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Q&A

Running a medical practice and maintaining an efficient medical billing department can prove to be challenging. Inasmuch as PIP claims need to be handled differently, outsourcing these denials can assist a practice that may be backlogged or unfamiliar the protocols governing these claims.

The key to successful recovery in PIP claims is efficiency. A claim needs to billed, followed-up on, appealed and sent to arbitration. Delays in handling these claims, can result in exhausted policies and lost revenue. By outsourcing these No-Fault denials, we maintain continuity through arbitration (if necessary). 

How are these services different from a billing company?

What we offer differs from a traditional billing company inasmuch as we typically take over a claim from the time of the EOB denial. With a strong background in assisting in the handling of PIP arbitrations, we know what PIP carriers .....

Doctor Examining CT Scan
Shoulder Treatment

How can this service benefit my practice?

Aside from preparing patient-specific appeals, efficiency is key with PIP claims. As these claims are subject to a particular benefit limit (as low as $15,000.00) it is important that denials are addressed expeditiously in an attempt to prevent being shut out. The goal is have claims paid before the PIP limit is exhausted.

What happens if a claim is not paid after your Post-Service Appeal?

After a Post-Service Appeal, the next step is arbitration. Once the appeal is forwarded to the insurance carrier, there is a required 45 day period where we must wait before a file can be forwarded to an attorney to be placed into arbitration. We work closely with experienced arbitration attorneys and provide monthly status reports.

If response to appeal is received maintaining the denial before the 45 day period is over, the file is forwarded to an attorney.

X-Ray Results
Doctor Operating CT Scanner

What is the cost of your service?

Our fees are on a per claim/patient basis, which varies depending on the number of dates of service involved. Fee arrangement can be discussed and set prior to any work.

Brain Surgeon
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