One Link

Team One Link MBS comes to play when it’s time to submit your medical bills to insurance carriers to get paid for the services and procedures you provided as quickly as possible. Our team will make sure your bills are sent to the carriers on the daily basis with no hold time to delay your payments.

Billing services include: 

• Electronic submission of the bills to insurance carriers for faster and more accurate processing.
• Applying appropriate CPT/ICD-10 codes as well as correct modifiers that correspond to the performed procedure and operative report, 
• Resubmission of rejected claims. 
• Claim scrubbing. 
• Appealing of denied claims, including Medicare, commercial health insurance, PIP and Workman’s Compensation claims. 
• Preparing denied PIP and Workman’s Compensation cases for arbitration. 
• Payment posting. 
• Monthly follow-ups with insurance carriers to confirm the claims are processed in timely manner and payments are received within 2-3 weeks after the submission of the claim. 
• Monthly follow-ups with patients for their (over)due balances. 
• Monthly follow-ups with attorneys for the balances protected under LOPs/LIENs, including periodic statement submissions showing the most recent balances due to reimbursement. 
• Negotiations with insurance carriers for higher UCR payments. 
• Negotiations with patients’ legal representatives to ensure our providers are paid for their clients’ owed balances. 
• Contracting with insurance carriers and third-party vendors (e.g. Qualcares). 
• Confirming claims are paid in higher UCR amounts and/or correct Fee Schedule and contract amounts. 
• Maintaining up-to-date aging reports, including monthly follow-ups on Account Receivables, providing analysis and reports to the providers. 

The key aspect to guarantee your correct payment is the utilization of appropriate medical codes both for the performed procedure and assigned diagnoses. Team One Link MBS is AAPC certified and has extensive years of experience in the industry and actively participates in webinars, seminars and conferences to stay up-to-date with the industry’s changes.

In addition to our billing and coding services, One Link MBS provides HIPAA compliant collection services to the providers for their overdue patient balances. One Link MBS partners with collection agencies that will take over the overdue balances and make sure your practice is paid what you rightfully deserve.

Services include: 

• Review of patient balance aging report, 
• Contacting and notifying patients, including sending statements, of their patient’s responsibility balance, such as co-pays and deductibles, 
• Preparation of collection package and submission to the collection agencies for filing.

One Link MBS also assists his providers with pre-authorization and checking eligibility and benefits to make sure the authorization is obtained for the upcoming procedure and/or whether patient’s plan will cover the intended procedure.

Services include: 

• Verifying whether patient has in-network and out-of-network benefits, 
• Verifying and confirming whether the patient’s insurance is active, 
• Verifying whether the planned procedure requires pre-authorization under the patient’s insurance plan, 
• Check the patient’s insurance policy and plan and verify if the planned procedure is covered under the plan,
• File retro-authorizations in case pre-authorization is missing and the procedure is denied due to missing authorization,
• Prepare proper office visit and clinical notes to submit to the carriers to obtain authorization, 
• Prepare and submit pre-certification documents to the PIP carriers, including pre-certification appeals, 
• Verify the patient’s PIP ledger, confirm patient has enough available funds in their PIP policy to cover the planned procedure before it is exhausted. 
• Prepare and submit Workers’ Compensation procedure authorization form, obtaining MG-2 form approving the planned procedure.