No-Fault Denial Management

• Immediate Appeal Responses: Medtrx will respond to insurance carriers with an appeal immediately after a denial is received, ensuring prompt action to recover owed amounts.
• Request for IME and Peer Review Reports: We will request Independent Medical Examination (IME) and peer review reports right after the denial is received to strengthen the case for appeal.
• Collaboration with Legal Experts: Medtrx will work with contracted or client-designated attorneys to arbitrate cases and claims effectively.
• Arbitration Package Preparation: For all eligible claims, MEDTRX will prepare an arbitration or litigation package for attorney review and filing, facilitating a smoother legal process.

Workers’ Compensation

• Denial Management:
  • MEDTRX will process and respond to insurance carriers with an appeal immediately after a denial is received.
  • We will process and post all denials with appropriate and valid adjustments, reporting these to the client along with proposed actions.
• Partial Payment Management (C8.4):
  • We will review payments received to determine if claims are paid according to the current fee schedule.
  • MEDTRX will appeal any underpayments, including initiating the arbitration process as necessary.
• WCB Decisions (C8.1):
  • All C8.1 forms will be processed according to their objections, with follow-up on all body parts not established. We will contact the patient’s attorney if necessary and review the WCB file for any other open cases.
  • MEDTRX will capture all necessary dates included on the C8.1 form to initiate appropriate claims follow-up.
  • Follow-up will be conducted on all decisions in favor of the provider if payment is not received within 30 days.
  • We will work on all proposed decisions in favor of the carrier with the provider and/or patient attorneys for immediate appeal.
• HP1 Management:
  • MEDTRX will collaborate with the client to establish a connection for the Medical Portal as the billing delegate.
  • We will review any pending legal issues for each claim by examining all C8.1s and Notices of Decision prior to submitting the HP-1 form.
  • Our team will obtain final resolution on any legal issues raised by the carrier.
  • MEDTRX will submit the HP1 for administrative awards or arbitration based on the information received.
  • If HP2 is received and payment is not obtained after the administrative or arbitration award, we will submit the HP-J1 form.

Why Choose MEDTRX for Medical Billing Collection?

• Specialized Expertise: Our team of billing and collection professionals has in-depth knowledge of payer contracts, claim adjudication processes, and collection best practices. We are well-versed in navigating the complexities of insurance claims and patient collections, ensuring maximum recovery for your practice.
• Streamlined Processes: We employ advanced technology and proven methodologies to expedite collections, allowing us to track claims efficiently, follow up on unpaid balances, and minimize delays in the reimbursement cycle.
• Tailored Solutions: We understand that each healthcare provider’s financial needs are unique. That’s why we offer customized collection strategies based on your specific billing cycle and payer mix, helping to optimize your revenue collection efforts.

Key Benefits of MEDTRX Medical Billing Collection Services

• Faster Collections: Our streamlined process ensures quicker reimbursement from insurance companies and faster patient payments, improving cash flow.
• Maximized Revenue: Through aggressive follow-up and appeals, we ensure that you receive the full reimbursement you’re entitled to, reducing revenue leakage.
• Reduced Administrative Burden: Let us handle the time-consuming process of claim follow-ups, appeals, and patient collections so your team can focus on patient care.
• Compliance and Accuracy: We adhere to all regulatory standards, ensuring your collections process is compliant with healthcare laws, including HIPAA, and accurately reflects your billing practices.

Let MEDTRX Handle Your Collections, So You Can Focus on Care

At MEDTRX Healthcare Solutions, we understand that collecting outstanding balances can be a challenge. With our comprehensive medical billing collection services, we help you streamline your revenue cycle, reduce outstanding AR, and maximize collections—allowing you to focus on delivering exceptional patient care.

Contact us today call (201) 634-8700 or Schedule a Consultation Online.

MEDTRX your partner for successful revenue recovery.