Filing & Statements

Insurance Claims Filing

HIMG files claims electronically on a daily basis. At the same time, “paper” claims are generated for carriers or entities that require submission in that format. At Data Entry, we have the capability to flag an account that requires special handling.

Patient Statements

Through Final Notice – Our goal is to bill each patient as soon as possible after the balance is known. If the patient is self-responsible, a statement is generated at the time the charges are entered. If payment (or a response) is not received on time, a second statement is automatically generated. The third statement bears a “Final Notice” message.

If a patient balance remains after all insurance has either paid or denied, a statement is generated when the last insurance payment or denial is posted – or when the account commented.

Pre-collection Status – Our experience has taught us if a patient does not respond to two statements (and one marked “Final Notice”), they generally will not respond to four or more. At the time the final statement is sent, the account is placed in “pre-collection” status.

Payment Reconciliation

Deposits are date-stamped and logged into our Deposit Reconciliation Module. As payments, adjustments and denials are posted, the EOBs are reviewed for insurance processing errors and the accounts are flagged.

Deposits are posted timely to ensure that payments, adjustments and denials are reflected in subsequent patient account billings. Secondary insurance claims are automatically generated upon completion of the posting process.

Managed Care Contract Administration

Since we recognize an increasing percentage of our clients’ revenues are based on managed care, our philosophy is to implement managed care contracts from inception. Copies of existing contracts are obtained during our New Client Implementation Protocol and made available to our Account Managers. To ensure top quality service, our Account Managers review the EOBs for disallows, etc.