Frequently Asked Questions
I have clients who are not covering their portion of the financial obligation to me as their midwife. Does LBS have anything in place that will help in situations like this?
If your client is not holding true to their financial obligations, and all other resources have been exhausted, you do have the option of sending them to collections. Larsen Billing Service has teamed up with a collections agency so we can offer this service/option to our clients. Please contact our Client Billing Department for more details.
What if I am currently using a billing service and would like to change over to using Larsen Billing Service? How are my current submitted claims dealt with in that situation?
We know a decision like this is not easy to make, but one thing you will not need to worry about is the transferring of responsibility from your current billing service over to Larsen Billing Service. We are fully capable of taking on such accounts right from the start and this includes any ‘troubled’ claims and old claims (up to 12 months timely filing). Once you are a part of Larsen billing Service, your billing team will meet with you to review your outstanding accounts and come up with ways to best manage each one from that point forward.
Why do you charge a percentage rate rather than a fixed fee on submitted claims?
We have proven that utilizing the percentage fee structure promotes an incentive to maximize your reimbursements. There is no additional charge for any follow-up or appeal we do on submitted claims. Our goal is to get your claims processed correctly the first time.
How will Larsen Billing Service collect their fees?
By tracking the accounts receivables, Larsen Billing Service can determine the total percentage amount that is due. You will receive an invoice from Larsen Billing Service once a month. Payments can be made both on-line or through the mail.
How is the best way I can support my billing team?
Sending your insurance correspondences (EOB’s, negotiation letters, etc) to your biller in a timely manner is the number one way you can best support your billing team. The information gained from these documents greatly enhances the ability to track claims and to watch for improper rulings on claims.
Another great way you can support your billing team is to respond to their emails in a timely manner. We find that corresponding via email is a great way to communicate with our clients as it is the least disruptive to their busy schedules. However, there are times when we do not hear back until it is too late or occasionally not at all, which greatly hinders the work of getting your claims to process quickly.
What information is needed to generate a claim?
This process begins with the provider submitting to her biller the Client Registration Form (CRF). We will use the visit marked on the CRF as the test claim, unless the insurance company will not allow us to bill outside the global fee. In that case there are other options for a test claim. Please contact your biller for information.
All additional charges will be submitted when the OB/GYN/Follow-Up Superbills are sent to your biller.
How old is too old for submitting claims?
Most insurance companies have a 12-month timely filing window. If you are a new client to LBS, seeing that there is no per claim fee, it is to your advantage to look back over the past 12 months to see if there are claims you would like us to submit. This includes facility claims.
What about balance billing my clients?
Our billing team has the ability to help you track what your clients have paid, and what they still owe. If there is a need to balance bill your client, we are able to send those statement to them in your behalf.
How do I determine what portion of a claim I hold the client accountable for and what portion I write off?
If you are a contracted provider, you can only hold your client accountable for the amount that the insurance company determines is patient responsibility. Deductibles, coinsurance and non-covered charges are typically considered patient responsibility. Contractual discounts must be written off.
If you are a non-contracted provider you can hold the client accountable for everything that was billed — or choose to write some of the charges off. Any amount that the insurance company reduces as over the usual and customary can be written off by the provider without any documentation. The patient is technically responsible for all deductible and coinsurance, so if you choose to write portions of those off, you must document financial hardship in the client’s charts.
Having a clear financial agreement in place to let your clients know what charges they are accountable for, and sticking to that agreement, will make reconciling their accounts easier. A sample of a well written financial agreement is available for LBS clients. Contact your biller for more details.
What is included in global maternity care?
Although each insurance company can designate its own interpretation on what to include in the Global Fee, there are some standard practices. The Global Fee typically includes the initial prenatal visit and routine prenatal care, routine chemical urinalysis, the birth, episiotomy, vaginal repair, and routine postpartum care.
Newborn care, labs, non-stress tests, and complications throughout the pregnancy/birth/postpartum care can be billed separately from the global fee.
I received a negotiation offer from the insurance company. What do I do with it?
Negotiations are a tricky thing. The wording makes it sound like YOU are the benefactor when agreeing to the negotiation, where in fact the negotiation will best benefit the insurance company. Not responding to a negation letter could greatly decrease the speed at which your claim is processed and could even send the message that you are agreeing to the proposed negotiation.
For our LBS clients, we manage the negotiations for you. During your initial consultation with your biller, she will ask you what your negotiations preferences are. Then, when a negotiation letter is sent to you, you can send it over to your biller and she will take it from there. Using the guidelines you set during your initial consultation, your biller will see to it that the negotiation letter is dealt with appropriately.
How quickly can I expect reimbursements from insurance companies?
Each state has different rules; however, insurance companies typically have 30 working days to process a clean claim. We submit 90% of our claims electronically so the processing of clean claims tends to be quicker. At LBS, once a claim is submitted we closely monitor it as it moves through the system. If we see that more is needed in order to finalize the claim, we take action to meet those needs.
Tip! Send us your EOBs as soon as they receive them. The faster we have that insurance information, the faster we can get a claim to finalize.
I am an established practice, but I know there is more I could be doing to help build my practice and become more efficient. How do I get to the point where I am running my practice, rather than having my practice run me?
Whether you are a solo practice or a birth center with office staff, this seems to be the ongoing battle with those who run their own businesses. Christine Provost, owner of Larsen Billing Service, has spent the last decade learning the in’s and out’s of running/owning her own business, all while getting to know her clients (midwives) and trying to understand and then meet their billing needs.
With the combined business and midwife billing knowledge she has obtained over the years, she is now offering seminars and training sessions to others in this field. If you are a midwife just starting up your practice and would like some advice, or if you are a birth center looking to educate your staff on midwife billing practices, and anything in between, Christine can help meet those needs. Read more about our Consulting Services »
What is my responsibility in complying with HIPAA?
As the provider it is your responsibility to ensure that your clients’ protected health information (PHI) is kept secure and private. If at any time this is breached, and PHI is seen by others without proper permission from the client, you will need to contact all parties involved to explain the breach itself and all circumstance which allowed the breach to take place. For more information, visit the HIPAA site.