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Medical Billing Software Questions / Re: Accessing Provider Software
« Last post by PMRNC on October 17, 2017, 07:01:34 PM »
I only have one seat and my cost is included in my clients fees. They did get pricey since being bought out. I'd prefer a VPN myself but can't really say the costs would be worth it for me since I don't have (or want) employees.
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Medical Billing Software Questions / Re: Accessing Provider Software
« Last post by Michele on October 17, 2017, 06:36:17 PM »
We have used logmein for years as well.  However they are getting very pricey.  We have 5 seats and in January they will be charging us over $700.  Their fee has doubled the past two years in a row.  I can't continue to pay those rates when we can do a VPN. 
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Medical Billing Software Questions / Re: Accessing Provider Software
« Last post by PMRNC on October 17, 2017, 04:02:10 PM »
I use LogMeIn as it has the best in security features with two factor authentication PLUS you can actually log in and out of the practice's computer (using your own login of course) . You can also boot and reboot the system if you need to.
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Medical Billing Software Questions / Re: Accessing Provider Software
« Last post by Michele on October 17, 2017, 09:23:07 AM »
You can set up a VPN (Virtual Private Network).  That has to be done by an IT person.  Other than the charge for the IT person I don't believe there are any costs.
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Medical Billing Software Questions / Accessing Provider Software
« Last post by Chiro Billing Collect on October 17, 2017, 09:06:48 AM »
If a doctor does not have cloud based billing software, how are you accessing the program? I have used Go To My PC but am looking for different options possibly without a fee.

Interested in learning more of the logistics of remote billing if you use the provider's software.

Thank you.
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Patient Billing / Re: HELP PLEASE! Primary/Secondary and Patient Responsibility
« Last post by PMRNC on October 17, 2017, 08:45:07 AM »
Quote
Total charges $110: BCBS (primary): Allowable $45 (went towards deductible) - Patient Responsibility $85 - Paid $0
 1199-Aetna (secondary): Allowable $35 - Patient Responsibility $0 - Paid $35

I slept on this one, and after few cups coffee. In one of the posts I think you said the patient's plan only allowed $45  you were adjusting off the $40 spinal charge..why is that? Just because the carrier didn't allow it doesn't mean you cannot bill the patient. That is why they show $85 as PR, then secondary comes into play and they pay $35. Can you break down the secondary EOB for me a bit better with each charge, secondary allowable per charge and any remarks on the EOB? The patient should STILL have to meet cost-sharing with the primary (you said secondary $0 copay $0 ded) and secondary paid $35 BUT the carrier is making patient responsible for the other $40 so you shouldn't have to write that off. The secondary didn't allow it all so need to know WHY? The way I calculate this patient owes $50 because of the $85 the primary says is owed, the secondary paid $35 of it making patient have to pay $50 

I think what is confusing you might be that you think all $0 allowable is a par adjustment and that's not so. The adjustment is the difference between the billed charge and the allowable amount due to the contractual discount. A zero allowable could be a "non" covered service which is why I'd like to see the secondary's breakdown and any remarks on it. Without the secondary plan the patient is responsible for $85 ($45 which was allowable they put towards deductible and the other $40 is "non covered" under patient plan) 

This might be an error on secondary plan's part. If you want to de-identify both EOB's and send to me I'll take a look if you want. Otherwise just post the breakdown of the secondary along with any remarks on the EOB that might explain why they say PR = $0  my email is linda@billerswebsite.com
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Yes,  Exactly! That is probably the first thing the patient will point out if billed $10 per visit. (There are multiple visits with this scenario).
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Patient Billing / Re: HELP PLEASE! Primary/Secondary and Patient Responsibility
« Last post by PMRNC on October 16, 2017, 08:45:04 PM »
Quote
This is a great topic.  It isn't something that comes up terribly often but when it does it is always a debate.  I know it goes by COB method but I'm still hung up on the fact that the secondary is saying $0 PR.

Well, the secondary paid $35... so yes I'm also hung up on on the $0 responsibility with secondary.   It would help tremendously if we had a full break down of charges and both primary / secondary allowable, payments.



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Patient Billing / Re: HELP PLEASE! Primary/Secondary and Patient Responsibility
« Last post by Michele on October 16, 2017, 06:31:55 PM »
$10 as they owe the copay from secondary :)


But doesn't that violate the contract with Aetna (1199)?

This is a great topic.  It isn't something that comes up terribly often but when it does it is always a debate.  I know it goes by COB method but I'm still hung up on the fact that the secondary is saying $0 PR.
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In my second post I stated that BCBS calculates non-covered charges as patient responsibility therefore they included the extra spinal charge of $40, plus the deductible charge/max per visit of $45 which went towards the deductible and that equals $85.

We are adjusting off the $40 extra spinal charge. Neither insurance considered it as an allowable expense therefore it should not be patient responsibility as per NAIC. Either way, the primary insurance only allows a max of $45 per visit no matter what the total charge. That leaves the following calculations I most recently laid out.


BCBS (primary): Total charges $115 - Allowable  $45  - (went towards deductible)- Patient responsibility $45 - Ins. Paid $0 <Benefits include $500 deduct which isn't met and $45 max per visit>

Aetna (1199-secondary): Allowable $35  - Patient responsibility $0 -Ins. Paid $35 <Benefits include $0 deduct  $0 copay>
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