MEDICAL BILLING AND CODING
With a track record spanning since 2001, we have assisted over 550 contracted customers, from small medical practices to large diagnostic facilities
MORE THAN
0 2500
CLAIMS
PER DAYMORE THAN
0 2500
CLAIMS
PER DAYClarity
Stay a few steps ahead with our comprehensive support. We are with you every step of the way, managing denials, rejections, and appeals. Let us handle these tasks, freeing up your valuable time
Comfort
Our providers enjoy 24/7 online transparency in their processes. Detailed reports and proof of pending or approved cases are are readily available upon request at any time
Security
Rest assured, we are the shield for your medical practice, ensuring strict confidentiality with third parties. With our commitment to HIPAA compliance, your data is securely stored in a protected environment
Our areas of expertise:
Audiology
Dermatology
Mental health
Podiatry
Medical necessity
Charge captures
Cardiology
IDTF
Neurology
Radiology
Denied claims
Accuracy of medical coding
for diagnoses, procedures
Chiropractic
Internal Medicine
Physical Therapy
Occupational Therapy
Surgery
Bundling issues
Patterns
Reasons to Choose Us
Cost Savings - Outsourcing medical billing services to WCH Service Bureau allows healthcare providers to save time and money by eliminating the need to hire and train an in-house staff of medical billers
Expertise - With years of experience, WCH Service Bureau possesses the knowledge and proficiency to handle the complexities of the billing process with efficiency and accuracy
Up-to-date Technology - WCH Service Bureau has access to the latest technology, enabling faster and more accurate processing of claims
Increased Revenue - WCH Service Bureau assists healthcare providers in maximizing their revenue by ensuring accurate, complete, and timely submission of claims
Reduced Administrative Burden - With WCH Service Bureau, healthcare providers can alleviate the administrative burden of managing their billing process and prioritize quality patient care
Start working with us today and leave the stress of medical billing behind. Our comprehensive services guarantee a seamless and hassle-free experience for your practice
Conquering Challenge
A healthcare provider, hereinafter referred to as "the client," approached WCH with a perplexing issue. They were experiencing repeated denials for their Chronic Care Management (CCM) and Remote Therapeutic Monitoring (RTM) services, despite these services being covered by insurance companies. The client was baffled by the inconsistency in payments and was unsure why certain claims were denied while others were paid. The client had never closely monitored their billing and collections processes, but they began noticing a disturbing trend of month-to-month denials and a decline in revenue. The lack of understanding regarding these payment discrepancies prompted them to seek assistance.
WCH, with over seven years of experience in these types of medical billing and collections, took a comprehensive approach to address the client's concerns. Not only did we provide an audit of their billing practices, but we also offered insights from a collection perspective. Our team members were well-versed in dealing with various payers, understanding their guidelines, and knowing how to bill CCM and RTM services correctly and efficiently. Upon investigating the client's billing, we discovered that their primary insurance providers were Medicaid HMO plans in the state of New York. We realized that, unlike Medicare, which follows federal policies consistently across states and plans, Medicaid HMO plans had their own unique policies and requirements for processing CCM and RTM services. These plans sometimes used different codes, and not all codes were uniformly utilized. WCH provided the client with a comprehensive understanding of the intricacies of billing for Medicaid HMO plans. We shared valuable information, provided links to relevant sources, and proposed a more effective billing approach. We helped the client identify the services they had rendered and guided them on proper billing procedures. This newfound knowledge empowered the client to streamline their billing process and serve their patients more effectively.
The client, impressed by the expertise and guidance provided by WCH, sought a second opinion and eventually decided to switch their entire billing operation to our company. The transition was seamless, and we continue to work closely with the client to ensure accurate billing processes, efficient collection methods, and consultations on expanding their services to multiple states. This case study highlights how WCH was able to address the client's pain points related to billing denials and revenue declines. By providing a comprehensive understanding of Medicaid HMO plans and offering effective billing solutions, we enabled the client to take control of their billing processes. The client's decision to partner with WCH has resulted in improved billing efficiency and financial stability. Never underestimate the value of seeking a second opinion or expert guidance when facing billing challenges. WCH is dedicated to helping healthcare providers navigate complex billing landscapes and achieve success in their practices. We look forward to the opportunity to assist you with your billing needs and help you overcome any obstacles you may encounter.
