We bill and follow up across in-network, out-of-network, PIP and MVA, workers' compensation and patient self-pay, so nothing falls between the cracks when one patient touches more than one.
Contracted payers pay by contract and by rule. The money is lost in timely filing, missed authorizations and quiet underpayments.
Out-of-network providers can earn more per claim, but only with the right billing, patient-balance rules and dispute strategy.
Auto-injury care is paid by the auto carrier first, under state no-fault rules, with its own forms and cut-offs.
Workplace injuries are billed to the employer's carrier under the state's workers' compensation fee schedule.
Patient balances are now a large share of revenue. Clear statements and kind follow-up get them paid without hurting the relationship.
When one patient touches several payers
PIP pays first, health insurance picks up after benefits run out, the patient owes a deductible, and an out-of-network surgeon may have a dispute right. We keep the order straight.
Billed under the state's no-fault rules until benefits are used or the claim is denied.
Billed with the PIP exhaustion letter or denial, in-network or out-of-network.
No-fault arbitration for PIP denials, federal IDR or state arbitration for health-plan underpayments.
Only what the patient legally owes, explained clearly on the statement.
That is where most practices lose money. We will show you where.
