| 1 Are all claims sent electronically? |
| Claims are transmitted to carriers that are able to receive electronically. To date, not all carriers or IPA's are able to receive electronically. |
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| 2 Does the payment go to the provider or the billing service? |
| All payments typically go to either the provider's office or a designated lockbox. Money is never deposited by PMEB. In some circumstances the provider may use PMEB as a mailing address for payments. When payment is received at the PMEB office, it is forwarded to the provider's bank or the provider as determined by the provider. |
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| 3 Who will work on my account? |
| There will be one person chosen to manage your account. However, PMEB has a staff of people who will be able to answer calls and questions from your staff or patients. You will always have the option to talk to the department supervisor or manager. |
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| 4 Do I have to use all of your services? |
| No. Not every practice requires or requests all of our services. We will discuss you needs and our services and find the perfect match. |
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| 5 How do I get the work to you? |
| The work from your office can be sent via mail, overnight, email or fax (only for smaller amounts). Whatever resources are available to you for sending the work to us will be fine with us. Some local providers (Houston area) will have pick up service available. |
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| 6 What are your hours? |
| Our business hours are 8:30 - 5:00 CT Monday - Friday. |
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| 7 Will I receive any reports? |
| There are several reports that are provided monthly. During our discussions we will determine if there are any additional reports that you may require. |
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| 8 How much do you charge? |
| Once it is identified as to your needs, the specific charges are identified. Typically we charge on a percent of collections. |
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| 9 Do I have to buy any software for my office? |
| No. We generally receive either hard copy or electronic files from your office. The data is entered into our software and transmitted to the clearinghouse/insurance carrier. No additional software purchases are required for your office. |
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| 10 Will I be required to use any special forms? |
| As long as the information we need to produce your claims is available on your current forms, there is no need to change. However, we will recommend forms for your use if we are able to reduce the amount of paperwork necessary for your staff to send to us for billing. |
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| 11 Who is responsible for the coding? |
| The provider's office is generally responsible for the coding. The provider is the one who saw the patient and would know the diagnosis and procedures performed. We will assist in coding guidance but will require diagnosis and procedure codes from the provider. There are special arrangements for EMS providers regarding coding. |
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| 12 Who sets my fee schedule? |
| You determine the fees you will be charging. We will assist or guide you to confirm that you are charging appropriately. |
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| 13 What happens to a claim that is not paid or denied by insurance? |
| A/R recovery for the claims filed by PMEB is covered in the fees charged to the provider. We deal directly with the insurance companies to determine claim status and resubmit if necessary. There is no additional charge for this service. |
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| 14 Does PMEB bill the patients for any balances that are patient responsibility? |
| Yes. Unless the provider specifies that they will collect all of the patient portions in-house, PMEB will be sending patient statements monthly (or as specified). |
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| 15 Will PMEB help me with my Medicare application? |
| PMEB has experience with many of the Medicare and Medicaid applications. There is a separate charge for assistance with the applications. |
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| 16 What happens when information is missing on the work sent to PMEB for processing? |
| The PMEB staff is trained to watch for errors or missing information on the data sent from the provider's office. A list of questions will be sent back to the provider requesting more information before the specific claim will be submitted to the insurance carrier. |
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| 17 Are there any additional fees? |
| There is an initial or set-up charge. In addition, should the provider request assistance with any Medicare or Medicaid application, there is an additional fee. |
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| 18 Can I purchase software from PMEB to do my billing internally? |
| PMEB is a reseller of Santiago's PM2000. Please contact our sales staff for additional information and pricing. |
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| 19 Do we send the claims directly to the insurance company? |
| PMEB transmits claims to a clearinghouse. The clearinghouse performs additional front-end edits before claims are forwarded to the insurance carriers. |
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| 20 Is PMEB accepting new clients? |
| Yes. PMEB is always open to new providers of all specialties. |
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Unanswered Questions? Give us a call at 281-671-1500
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FAQS
