Thanks for your question! I see that Medical Billing Maven did a fantastic job at answering. Thanks!! :) Let us know if you have any additional questions.
How do you decide what you are going to charge for the claim? There is an allowed amount which is the charge minus the CO45, but do you have a rule of thumb you go by when deciding how much over your allowed contracted rate you are going to charge for the claim? I have seen some providers just make their charge amount be the same as the allowed but I don't think that is ideal personally I like to have a bit of cushion just in case. Any insight you have on that is appreciated!
Hi there! We do not currently have any training related to medical claims, but we are planning on covering them on our live streams here soon. Is there anything specific you'd like us to cover on the topic?
Hi Jasmine, You were discussing the contractual W/O and the gross amount paid. How does one figure or predict possible future payments? If the provider is submitting claims with a higher than the allowed amount, how can you take that submitted dollar amount and figure approximately what could be expected revenue?
You are correct! If you know the contract rates for the submitted claims you can use that value or alternatively you could factor your average W/O into the total production and remaining would be the approximent expected revenue. For example, if the total was $100 & the W/O is $25 (or 25%) So if its scaled up to $1,000 then the total would still 25% which would me $250 so the expected revenue would be $750. I hope that helps!
Sure! We base our distritution off the volume of claims and the average number of claims one individual can typically touch in a business hour. Taking into consideration, the avaliable resources (software, payer portal & etc) and specialty (which would tell you the number of charges per claims)
Hi, this was a livestream when it aired, but we leave them up for replays so people can get the information after the fact. But we do go live on Thursday's at 2:00pm EST almost every week, so you can join us then! If that doesn't work for you, then you can always watch the replay and we will respond to your questions here in the comments 😃 Hope that helped!
Thank you so much!! I appreciate you and look forward to Thursdays!! 😁
We're so glad we can brighten up your week a little! 💕
#replay, are your courses certified and nationwide recognized
When you take a course, you usually get a certificate. In order to get certified, you have to sit for and pass an exam.
Thanks for your question! I see that Medical Billing Maven did a fantastic job at answering. Thanks!! :) Let us know if you have any additional questions.
Great Course
Thank you! We're glad you think so
How do you decide what you are going to charge for the claim? There is an allowed amount which is the charge minus the CO45, but do you have a rule of thumb you go by when deciding how much over your allowed contracted rate you are going to charge for the claim? I have seen some providers just make their charge amount be the same as the allowed but I don't think that is ideal personally I like to have a bit of cushion just in case. Any insight you have on that is appreciated!
Hi do you have any training related to medical claims? thank you
Hi there! We do not currently have any training related to medical claims, but we are planning on covering them on our live streams here soon. Is there anything specific you'd like us to cover on the topic?
What about 835 ERAs for automated posting?
Hi Jasmine,
You were discussing the contractual W/O and the gross amount paid. How does one figure or predict possible future payments? If the provider is submitting claims with a higher than the allowed amount, how can you take that submitted dollar amount and figure approximately what could be expected revenue?
You are correct! If you know the contract rates for the submitted claims you can use that value or alternatively you could factor your average W/O into the total production and remaining would be the approximent expected revenue.
For example, if the total was $100 & the W/O is $25 (or 25%) So if its scaled up to $1,000 then the total would still 25% which would me $250 so the expected revenue would be $750.
I hope that helps!
Can i know what will be your strategy to allocate inventory to your team members?
Sure! We base our distritution off the volume of claims and the average number of claims one individual can typically touch in a business hour. Taking into consideration, the avaliable resources (software, payer portal & etc) and specialty (which would tell you the number of charges per claims)
Live? It starts from the same countdown on different devices
Hi, this was a livestream when it aired, but we leave them up for replays so people can get the information after the fact. But we do go live on Thursday's at 2:00pm EST almost every week, so you can join us then!
If that doesn't work for you, then you can always watch the replay and we will respond to your questions here in the comments 😃 Hope that helped!
Hi Jasmine
I am from India
Hello!