Our Services

Our medical billing services provide maximum reimbursement for our clients and reduce overall costs.

Daily claims entry
Electronic and paper claim submission
Dedicated follow-up
Claim correction and/or re-submission
Government, commercial and private billing
Weekly / monthly customized reports
Patient statements* (soft collections, up to 3 past due notices)
Payment posting / adjustments
Denial management
Tracking / claims management
Managing collections
Patient inquires
A/R recovery
Approved Authorizations
24/7 Support

Our Coders work with all specialties; we can help you maximize revenue.

Clean Claims
Fewer Denials
Certified Coders
HIPAA Compliance
Latest Coding Tools & Software
CPT, ICD-10 and HCPCS Coding
Meet Insurance & Government regulatory requirements
Fast turnaround times

Our Billing Services and Revenue Cycle Management Services are used by:

Small and Large Practices
Solo Physicians
Independent Medical Practice Groups
Physician Groups
Hospital-owned Physician Practices and Groups
Medical Clinics
Hospitals
In-home health services providers
Non-Emergency Medical Transportation (NEMT)
Freestanding Emergency Centers
Urgent Cares
Ambulance Service (EMS)
DME companies
Laboratories
and more

Credentialing

Many claim denials are a result of improperly credentialing of the provider. Credentialing with a payer is required before a physician can bill for a patient using that insurance. It is a detailed process that often takes five months to complete, requiring an exhaustive submission of information regarding the physician’s education, training, residency and licenses, as well as any specialty certificates.

It is estimated that 85% of applications are incomplete, resulting in significant delays. WeMedBill, Inc. can help with credentialing, usually for new practices and new doctors, to ensure complete applications and proper submission. We have an efficient and effective new practice set up protocol for new providers to help get their practices up and running–and paid–fast.

We counsel new doctors to cultivate a balanced mix of payers- ideally one third Medicare, one third PPO, and the rest depending on their specialty.

Medical Coding: the key to successful Medicare and Medicaid Billing

Medicare claims are processed by a Medicare Administrative Contractor (MAC). In a process that takes about 30 days, the MAC both evaluates and processes the claim. As with all medical billing, but especially for Medicare and Medicaid, coding must be accurate for thorough and quick payment.

Billers follow the same protocol as for private, third-party payers when billing for traditional Medicare, Parts A and B. The patient information, NPI numbers, procedure codes, diagnosis codes, price, and Place of Service codes used are the same. However, the forms used are different, UB-04 for Part A, and CMS-1500 for Part B.

When a MAC processes a Part A claim, Medicare pays the provider directly. However, for a Part B claim, if the provider accepts the assignment of the claim, Medicare will pay the provider 80%, while 20% is billed to the patient.

Part of the complexity of billing Medicare claims is that although co-pays, deductibles, premiums, and coinsurance rates are at standard rates, set by the Centers for Medicare and Medicaid Services, they vary between procedures and patients. Figuring out the correct number for a patient is our specialty.

When your practice gets to a certain size getting expert medical coding help is a smart business decision. WeMedBill, Inc. offers that team and the peace of mind that having expert medical coding help comes with. Call us at (424) 330-8585 to schedule an appointment.

PQRS & MIPS

We have assisted many physicians with their PQRS (Physician Quality Reassurance) medicare reporting, and are now helping navigate the CMS’s new Merit-based Incentive Payment System (MIPS). Essentially, these programs evaluate how efficiently physicians are getting their patients healthy.

Under MIPS, clinicians are included if they are an eligible clinician type and meet the low volume threshold, which is based on allowed charges for covered professional services under the Medicare Physician Fee Schedule (PFS) and the number of Medicare Part B patients who are furnished covered professional services under the Medicare Physician Fee Schedule.

Performance is measured through the data clinicians report in four areas - Quality, Improvement Activities, Advancing Care Information, and Cost.

We have found that physicians can be penalized 3-6% off of reimbursement if they do not report off the MIPS. We can help by compiling all the necessary data in the form required by the program. We pride ourselves in getting physicians paid in full, and fast.