Frequently Asked Questions

Who answers patient questions about their statements?

We answer all questions. Our clients are asked to direct their patients to contact CLS Billing Services, Inc.

Is your software, hardware and office HIPAA compliant?

Yes, our software is HIPAA compliant. All our hardware is purchased through one company and is state-of-the-art.

What is your claim submission turn around time?

We process all claims within 24 to 48 hours. We file electronically and directly with Medicare, Medicaid, and Blue Cross Blue Shield. We have an excellent clearinghouse and any claim that can be electronically filed is sent electronically.

How many times do you come to the office for pick-ups?

We tailor pick-ups to our clients’ needs.

How do you handle Medigap patients?

We file the claims to the secondary insurance through intense follow-up procedures. We bill the patient when we find the patient was sent the check.

What do we collect at the front desk?

Physician offices only collect a patient’s co-payment and the 20% co-insurance for Medicare if the patient does not have a secondary insurance. Any self-pay patients should pay in full.

How do you handle insurance collections and patient collections?

We are responsible for appealing all claims and working with insurance companies until the maximum reimbursement is met. We send three statements to patients and if the patient does not pay the statement after the final notice, we attempt to contact the patient and make payment arrangements. If the patient does not respond, we inform our client to refer the patient to a collection agency. We have collection agencies that we can recommend.

Who is contacted if someone has a question about an account?

All questions about billing are directed to us, unless we have instructed the office otherwise.

What is included in your set-up cost?

We include

  1. Computer set-up. This includes a) checking the DSL Line, b) verifying the integrity of the computer equipment in the client’s office, c) checking the correct operation of network systems, and d) ensuring that the service relays the data accurately and at optimum speed.
  2. Software installation
  3. Training
  4. Support for both on and off-site.

We analyze the client’s insurance contracts with various companies and any entities with whom they do business. Included in Contract Analysis is fixing anything that needs to be updated or changed, as well as an Office Procedures Analysis to ensure that it is easy for the client to get CLS Billing Services the bills and EOBs. This also includes a one-time office set-up charge, which is for patient statement return envelopes, client stamps, and more. Set-up fees are adjusted on a client-to-client basis.

Why would you file a secondary claim or bill a patient, if the claim or bill is less than twenty dollars?

First and foremost, that is what we are hired to do. It is part of our job. We get you the maximum reimbursement from your accounts receivable.

What is included in your general contract?

Many value-added services, including specialized end-of-the-month reporting, detailed and extensive follow-up through status calls and appeals, and all coding verification to obtain maximum reimbursement.

Also included are electronic and manual claim submission, 24-48 hour turnaround time, extensive research to ensure correct billing procedures, and negotiating contracts as necessary.

We provide assistance in ensuring correct forms are prepared for Medicare and Medicaid, allow providers to process claims electronically through CLS Billing Services, and use specialized faxes to inform clients when further information is needed to process or appeal a claim.

In addition, our general contract includes extensive technical and billing support, several software packages, and we assurance of proper insurance payments by providing individual fee schedules, processing co-insurance claims, and extensive follow-ups.

Do you inform us of changes within the industry?

Yes, we inform all clients of changes that will affect them, explain what the changes mean, and suggest ways of handling the changes

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