FAQS | Medi-Concepts

Medical Billing

Cost Recovery (Stop Loss Claims Audit)

Is the audit done prepayment or post payment?
Upon execution of contract, the initial review is done on all stop loss claims paid within the past six months. On an ongoing basis, line item review is done on a prepayment basis making the savings real time. Clinical audits are also done on a post payment basis at the facility where the services were rendered. These audits are handled by highly qualified Clinicians with over 30+ years experience in medical audit field. Our clients can opt for either prepayment audit, post-payment audit or both.

Does Medi-Concepts provide details of savings and the documentation to support?

Yes we do. This documentation can be presented to the providers/facilities and serves as justification for the review.

How does Medi-Concepts charge for these audit services?

We charge a flat rate or percentage of the savings as agreed upon with our clients.

How do we track all savings as a result of all audits completed?

Medi-Concepts provides regular report to all clients either on a weekly or monthly basis. All reports are customized in accordance with the need of our clients.

What Specialties can Medi-Concepts submit claims for?

Mediconcepts submits claims (CMS-1500 and UB-04) for all specialties, practitioners' providers and facilities.

Range of providers includes but isn't limited to the following:

Family Practice
Pediatrics
Internal Medicine
General Practice
Obstetrics and Gynecology
Anesthesia
And all other specialties

Is it efficient to outsource my billing?

According to industry experts, it is smart and cost efficient to concentrate on your core competencies i.e. providing quality medical care while ancillary functions like billing is outsourced. Medi-concepts takes away the onerous burden of dealing with multiple insurance companies and staffing for billing staff. We improve your cash flow and strengthen your relationship with stakeholders

Is Medi-Concepts, LLC HIPAA compliant?

Yes. Medi-Concepts, LLC uphold the highest standards and comply with all privacy and security regulations.

Billing companies always promise to increase revenue, what makes Medi-Concepts different?

We are experts in our field and we increase your revenue by ensuring that our codes (CPT and ICD-10) are up to date resulting in accurate billing. We follow up with insurance companies to ensure timely payment. With vast experience of running claims payment shops, we know what insurance companies look for to ensure maximum reimbursement in a timely manner. We guarantee payment on first submission of claims

How do we transfer billing information to Medi-Concepts?

We can arrange to pick up super bills weekly or as often depending on the volume. This data can also be transferred to us via a secure server.

How frequently or promptly will my claims be submitted to Payers?

Medi-Concepts, LLC guarantees billing within 24 hours of receipt and will submit claims daily with the exception of holidays and weekends

How will I be notified of claims submission and the status of billing?

Once claims have been filed, Medi-Concepts, LLC will provide a detailed report via secure e-mail on a weekly basis or more frequently depending on the volume of claims.

Does Medi-Concepts follow up on outstanding claims?

Yes, we provide prompt follow up on all claims not paid within 14-30 days depending on whether they were submitted electronically or via paper.

Does Medi-Concepts assist with setting up electronic submission with payers?

Yes, we do. To facilitate prompt payment of claims, we encourage all our clients to submit electronically. In some jurisdictions, the law mandates that electronic claims must be paid within 14 days of receipt.

Will I have to turn over control of all billing, checks and reconciliation to Medi-Concepts?

You will always have control of the checks, explanation of benefits/remittance advice. We will need copies of the remittance advice/explanation of benefits so we can post payment or bill patients as may be applicable. We are here to work with you and are flexible.

How does Medi-Concepts charge for billing services?

Our clients always have options. Charges could be set up on a per claims basis or as a percentage of total revenue collected. The revenue includes all collected from payers and patients if applicable. Mediconcepts works with all clients to obtain maximum reimbursement in a prompt manner. We will work with all clients to maximize revenue. We do not leave any money on the table.

Does Medi-Concepts provide consulting services?

Yes, we do. The services range from appeal management to contracts review and renegotiation, provider education and other areas within the Healthcare industry. We also provide on site training for front office staff in your offices, Claims Processors, Customer Service staff and others. Consulting services are billed at an agreed upon flat rate or per hour rate.

Do you handle patient billing?

We handle patient billing at your request. We process patients statements on a weekly basis and resend unpaid statements after 30 days of the initial bill. We make recommendations after three unsuccessful attempts to collect. We are in regular contact with your offices to assist in collecting from repeat patients that have outstanding balances.

Consulting and Project Management