Medical Billing services

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 the 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 always ready to provide education to our clients in order to avoid and prevent any denials.

WCH Service Bureau, INC is no longer provides receptionist services. We do not check patients’ eligibility and benefits, but we can offer great software tools through our EHR that can save valuable time and client’s money and make the process automated. WCH Real-Time Patient Insurance Eligibility tool that has the ability to check eligibility for more than 300 payers under one access. This application eliminates the need for searching for multiple web portals where separate registration is required, eliminates the need for time-consuming phone calls, and helps in patients’ management. Each transaction gives full information on benefits, effective dates, patient’s responsibility, etc. The information can be printed and stored for future use. Along with that, we can provide training for your staff for accurate eligibility and benefits verification as well as understanding how to determine primary and secondary insurances as per patient’s Coordination of Benefits.

All reports are computerized. WCH software, which we install for our clients, gives full access to view claims, claims details, payments, run any reports, and any time. All types of reports, including billing and outstanding, are available in PMBOS (Practice Management and Billing Operations Software). To access the information, our clients may use a mobile phone or laptop. The system is web-based and is updated daily. If a Client requests a customized report, it will be provided for an additional fee. The price for a customized report will be determined based on the volume of work and specs of the request.

We do process superbills and submit claims within five business days after the receipt. We do want to remind our clients that HealthCare payers have strict, timely filing regulations for claims submission. In order to avoid any loss in reimbursement due to late filing, all superbills must be provided to WCH, for “medical services” within 60 days after the date of service and for Workers' compensation and No-Fault cases within one week. We do also encourage our clients to check each superbill for accuracy before submission to WCH, as any missing or inaccurate information leads to billing requests and results in delayed or denied payments.

Health Insurance Portability and Accountability Act (HIPAA) has strict guidelines and requires comprehensive administrative, physical, and technical safeguards to ensure the security of Protected health information (PHI). Electronic protected health information (ePHI) is any PHI that stored, transmitted or received electronically. All covered entities (health plans, Health Care Providers, and any Business Associates such as billing service bureaus) must implement technical security measures that guard against unauthorized access to e-PHI that is being transmitted over an electronic network. For WCH to stay HIPAA compliant and keep our clients HIPAA compliant, we use a secure email messaging system when data transition contains any ePHI.

As per WCH Service Bureau, INC Billing Service Agreement in the case of missed or untimely payment on billing invoice, the late fee of $35.00 is being applied. Invoice due date is five business days of the invoice receipt — every two weeks of delay in payment results in an additional late fee of $ 35.00. In the case of non-payment in full of two consecutive invoices, WCH has a right to suspend services until the full payment is received. WCH has total transparency by providing our clients with full access to claims and payments information. Our clients can review all invoiced payments.

Practice Management and Billing Operations Software is the most effective way of communication, management, compliance, and practice income control for our clients. Total transparency, up-to-date information, and 24/7 availability give our clients a powerful instrument in managing the practice. The program contains a great volume of options that allow providers to use the system as the only management system in the office — appointments, patients’ information, ledger, e-sb, claims, payments, reports. Clients receive full WCH IT support.

Medicare processes and issue payments for clean claims within 14 days after the acceptance. The maximum time frame for processing maybe 30 days. Commercial payers process claims within 30-45 days after the receipt, unless the claim is pending due to additional information request. Some self-funded plans may process claims around 60 days and longer.

We want to address all client’s needs any time during our business hours. In order 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!

As per WCH Service Bureau, INC Billing Service Agreement, the payment cycle is determined as to be done once in two weeks.

The initial term of the Billing Services Agreement is at least three (3) years. The Agreement can be automatically prolonged without any written notice(s). Due to large investments such as resources for Clients’ education, trainings, and webinars that WCH makes, in case of early termination of the Agreement voluntarily by the Client during this period, WCH reserve the right to get reimbursement for all expenses incurred by WCH for Client’s education, trainings, and webinars that are provided on a free of charge basis.

As per Billing Service Agreement, both Parties can terminate the Agreement by giving thirty (30) 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 (90) 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 being 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.

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 Client’s default in payments in full two invoices to WCH for any rendered services.

WCH resumes services after the payment in full for the overdue balance is received and cleared by the bank.

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 (2) weeks after the receipt. If the client agrees, the amount can be subtracted from the billing invoice.