.: MD 4 Front :.

	(812) 402-4819
	administration@md4front.com

Billing Policies and Procedures



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The following is a list of our procedures that are followed on a daily basis by all billing employees of MD4Front

All daily work sheets are checked for accuracy against the appointment schedule to make sure that we have a charge and payment if appropriate for each patient who was scheduled. The front desk office personnel notify all patients who did not keep their appointments in follow-up.

Provider charges are verified in our system for accuracy as far as procedure and diagnosis code and correct modifier use. Report is generated and matched against daily work sheet for accuracy.

Electronic claim submission to payers is done at the end of each day for those charges that were inputted that day. Reports are run to cross check that all claims are sent. Acceptance reports (EDI) are automatically generated by our third party payers and downloaded and printed the next morning. All front-end verification reports are kept on file.

All primary (1500) HCFA forms are run and matched to any appropriate documentation and mailed at the end of each day following the same format as we do for electronic claims submission.

Any payments (EOB’s) that are received on a daily basis are batched, each check is copied and inputted and balanced against the deposit for that day.

All secondary bills are also generated on a daily basis; during payment posting, appropriate patient statements are also generated at this time.

Claims requiring a formal appeal are brought to the attention of the manager, who reviews and determines if the appeal process should take place. If appeal is processed, it is sent with all appropriate documentation (copy of coding manuals, inpatient/outpatient progress notes, discharge summaries or consultation reports etc.) is attached to the appropriate appeals form. Forms are mailed, copies are kept, and patient account is noted by placing a note on the account for follow-up in 30 days. If appeal is denied, manager is notified and makes the final decision on final disposition of account.

All routine claims follow up begins at day 31, carriers are called and if necessary, resubmission and or correction of claims occur. All follow-ups are properly documented in account notes within the patient’s individual account.

Any overpayment that occurs during payment posting creates a negative balance in the patients account. Manager is notified via refund request form to secure refund to either patient or insurance company. No insurance account is left in negative status longer than 60 days.

All patients who are balance billed are notified of their balances by generating three (3) patient statements. The third statement notifies the patient of our practices intent to turn their account over to our collection agency for recovery.

All effort is made to collect any account over 45 days; all patients are offered options to settle their account, either by making payment arrangements, credit card or credit card consent on file or by post dated check.

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