Frequently Asked Questions
- What kind of services do you bill? MediClaims Billing focuses on non-collection services, such as Medicaid-funded and Medicare-funded services for behavioral health and mental health and other fully-funded services.
- Who can use your services? Our strength is improving upon your process. MediClaims Billing serves both service providers and billers to streamline the claims billing process. Whether you manage a facility, agency, practice, billing department, or billing company, our service is a benefit to you.
- How long is it to get set up with MediClaims Billing, and how much does it cost? You can be up and running in less than 24 hours after your client claim information is entered into your secure form when you log in. Your actual invoiced flat-rate fee is determined by your contract before services start and is tailored to your company's claims processing needs. We are not compensated with a percentage of the total amount of your paid claims. All services are included with no hidden charges, and there is no long-term contract to use our service.
- How do you have the fastest claims billing process? MediClaims Billing has a unique processing agreement to submit claims through a direct connection to each payer rather than through a frontend or manual process. This process allows for the receipt of your claims within hours rather than days during the adjudication process so that you get paid faster.
- How long does it take to get paid, and how will I know? Although most insurance companies state 30-45 days from date of post, MediClaims works with a shortened schedule that usually pays inside of 3 weeks, typically on the second scheduled pay day from posting.
- Is this process secure and HIPAA Compliant? Yes to both. This site is secure, as indicated by the "s" after "http" in the address bar when you log in. This security measure is expanded throughout our entire process. The submission and posting systems used MediClaims Billing are designed around being compliant and providing a secure environment for your company and member information.
- What information do you need to process a claim? We will simply need the CMS form 1500 details as they are listed with Medicaid. Additionally, we will need the service authorization date and authorization number.
- How will I get my claims information to MediClaims Billing for processing? MediClaims Billing will provide you with a secure form containing pertinent claim information. The information you enter into your form will be automatically processed at the time of submission.
- How often are claims submitted for billing? The most popular billing submission schedule is weekly after Saturday 11:59pm Eastern Time. We will work with you for any other scheduling for the first week of service.
- How will I know whether the claim has been submitted? Once we have submitted the claims, an email confirmation will be sent to you confirming that claims have been submitted and processed and are in process for payment from the payer. In addition, all payers generate an Electronic Remittance Advice (ERA) and Explanation of Benefits (EOB) report, which is sent directly to you confirming payment status of submitted claims.
- How will I know if a claim has been rejected or denied? Upon receipt of denial, MediClaims Billing will generate a denial report with a list of claims rejected or denied by the payer. If you are using our follow-through service, we will work with you to resolve these claims and get them paid.
- Can service authorization dates be tracked? Yes. You may choose to have your secure form contain highlights for upcoming dates to address service authorizations. This feature is very useful and important to the entire claims billing process.
- How are multiple locations or multiple providers handled? Our system is built to handle multiple locations and providers with ease and automatically separates each claim into the proper service and location categories for a smooth and fast billing process.
- If I am a biller, will you also market to my provider clients? No. Billers make up the majority of MediClaims clients. It is in our best interest to protect the relationship billers have with service provider clients. We want to make it easier for you to enrich and expand your network because this is a great help to our field of service. Therefore, when you disclose your clients to us through the billing process, we maintain strict confidence with you and will not have any intentional contact with them.
- If I am a provider, will you also market to my biller? Yes, when possible and where there is no conflict with your business. There is no additional cost to you when we assist your biller, and if your biller serves more providers, connecting with them can be a great help to other fellow providers in a noncompetitive way. We highly value our providers, and our main objective is to help make more room for you to serve our communities by providing your much-needed services.