We specialize in providing top-notch medical billing and credentialing services, along with advanced software solutions. With our comprehensive offerings, we aim to ensure that you have access to the finest medical billing and credentialing services available in the industry. Our dedicated team of experts will guide you through every step of the process, from system configuration to efficient management of billing and credentialing tasks. Experience the difference with our exceptional services and solutions, designed to optimize your operations and maximize your success. Start your journey with us today and discover the best in medical billing and credentialing services.
FAQ
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What is the claim’s fixed price of $6.79, and in which cases do you charge a set fixed price?
As per WCH Service Bureau, INC Billing Service Agreement, the Client agrees to be responsible for providing correct information, including but not limited to the correct and authorized CPT, HCPCS & ICD 10 Codes, correct patients’ information, insurance, etc. If a claim is denied due to the fault of Client’s mistake, WCH charges the fixed rate of $ 6.79 per claim. In addition, the fixed charge of $ 6.79 per claim is being applied to all HMO capitated services. This amount is subject to change and represents a nominal fee to cover expenses for one claim creation, submission, and processing. We are always ready to provide education to our clients to avoid and prevent any denials. -
Can you check the eligibility and benefits for my patients?
At WCH Service Bureau, INC, we no longer offer receptionist services. However, we provide excellent software tools through our EHR that can streamline and automate the process, saving you valuable time and money. Our WCH Real-Time Patient Insurance Eligibility tool allows you to check eligibility for over 300 payers with just one access. It eliminates the need for multiple web portal searches and time-consuming phone calls, simplifying patient management. Each transaction provides comprehensive information on benefits, effective dates, and patient responsibilities. You can also print and store the information for future reference. Along with that, we offer training for your staff to ensure accurate eligibility and benefits verification, as well as an understanding of how to determine primary and secondary insurances based on the patient's Coordination of Benefits.
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I require a report for outstanding claims. How often do you provide this report?
At WCH Service Bureau, INC, all reports are computerized for convenience and accessibility. Our clients have full access to view claims, claim details, payments, and run various reports through our WCH software, which we install for their use. It includes billing reports as well as reports on outstanding claims. Our Practice Management and Billing Operations Software (PMBOS) offers a comprehensive range of reports. Clients can access this information using a mobile phone or laptop as our system is web-based and updated daily. For clients who require a customized report, we can provide it for an additional fee. The price for a customized report will be determined based on the volume of work and specifications of the request.
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What is the timeframe for billing submission after you receive my superbills?
At WCH Service Bureau, INC, we process superbills and submit claims within five business days of receipt. It's important to note that healthcare payers have strict regulations regarding the timely filing of claims. To ensure there is no loss in reimbursement due to late filing, we require all superbills for "medical services" to be provided to WCH within 60 days after the date of service. For Workers' Compensation and No-Fault cases, we request that superbills be submitted within one week. We strongly encourage our clients to carefully review each superbill for accuracy before submitting them to WCH. Any missing or inaccurate information may result in billing requests and can cause delays or denials in payments. Ensuring the accuracy of the superbills helps facilitate a smooth and timely billing process.
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I do not want to use a secure email. Can I opt out?
As a healthcare service provider, WCH Service Bureau, INC adheres to the strict guidelines set forth by the Health Insurance Portability and Accountability Act (HIPAA). HIPAA requires comprehensive measures to safeguard Protected Health Information (PHI), including administrative, physical, and technical safeguards. Electronic Protected Health Information (ePHI) refers to any PHI that is stored, transmitted, or received electronically. To ensure the security of ePHI, covered entities, such as health plans, healthcare providers, and business associates like billing service bureaus, are required to implement technical security measures that protect against unauthorized access to ePHI transmitted over electronic networks. At WCH, we prioritize HIPAA compliance to safeguard our client's data. Therefore, when the data transmission involves any ePHI, we utilize a secure email messaging system. It ensures that sensitive information is protected during transit and helps us maintain compliance with HIPAA regulations.
