Contact 800.275.6011

Billing Services FAQ

Interacting with MedHelp

Will you have a dedicated staff working our account?

Yes. All our clients have full and immediate access to our owners, billing managers, and IT director 24 hours a day, 7 days a week, 365 days a year. In addition, you and your staff will have full access to all of our billing personnel during normal business hours. We are not just your billing company, we act as an extension of your business, which means any questions you may have will be addressed immediately. The only protocol for contacting our personnel is to pick up the phone or send an email. Your issue(s) will be addressed then and there. You will not have a waiting period before getting an answer to your question(s).

Do I have a designated representative that handles on my accounts?

Yes. That representative will be accountable for your receivables and will be available to talk when you need them. If they are not in when you have a question then any one of our managers will be able to access your account and provide you with an answer.

Can we interview your staff, not just the sales and management teams?

Yes. We actually recommend this to all of our potential and existing clients. We strongly encourage interaction between those in your office or facility with our staff who’ll be entrusted with the collection of your receivables.

Will any of my receivables be sent offshore as part of your service?

No. All work is done right here in the U.S.

How often do you meet with your clients?

We prefer to meet each month to address your monthly revenue reports, which are customized to meet your needs. Some clients choose to meet less frequently and we respect that decision, but they still receive their monthly reports.

Speaking of monthly revenue reports, what kind of reports do you generate for my practice or facility?

We have standard reports which will more than meet the needs of most clients, however if your practice or facility requires additional information, or a change in formatting different from our standard reports we will happily accommodate your needs.

Do I have to wait until the end of the month to get my reports?

No. You will have password protected 24/7, 365 days a year access to your companies reports through our software, where you can see exactly where your money is, what’s happening with your receivables, and the financial health of your business in real time.

Our Practice Management System

What medical billing system do you use?

Our clients use the ProtoMED Practice Management System from Protologics. We have found that ProtoMED is one of the easiest to learn and use, with an excellent long term track record of reliability and performance.

How do I get the ProtoMED system?

We provide the system to you.

Is there a cost associated with the system?

MedHelp, Inc. does not charge for the use of our system, however, your organization may incur a fee if you are porting over your EMR/EHR from another software vendor; I.E. an HL7 Interface. This charge would occur from your VENDOR and NOT MedHelp, Inc. MedHelp does reserve the right, though, to charge a nominal service fee for any modification requests to our system that requires substantial upgrading by your organization.

How will my staff be trained to use ProtoMED?

We provide on-site training in the use of ProtoMED to your entire staff, as well as provide you with an easy to follow manual. The system is so easy to use that training takes only an hour or two before your staff is proficient with the system, but we will work with you for as long as it takes.

What aspects of the ProtoMED system will we be trained to use?

You and your staff will be trained on how to use the scheduler, electronic insurance verification, scanner, patient demographics, and charge entry. You will also have access to day-end/month-end reports.

So my staff will be responsible for charge entry?

Yes. MedHelp bills daily, so we have found that when the charge entry is completed by you or your staff at the point of service, or by the end of the day, this will speed up the collections process immensely. In addition, if you were to send us the super bills via snail mail there is a much greater chance that something can slip through the cracks. Mail can get lost or delayed; claims may not find their way into the outgoing envelope, or a multitude of other possibilities. This can also become a HIPAA issue. Charge entry can be completed by your staff in just seconds per encounter, and it eliminates the possibility of lost claims.

Whom do you use as a clearinghouse?

Protologics is one of only 40 accredited clearinghouses in the country, so ProtoMED goes direct to most major insurers. Over 40 billion dollars of claims has gone through their clearinghouse since its inception, and not one single cent has been lost by the system in all that time.

What are my clearinghouse fees?

Zero. You will not get charged one penny in fees for use of the clearinghouse.

Does Protologics have an EHR (Electronic Health Records) program?

Yes. The EHR is called Cyfluent, and it’s the next generation in electronic medical records.

If I go with MedHelp and use the ProtoMED Practice Management System, do I have to use Cyfluent as my EHR?

No. While we believe Cyfluent is the best system in use today, you can still use another EHR with ProtoMED. By utilizing its built-in HL7 interface ProtoMED can interact with any EHR currently on the market.

MedHelp’s Service

How does the initial start-up work?

