reputable law firms specializing in out-of-network cases for arbitration and litigation to secure fair reimbursement.
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    MediBill Health Partners
    Medi Bill Health Partners

    Why Choose MBHP for Out-of-Network Billing?

    Insurance companies are becoming more stringent these days when it comes to limiting payments to healthcare providers. Collaborate with MediBill Health Partners, a proficient provider of out-of-network billing services, to optimize your practice's revenue generated from non-network sources. Our team possesses vast knowledge in surmounting insurance-related challenges, and we will customize an effective approach and customized solution for your practice. You may rely on us to maximize your earnings potential and handle the reimbursement process with ease.
    • Error-Free Claim Submission
    • Assured Revenue Growth
    • Tailored Out-of-Network Reports
    • Patient Contentment
    • Lower operational costs
    • Quick turnaround time

    Feel free to reach out today for a brief consultation call or to request a demonstration of our services

    (347) 502-6465

    Ask any question