vary from deductibles, co pay amounts, co-insurance, maximum allowed and authorization requirements. We make this simple for you by doing the research ourselves and providing you with the necessary information.

Authorization Tracking - ABCS will prompt you when the authorization is about to expire, or visit limit is met (2 visits prior). Since we receive the data from the client after the service has been performed it is essential that the provider have an internal system in place as well. Initial authorizations and extension can be made by ABCS as part of this service.

Data Entry

• Charge Entry- Charges supplied on a billing log or superbill will be entered and processed through our claim inspector module.

The Claim Inspector identifies claim submission problems before claims are sent to the payor. After each claim is entered, Claim Inspector checks the claims for potential rejection errors considering items such as:

• Procedure coding - Compliance with CCI policies, gender and age restrictions, as well as medical necessity using CPT/ICD9 crosswalk data
• Diagnosis coding - Valid primary diagnoses, proper levels of specificity and the inclusion and ordering of any required accompanying diagnoses.
• Date validation - HIPAA specific required elements, codes, situational fields and more.
• Payor Specific Rules Editing - Including LMRPs for all major government and commercial payers.
• Electronic Claim Submission
• ERA and explanation of payments made by carriers are applied

Patient Statements- A description of services with balances due are generated on a 25 day billing cycle or when new personal balances become due. It is not necessary to wait until claims are processed by the insurance carrier.

Insurance Delinquency- Follow up calls and appeals made to insurance carriers when a claim remains outstanding for more than 21 days on electronic claims and 45 days for electronic claims submitted.

Patient Delinquency - Follow up calls with a series of collection letters will be made to patients with accounts 30 days or older.

Credentialing - Applying and updating provider applications with insurance carriers and managed care companies. ~separate fee applies~

Exclusive Projects- Design of intake forms, payment policies and staff training.

Onsite Educational Seminars/Training- an affordable way to bring training specifically designed to meet your practice needs.