FAQ - Frequently asked questions

We have standard processes and procedures and customize the overall scope of work for each client. The preferred method for most client is via secure fax or scan and upload to our secure cloud document service. Clients can also send encounter form information via US mail, Overnight Courier, or same-day courier but will need to pay for those methods of delivery. Clients have remote, real-time access to their data. Monthly reports are sent via email and available via the cloud. Worth Healthcare can also conduct regular client meetings to review reports and discuss process improvement via web based screen sharing and conference call if your practice is not located near our offices.
Worth Healthcare's feels that each client should have a dedicated Billing Specialist assigned to their account with a cross-trained client Billing Specialist to partner with and a Manager providing support and oversight. Each client has a dedicated billing specialist that is responsible for the day-to-day processing of their account. Our Billing Specialists are grouped into teams and anyone on the team can provide the same level of service as the primary biller for patient calls or if the main Billing Specialist is sick or on vacation.

No, we do not. We live in a global economy and Worth Healthcare understands that some organizations feel the need to outsource healthcare billing services to foreign based third-party service entities. Worth Healthcare does not do this type of outsourcing but it’s not because we are biased against foreign based entities.

Many firms in our industry have become “front-companies” or shell organizations that have a USA based address with some local sales personnel but all the real work is done by low paid personnel in other countries. Worth Healthcare believes in transparency and will not mislead clients in this manner.

There are several reasons why we’ve decided not to outsource to third-party foreign entities. We want our Billing Specialists to have a close relationship with their clients and most are located near our client’s offices. There is a noticeable difference between basic outsourced data entry services and what is required of our Professional Healthcare Billing Specialist in 2017 and beyond. We are also very cautious about the fact that HIPAA law does not apply to nor is it truly enforceable in other countries. We don’t want to take undo risks with our client’s Protected Health Information because it’s already hard enough to protect right here in the USA.

Yes, we can work with, interface with and use a multitude of systems that can produce an excel, ASCII or HL7 output file. Many of our clients have made significant investments in their EHR/PM systems so we’ve learned numerous solutions to accommodate them. Contact us today to find out if we can work with your system.
Yes, we have an interface with EPIC for billing purposes and have staff who are trained users of EPIC hospital and ambulatory software as well. Each hospital system has their own version of EPIC but we are confident in our ability to work with yours.
Yes, we offer clients access to the software and/or access to our cloud based reporting dashboard portal so that they can see their results 24/7.
Yes, we encourage all our clients to use EHR/PM claims software but not every provider wants to do so. Therefore, we still offer two different systems to process claims.
  1. Paper based practices: Encounter forms/claims are securely sent to us via Secure e-Fax or Scanned and uploaded to us via secure file sharing or via encrypted email. Claims are reviewed for accuracy and provider coding and then entered into our software and transmitted electronically to the claims clearinghouse.
  2. Electronically provided information: Charges are entered at the client’s office, claims are reviewed for accuracy and coding and then the approved claim is sent to the claims clearinghouse.
Each biller typically handles 2-3 accounts depending on size and specialty. Our biller/practice ratio is lower than industry standards. This allows our billers to devote more time to each client to ensure excellent customer service and responsiveness to our client's needs. Other Billing Specialists and Managers provide back up as needed.
The practice is responsible for all coding using Worth Healthcare as a resource as necessary.
Yes. These services are in addition to our usual billing rate. We have two Credentialing Professionals on staff.
No, but we can also help you create an encounter form if need one.
We bill to all insurance carriers that accept electronic claims.
We work with a main contact within the practice to obtain all necessary billing information. If it is patient related, we call the patient directly to try and obtain any missing information.
Monthly but also stagger the statements for more effective processing.
We stagger our client statements throughout the month so that the resulting call volume is not too high at any point in the month.
You do. Our client always owns their own data. We don’t make it difficult.
If payment is not collected up front by the practice, the patient receives a statement. If payment is not received within 30 days, a reminder notice is sent. If no payment is received after 60 days, a second past due notice is sent. If no payment is received after 90 days, we make several attempts to reach the patient by phone. If unsuccessful, the patient is notified by mail that their account will be sent to a collection agency. We require the client to approve in writing the transfer of any patient account to the collection agency.
We work with our practice main contact to follow up on who is responsible for obtaining correct Authorizations and see if we can clear up any problems. If there is no way of retroactively correcting the error, we notify our primary contact so that the practice can see the financial impact.
Yes, and the format is created with input from the client.
It normally takes a few days to get set up with the practice and gather all of the required provider information. At that point, we can begin transferring demographics and old AR, and start sending claims on paper. It takes approximately another three weeks to complete electronic claims setup and carrier address changes.
No, we try to make it simple to work with us. We will meet with you to understand your specific needs and set goals for the transition. We obtain all practice and provider information, establish any client specific policies on refunds, bad debts, finance charges and late fees, minimum balance statements, account numbering etc. We then install or interface with the client’s software, configure providers, fee schedules, adjustment codes and reporting preferences. Next, we apply for electronic claims submission and submit payment address changes if required. We begin data entry (or set up electronic transfer) of patient demographics. Then we are ready to begin claims submission. The provider then gets paid and we begin follow up on old and new AR when available.
Worth Healthcare normally charges a monthly percentage based fee. We also now offer a flat retainer fee model for clients who want one of more dedicated billing specialists for their practice(s). The fee can be anywhere from 4.25% to 8% of NET (not gross) collected revenue. The retainer fee varies on volume and need as well.
Not for the process but pass through cost for postage for mailing them.
Worth Healthcare and the client determine a start date at which all future claims will be handled by Worth Healthcare. We can either get all demographics in beforehand (manually or electronically), or we can enter demographics as we receive new claims. (Many practices take this opportunity to have patients confirm and correct their demographic and insurance data). Usually the previous billing company is given 90 days to wrap up any claims that they have in their AR, after which time old AR is transferred to Worth Healthcare. We don’t have a standard conversion fee but depending on the needs of the client, there are sometimes startup fees for the up-front work we do for transitions.
Yes, we provide “off-the-shelf” type I.T. services to our clients as a value-added service that we keep affordably priced for small to large practices who don’t need overly sophisticated I.T. systems. If a client does need more advanced I.T. support, we have partnered a national I.T. support firm that can help you as well.