FAQ

The Answers You Need

 

WHAT INFORMATION DO YOU NEED FROM NEW PROVIDERS FOR BILLING?

Before we can begin serving you, we need:

  • Your contact information

  • A copy of your driver’s license

  • Your National Provider Identifier (NPI) number

  • Tax ID number

  • Face sheet with CPT codes and ICD-10 (if available)

WHAT IS THE TURNAROUND TIME FOR BILLING?

For established providers, we bill 30 days after the date of service. We typically start seeing payments 45-60 days from the date of service.
If you are a provider billing under a new tax ID, the turnaround time is 60-90 days before you can expect to see payment because we have to ensure you are established with the insurance companies.

WHAT CAUSES DELAYS IN COLLECTION?

  • If the face sheets are not given to us in a timely manner

  • If we have issues getting the codes from the primary surgeon’s office

  • If the insurance company needs additional information from us or the patient

DO CLAIMS EVER GET DENIED?

Yes, there are claims and codes that are not payable by the insurance companies. We are always available to answer any questions you have about billing codes and payable claims.

WHO SEE’S MY INFORMATION?

Only the claim reps in our office and the company that provides our billing software have access to your information.

HOW OFTEN WILL I GET PAID?

If you are billing under your own tax ID, you will get paid directly from the insurance companies once your claims are processed.

WHAT IF I HAVE ISSUES WITH HOW A CLAIM WAS FILED/COLLECTED?

You are always welcome to contact our office and discuss the claim with one of our reps. We will do our best to work with you and see what, if any, options there are for appealing the claim.

WHAT IS MY RESPONSIBILITY FOR FOLLOWING UP ON CLAIMS/COLLECTIONS?

We follow up with the insurance companies on all aspects of your claims, but you are more than welcome to track them as well for your own peace of mind. Rest assured you can count on 5 Star Medical Billing to monitor your collections.

WHAT INFORMATION IS NEEDED FOR CREDENTIALING FOR PRIVILEGES?

  • Copies of your licenses and certificates

  • A copy of your malpractice insurance

  • A copy of your TDI credentialing application

  • Your shot records

  • A copy of your driver’s license

  • W9

WHAT IF I HAVE QUESTIONS?

Please don’t hesitate to call, email, or come by our office. We are happy to discuss any questions or concerns you have.