BILLING SERVICES

CUSTOM BILLING SOFTWARE

Expert Billing uses a custom designed billing software program that specifically meets the needs of HCBS Waiver Providers.

The custom software provides an array of capabilities that commercial medical billing software or the Winasap software provided by Medicaid doesn't offer.

Some of the capabilities it offers are:

• The ability to input approved services according to the service authorization
• Allow billing only from the approved service information to ensure compliance as well as tabulate monthly reports on remaining balances of approved services
• In addition, to avoid unnecessary denials, the system reviews past claims for duplicate billing and performs a series of error checks to ensure the claim meets the HCBS and Medicaid standards for payment prior to submission

ELECTRONIC CLAIM PROCESSING

Expert Billing submits claims to Medicaid on a daily basis to ensure prompt payment to providers. Claims are usually processed by Medicaid within 7 days.

Invoices must be submitted to Expert Billing by Noon on Tuesdays to be processed by Medicaid's weekly deadline of Wednesday.

Expert Billing will work with you to set up an invoice submission schedule that meets your individual needs.

CLAIM RESOLUTION

Expert Billing understands that providers like to get paid on time!

To facilitate the resolution of unpaid claims, Expert Billing has access to view claim status online. This saves a tremendous amount of time contacting Claim Inquiry or waiting for the remittance voucher to come in the mail to determine why the claim was not paid.

Expert Billing will work to resolve any claim problems that may arise and reprocess the claim as quickly as possible at no additional charge.

SERVICE BALANCE REPORTS

One of the best features of the custom software used by Expert Billing is the ability to input approved services according to the service authorization. This ensures billing accuracy based on the approved service, number of units and unit rate to avoid unnecessary denials.

In addition, the system automatically keeps track of what has been billed against the service authorization. At any time, a report can be created that details the total amount of service approved, the total amount of service billled to date and the remaining balance of the approved service.

It is easy to see what an asset this is to help providers ensure services are not provided in excess of the approved limits.

ELIGIBILITY VERIFICATION

Expert Billing verifies client Medicaid eligibility monthly to ensure that the client's eligibility is active to ensure timely payment to providers.

Eligibilities are run by the 5th of each month. Providers are notified immediately of any lapse in eligibility so that the appropriate action can be initiated to avoid any further delay in payments.

This service is included in the standard fee

AFFORDABLE PRICING

Expert Billing works with providers of all types and sizes. Fees are based on the number of clients billed and the frequency at which invoices are submitted for processing.

Electronic claim processing, claim resolution, eligibility verification and service balance reports are all included in the standard fee.

Call for pricing schedule.

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