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Client Case Study - Stuck In A Medical Billing Contract

10/15/2014

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It is unfortunate, but some clients come to us because they are stuck in a contract but the billing service is either inadequate or not being provided. One such client, let's call them Trusted Providers, was in a billing contract for two years and charged a minimum balance each month. The billing service was owned by a group that turned out to have no experience with medical billing, or any medical background besides starting up various medical billing companies. 
After Midwest Medical Billing (MMB) performed a background search on the owners, it was revealed that they had previously owned other billing companies who outsourced the work offshore. After the coding and billing was done incorrectly and doctor's offices lost money, the billing company would file for bankruptcy and start under a new name. The minimum balance charged to my client was close to the regular charge she would have accrued had the service been actually billing her claims. Since they Trusted Providers was in a two year contract, the service quit billing and just charged the monthly minimum to my client. 

This left Trusted Providers in a really bad situation. They were receiving no insurance payments, since no claims were going out, and still paying a billing service every month. MMB reviewed the client's contract with the billing service and was able to determine that contract stated that the billing service would bill all charges to the insurance within a specific amount of time.

MMB found proof in the billing software that charges were entered and not billed within the contract time frame; meaning the billing service had broken their own contract to the client. MMB assisted the client in drafting the cancellation letter and then transitioned the billing over to our services. Fortunately, MMB was able to get the client out of the bad situation and get full payments on most of those old claims that were never billed.
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Medical Reimbursement Experts
711 East Lemon St PMB 28
Tempe, AZ 85281
Phone: 402-750-4024
Fax: 800-210-9445
mweigel@medicalreimbursementexperts.com