Upon the signing of the contract and an agreed upon start date, MedHelp will order you a ProtoMED database and begin training around your schedule.

Do you also offer credentialing services?

MedHelp, Inc. has an In-House Credentialing Management Team that facilitates all of our business partner’s Credentialing needs.

Who handles cash posting?

We do. Your cash will be posted on the same day the EOB is received.

Do you receive any checks from the third party payers on our behalf?

No. We never come into contact with your payments from the third party payers. A lockbox may be established with your preferred bank. Your checks go directly into your account(s), while copies of the EOB’s are sent directly to us for use in cash posting.

If we collect co-pays or deductibles in our office do you expect to get paid for that?

Absolutely Not. Our office has nothing to do with the collections of that money, so no fee is owed.

When do you conduct follow-up on our claims?

We use an average A/R day per payer and begin follow-up 6 days after the time period has passed. For example our company wide average for Blue Cross payments is only 14 days. So on the 20th day after the initial billing we begin follow-up on all unpaid claims. We believe follow-up is where a billing company really earns its keep, and builds its reputation within the industry. This is also the most time consuming and labor intensive step in the billing process. We pride ourselves on our ability to conduct quick and effective follow-up to get you paid for what you’ve earned.

What are your company-wide average A/R days for physician billing?

We run overall average gross A/R days of 28.45 over all payers combined.

Why gross and not net A/R days?

We feel it is a more accurate description of your receivables. If we removed self-pay to tout your net days, and in the process lower your A/R days, then we would be saying that self-pay isn’t part of your receivables. As you know, all monies owed to you, including self-pay, is part of your receivables.

How is it that your average gross A/R days are so low?

It begins in your office at the initial Point of Service. We work closely with you and your staff to eliminate mistakes in every step of the billing process. The billing process truly begins when the patient calls to make an appointment. If important insurance and demographic questions are not asked and verified, then a mistake can occur which will cause delays in you getting paid, or not paid at all. By teaming up with your facility or practice and working together we can virtually eliminate costly mistakes, and get you paid for your valuable time and service.

What is your company-wide rejection rate on third party claims?

Due to the front-end work we do with your staff, we run a claim rejection rate of less than 2% on all first-time billings.

What is your write-off policy?

We work with you to establish a clear policy for write-offs. We do not believe in writing off a valid charge. We feel that, if a medical procedure was completed, and subsequently billed within the allowed timeframe, then we need to adjudicate that claim to completion.

Do you send accounts to collections, and if so, when?

We send out the first of three statements to the patient on the first business day following the day the insurance company pays their portion. Each of the subsequent two statements is sent 30 days apart. After the three statements are sent we submit a collections report to you for approval to send them on to a collections company. If you do not wish to send your patients to collections then that decision is up to you, and we return those unpaid balances back to you.

Understanding Your Specialty

Do you understand modifiers?

Modifiers are used to show why one procedure was done in conjunction with another. An example of this would be if a cardiac patient has two EKG’s done on the same day, a modifier would be required to get the second procedure paid.

What specialties has MedHelp billed for?

  • Behavioral Health
  • Cardiology
  • Dental
  • Ear, Nose and Throat
  • Emergency Room
  • Family Medicine
  • General Surgery
  • Gynecology/OB-GYN
  • Neurology
  • Nuclear Medicine
  • Oral Surgery
  • Orthopedics/Surgery
  • Pain Management
  • Pathology
  • Pediatrics
  • Physical Therapy
  • Plastic Surgery
  • Radiology
  • Substance Abuse
  • Urgent Care
  • Urology

I don’t see my specialty on your list?

There was a time when we were just starting out where we hadn’t billed for any specialties. What we’ve learned is unless you’re an Anesthesiologist where your billing is done in units, then billing is billing. We understand the difference in codes, modifiers and limited coverage guidelines, but learning those has never been an issue. As long as the core of our business, and the way in which we conduct our job is strong, then your particular specialty will meet with the same success as the rest of our clients.

Speaking of codes and modifiers, do you have certified coders on staff?

Yes. Our coders are certified in the newest ICD-10 codes.

If we hire MedHelp and chose to utilize the Cyflent EHR who would set up the templates for my specialty?

Protologics will work with both you and MedHelp to ensure the templates are to your liking.