Author Topic: Over the limit denial. Can biller be held accountable?  (Read 5417 times)


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Re: Over the limit denial. Can biller be held accountable?
« Reply #15 on: September 30, 2015, 12:40:46 PM »
I'm sorry to hear about your billing troubles!

I got into the medical billing business from a similar situation. The practice was new and the biller was pretty well known but when the dust settled and I was a brand new biller in the hot seat trying to do damage control, we calculated that over the two years that this other biller had been dropping the ball, she had lost the provider something to the tune of $50,000 due to denials, unfiled claims and untimely filing. Get a good biller!

I'm not sure where you stand now on your hiring process but I went to a business development seminar this weekend where I learned a new strategy for hiring and I thought it was pretty slick it because it weeds out many of the unfit candidates even before you get involved.

The gist of it is that you put out an anonymous job listing with the basics of the position,  then when you hear from qualified applicants, you send them an email listing three basic tasks to complete so you can see if they can follow directions (1. complete this online test, 2. format the results in pdf and 3. mail the results to Jon Doe for further instructions).

I thought it was pretty neat I look forward to implementing it. If you want, I can share the package they sent home with us. PM me.
Partners Billing LLC - Houston Texas

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Re: Over the limit denial. Can biller be held accountable?
« Reply #16 on: October 02, 2015, 02:14:08 PM »
Hello Everyone,

Wow, what an unbelievable story.  I readily admit that I'm not a biller, but I do provide services for healthcare providers in recovering reimbursements and I take my job very serious and I really do care about my clients.  As a small business owner, I find it hard to understand how anyone cannot be concerned about providing quality service to their clients.

I would like to give a little advice for this matter if I may.  First, I agree with the others in that you should contact your provider rep and tell them your story.  They may understand and process your claims.

However, if that doesn't work, there still may be hope.  I run a home-based business where I recover revenue on providers' closed accounts.  I mostly deal with improper discounts, repricings and reductions, however, there was a time when a provider/client of mine filed his claims too late which caused the claims to be denied.  Although, I was still able to get his claims paid.  Do you mind if I ask you what state you provide your services in, there may be insurance regulations that can be in your favor.