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Why did I receive an extra charge of $35 on my invoice?
As stated in the WCH Service Bureau, INC Billing Service Agreement, a late fee of $35.00 is applied in the event of missed or untimely payment on a billing invoice. The invoice is due within five business days of receipt. Each two-week delay in payment incurs an additional late fee of $35.00. Please note that if two consecutive invoices are not paid in full, WCH reserves the right to suspend services until the full payment is received. We strive to maintain transparency with our clients by providing access to claims and payment information. You can review all invoiced payments for clarity and verification.
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Why should I use the PMBOS system?
The PMBOS (Practice Management and Billing Operations Software) system is an essential tool for effective communication, practice management, compliance, and control of your practice's income. It offers our clients total transparency, up-to-date information, and 24/7 availability, empowering them with a powerful instrument to manage their practice efficiently. The PMBOS system provides a wide range of features and options, allowing healthcare providers to streamline their operations by utilizing it as their primary management system. It covers various aspects such as appointment scheduling, patient information management, ledger, electronic superbills (e-sb), claims processing, payment tracking, and generating comprehensive reports. In addition, clients using the PMBOS system benefit from full IT support provided by WCH. Our team is readily available to assist with any technical issues or questions that may arise.
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What is the time frame for claims processing?
Medicare processes and issues payments for clean claims within 14 days after the acceptance. The maximum time frame for processing may be 30 days. Commercial payers process claims within 30-45 days after the receipt, unless the claim is pending due to additional information requests. Some self-funded plans may process claims for around 60 days and longer.
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Why do I have so many people involved in working with my account?
We want to address all client needs at any time during our business hours. To have this achieved, we assign more than one responsible person. Thus qualified specialist who is familiar with all practice nuances is always available for you!
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Can I pay the billing invoice monthly?
As per WCH Service Bureau, INC Billing Service Agreement, the payment cycle is determined to be done once in two weeks.
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What is the duration of the Billing Services Agreement?
The initial term of the Billing Services Agreement is at least three years. The Agreement can be automatically prolonged without any written notice(s). Due to large investments such as resources for Clients’ education, training, and webinars that WCH makes, in case of early termination of the Agreement voluntarily by the Client during this period, WCH reserves the right to get reimbursement for all expenses incurred by WCH for Client’s education, training, and webinars that are provided on a free of charge basis.
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What is the closing process of Accounts?
As per Billing Service Agreement, both Parties can terminate the Agreement by giving thirty days written notice to the other Party. WCH Service Bureau will continue to accept superbills from a Client during the first 15 days after receiving the letter of termination unless the services are being suspended due to a non-payment on full of two consecutive billing invoices.
Upon termination of the Agreement, WCH reserves ninety days to finish all work with the Client’s account and to issue a final invoice. Access to all Programs will remain open for a period not exceeding 90 days after receiving a termination letter. Monthly fees will be applied.
All Programs access will be closed if the services are suspended due to a non-payment on full of two consecutive billing invoices. WCH gives access to the Programs after payment in full is received and cleared by the bank. If the payment is received later than 30 days, WCH will not give access to the Programs anymore.
The Client shall be responsible for all unpaid amounts owed to WCH for the services WCH has performed under the Agreement.
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What is the suspension of the billing process, and in which cases it will be applied?
Suspension of billing means that WCH will temporarily stop accepting new superbills for processing and submission to healthcare payers. Access to all WCH Software (PMBOS, iSmart, CredyApp) will be closed as well. The suspension will be applied in case of the Client’s default in payments in full two invoices to WCH for any rendered services.
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How can I resume suspended billing?
WCH resumes services after the payment in full for the overdue balance is received and cleared by the bank.
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Within what timeframe can I get the patient’s payments?
In case of payment from a patient is received by WCH on behalf of a client as a result of patient billing, WCH issues the payment to the client within two weeks after the receipt. If the client agrees, the amount can be subtracted from the billing invoice.
