Medical Billing Forum

Starting a Medical Billing Business => Starting Your Own Medical Billing Business => Topic started by: ReliefMedBill on March 11, 2015, 04:50:26 PM

Title: Pre-filling HCFA 1500's
Post by: ReliefMedBill on March 11, 2015, 04:50:26 PM
Hello all,

Our company provides scheduling, intake, and billing for counselors and therapists. We've done the scheduling and intake for going on five years, and just added billing.

In the past, we've filled out a separate intake form when the patient calls in.

We're using PracticeMate, and I've started filling out the patient information directly into PracticeMate instead of our intake form.

I'd like to print the HCFA with their pre-filled information, ask them to verify and fill out any missing information, and have them sign.

We don't do any paper submissions, so we wouldn't be using the actual paper version of the HCFA other than for records.

What do you think? Is this OK? Have you done this in the past and are people not validating the information so you end up with errors anyway?

Many thanks!

Warmest regards,
Title: Re: Pre-filling HCFA 1500's
Post by: rdmoore2003 on March 12, 2015, 03:02:44 PM
If I am understanding this correctly, why would you fill out a paper hcfa if your not filing it?  It sounds like your doing more work than needed that is not necessary.    Again,  if I am understanding correctly!
Title: Re: Pre-filling HCFA 1500's
Post by: ReliefMedBill on March 12, 2015, 04:04:22 PM
And did I mention we just started billing  ;D LOL some of what may seem basic is really new to us :)

We're coming in the middle of someone else's billing process that has been in place for 15 years. So I was figuring that was how it HAD to be done.

The last five years, our company answers phones and does an initial intake. We email a password protected file whenever there is a new patient to the provider. Provider prints out and puts in their new patient file. Client comes in, fills out HCFA and other forms, provider faxes HCFA, insurance card, and intake form to billing.

Now that we are also doing billing, we already have the intake information, and I'm entering intake directly into PracticeMate.

So I thought the new process would be:

We answer phone, get all intake info into PracticeMate, send HCFA to provider for the client to authorize services in PDF form (we're remote), client signs HCFA, provider faxes HCFA with their insurance card and billing log.

Am I making this harder than needed? My assumption was that the HCFA was required as a papertrail of information directly from the client/patient.
Title: Re: Pre-filling HCFA 1500's
Post by: kristin on March 12, 2015, 09:15:39 PM
The HCFA is not required as part of a paper trail. Most patients never even see a HCFA, or know what it is. It is strictly used for paper claims to be submitted to insurance companies. Which you won't be doing, so you really don't need the HCFA at all.

Do the patients fill out any paperwork at the office when they get there, or beforehand from a website or having it sent to them? Because that is the normal way this goes. Patient calls to make an appointment. Some information is gotten at that time, such as name, address, phone #, DOB, reason for appt, and insurance info. That way, benefits can be checked before the patient comes in for their appointment. Whatever information is gotten ahead of time can be entered into the PM software before the appointment. When patient shows up for appointment, they either have already filled out the rest of the paperwork needed because they have gotten it from the practice website, or had it mailed to them, or, they do it right there in the office. This is where they actually are signing the paperwork giving permission to treat, signing that they accept financial responsibility, signing for HIPAA, and assigning benefits to the provider, and any other forms, such as a financial policy, etc.

You as the billing company don't need this paperwork, so long as it is on file at the provider's office(which is where it should be, in their chart, paper or otherwise). You just need to know that the patient has signed, so that you can check "signature on file" for your electronic claims, and submit the claims to their insurance company. Certainly, it is nice to have access to the paperwork if needed for some reason, but so long as you have the basic demo info and insurance info needed to submit the claim, as well as knowing there is a signature on file from the patient, you are good to bill. I am not familiar with Practice Mate and it's functionality, but if there is a way to scan and upload documents to each patient's chart, then you can ask the provider to send you the paperwork the patient has filled out, so you can get it uploaded on your end.

Obviously you will still need the superbill from the provider sent to you in order to bill the claims, but a HCFA is not needed.
Title: Re: Pre-filling HCFA 1500's
Post by: rdmoore2003 on March 13, 2015, 09:06:34 AM
These are my thoughts.   The providers office should be getting all this information and inputting into Practice Mate.   If you are doing billing thru remote, all you should do is the charges and file, unless your contract is including you to answer phones, do intakes, schedule, etc.  (I never have heard of billing agencies doing this, unless provider has no employees.)

However, if you are answering calls and scheduling, you should just get the patients demographics and insurance information and enter into PM software.   When provider sees that patient, they should send you the superbill to bill charges. (of course, after they have the patient sign necessary paperwork in office).   
Title: Re: Pre-filling HCFA 1500's
Post by: ReliefMedBill on March 13, 2015, 10:22:29 AM
Thank you so much for your help!

Billing is not our primary business function, we are adding it on to our primary services, which is remote office support.

We work with solo-practitioners, they do not have employees.
Title: Re: Pre-filling HCFA 1500's
Post by: PMRNC on March 13, 2015, 04:41:28 PM
Let's first catch up to the fact it's NOW called a CMS 1500.. HCFA implies OLD OLD OLD..

Yes, it does honestly sound like your doing a ton more work than necessary. My clients do the intiial intake on a special form, that form is given to me, I verify benefits eligibility and get pre-auth if needed. When the patient comes in the New PI sheet comes my way with the claim, it's entered into the PM system for that date and then filed.

I think we had patients complete the 1500 form about 15 years ago. <g>
Title: Re: Pre-filling HCFA 1500's
Post by: ReliefMedBill on March 13, 2015, 10:03:11 PM
Love it! Thanks again :)