Appointment/Scheduling;

• When a patient calls to set up an appointment your front office staff points and clicks on the date and time in the scheduling calendar.
• After some insurance information is gathered the system checks for eligibility. If eligible the patient's demographics can be downloaded directly from the carrier's site in to their chart with just a click.

On the day of the visit;

• The office staff; will verified and scan insurance cards auto-create an electronic charge slip, and collect any co-payments.
• The physician; will simply touch the appropriated service and diagnosis codes on a touch screen PocketPC or iPad (note we will do paper too if you or the payers requires, we're flexible). This information will be automatically transferred into our billing data base in real time.



You're done leave the rest to us...

Claims Processing

• Our claims specialist will review and apply the correct modifiers and cpt codes. After this the claim will undergo a litany of advanced validation test, the Denial Defender Scrubber and then rechecked for any possible discrepancy (because of all this our first submission denial rate is less than 2%).
• The Claim is then submitted electronically or if necessary a paper claim is generated and mailed
• Then the claim is rescrubbed and edited at our clearing house for further denial protection

Fee Schedules it is very important to have accurate fee schedules with the insurance companies and networks that you participate. These fee schedules require updating on a regular basis. We request these fee schedules and negotiate the pricing on your behalf. With the current economic environment increases to payers are inevitable we make it our job to see to it that you are proportionally compensated.

Receipt of payment;

• As we receive payments and explanations of benefits from you, we post these in to our database. Each EOB will be audited for correct payment and/or benefits. Payments are then posting and forwarded to Advanced Medical Consultants electronically for review and disbursement.
• If necessary reprocessing/appeals for any disputable claims begins.

Secondary claims;

• Submitted to additional payers and or as patient responsibility.
• Statements - are mailed out from our office on behalf of your practice or facility. The protocols of statements and collections are done specifically to your specifications.
If we don't get a response from the patient we initiate a letter and/or call cycle to obtain payment. These calls come to Advanced Medical Consultants where they are answered as your claims department. We structure our collection efforts in a way to encourage your patients to work with us to resolve a claim. Sometimes it may require a cyclical payment plan that is affordable and amicable to ensure you not only get paid, but also keep the patient relationship. However, in the event that a patient refuses to work with us, as a last resort Advanced Medical Consultants will then turn the balances to a collection agency for payment.

Follow-up;

Is a major part of our business, there is no guarantee that a claim will be paid or even acknowledged by a insurance company. It's their job not to pay and they have many ways to do this. Even clean claim will be ignored by insurers without even a notification of denial. In addition insurers are continually tightening up their rules, for the purpose of not paying provider their fair share. And now more and more payers are jumping on the timely filing limits bandwagon as well.

It's more important than ever that you have a team of professional fighting for your income. We have several methods at our disposal to ensure you are paid as promptly as possible, and not lose money in the cracks. That's why Advanced Medical Consultants is a leader in Derm claims reimbursements. We don't quit until you are fully compensated.

Past Due Claims;

• If a claim becomes past due our sophisticated alert system notifies our follow-up team to take immediate action. Phone calls and faxes to appropriate agencies and payer are required at this time.
• Because we understand all of the critical components for reimbursement, our partners receive the maximum compensation for their efforts. When other billing firms give up we get started. Most practices have their largest revenue draw down for lack of diligence on claim follow-up. That's why we devote a great deal of our time to this activity.