Frequently Ask Questions

Any PMS – Apple billing and credentialing will work with any practice management system. The billing is done remotely on the practice billing system there is no limitations on specific system.

File download – All files such as super bills, face sheet, hospital census, medical records, EOBs etc will be downloaded directly from file sharing services such as drop box, Google drive, PMS, FTP, Email and Fax.

Patient’s demographic posting – All non office patient demographics will be added in practice management system by ABCLLC.

Hospital patient’s demographic request

ABCLLC will request non office patient demographics directly from facilities such as hospital, dialysis center, hospice, nursing home etc.

Eligibility verification – All non office visit patients eligibility are verified before the claims are submitted.

Member ID – Initial patient admission face-sheet may not have all the information needed specially member ID in such a cases ABCLLC will directly contact the member or the facility to collect the missing information.

Pre-cert verification – Office patients precertification number is verified in the EMR system before the claim is submitted if precert is not requested the front office is informed about the precert missing. Hospital or non office patients precerts are obtained directly from the facility rather than relaying on the practice.

Claim submission 8 hrs – Claims are submitted every 8 hrs

Hospital Diagnosis – While hospital charges are posted ABCLLC login to hospital portal to find out all the diagnosis related to the service and order them according to the high specificity if the diagnosis is not mentioned by the provider.

Handwritten diagnosis – All handwritten diagnosis by the providers are interpreted for correct coding. ABCLLC create an algorithm to interpret the handwritten diagnosis manually. All interpreted diagnosis can be verified with the provider before claim submission.

No show – Every day claims are created manually for no show patients and the patient statement are sent out for the no show balance immediately.

Reminders – Charges – Weekly reminders are emailed for missing hospital charges by reconciling the received hospital charges for specific dates. And incomplete/unsigned progress note reminders are emailed. Every week patient appointments to the claims created.

Calling hospital – ABCLLC will call, fax or email the facilities such as hospital, dialysis center, hospice, nursing home etc for missing demographics.

Payer portal creation – With in a first week ABCLLC will create portal access for all payers eligibility, claim status etc. And will maintain updated sheet of user name and password for the practice to access.

Charges checking – ABCLLC ensures the correctness of all the charges entered by employing a team of experts to check the each and every claim for erroneous to diminish the rejection and denial rate.

Report – Pre-certs/Authorization – Weekly report of missing precertification and authorization are emailed.

Missing pre-cert – ABCLLC will call, fax or email the facilities such as hospital, dialysis center, hospice, nursing home etc for precertification.

Prior authorization denial – Most of the time payer may deny the claim even if prior authorization is present in the claim ABCLLC will call the insurance to reprocess the claim.