Billing Services - Closing a Sale
A. Practice is interested in or asking about Billing Service.
- Send an email to the practice using the format below.
Hello Anthea,
Good Day!
WRS Health Billing Services focuses on the following domains:
- Claims Creation - create claims as soon as coded notes are signed (Paper Superbill or EMR Notes)
- Rejections - work clearinghouse and carrier rejections
- Payment Posting - post paper EOBs and ERAs
- Denial Management - WRS will work denials to prevent them from aging, appeal as necessary
- Insurance Aging - follow up on aged claims, work denials, appeal as necessary
- Monthly Billing Report - meet with practice monthly or as needed to discuss practice health
We will create a Billing Guideline specific to your practice. This guide will include rules on how you want your claims billed, any credentialing issues, posting rules, escalation process, etc.
The biller will NOT write-off any CPT Code or Claim without your approval. If a claim is denied and all action from our end is exhausted, we will escalate the claim to you for the decision whether to write-off or bill the patient.
Escalations will be sent on a weekly or monthly basis. These escalations will consist of items that need your attention or approval.
A dedicated Billing Manager and Billing Lead will be assigned to your practice who will provide real-time assistance with any billing-related inquiries.
The monthly fee is 6% of your monthly insurance posting or a minimum of $1,299 per provider.
Let me know if you want to discuss this further so that I can set up a call.
B. Practice asks for an estimate on how much they will pay monthly if we charge 6% of the insurance posting.
- 1st Formula - 6% of the actual monthly insurance posting.
- Go to Billing > Payment Management > Payment Search > Received from Entity: INSURANCE > # of Checks: ALL > get the TOTAL posting amount. Provide at least 3-6 months data.
|
Month |
Insurance Posting |
6% |
| January | $ 100,000.00 | $ 6,000.00 |
| February | $ 100,000.00 | $ 6,000.00 |
| March | $ 100,000.00 | $ 6,000.00 |
| April | $ 100,000.00 | $ 6,000.00 |
| May | $ 100,000.00 | $ 6,000.00 |
| June | $ 100,000.00 | $ 6,000.00 |
- Use this formula if there is no available insurance posting in the payment management section.
- Go to Billing > Claims > View Claims > Choose the Date of Service range > Display: All Results > get the TOTAL AMOUNT BILLED (bottom page). Provide at least 3-6 months data.
|
Month |
Charge Amount |
40% Allowable Estimated Ins Posting |
6% of Estimated Insurance Payment |
| January | $ 200,000.00 | $ 80,000.00 | $ 4,800.00 |
| February | $ 200,000.00 | $ 80,000.00 | $ 4,800.00 |
| March | $ 200,000.00 | $ 80,000.00 | $ 4,800.00 |
| April | $ 200,000.00 | $ 80,000.00 | $ 4,800.00 |
| May | $ 200,000.00 | $ 80,000.00 | $ 4,800.00 |
| June | $ 200,000.00 | $ 80,000.00 | $ 4,800.00 |
C. Practice asks for a lower percentage.
- Re-calculate based on the formula in B.
- Send an email to "Patti Van Zuuk" <pvanzuuk@wrshealth.com> for approval, cc "Anthea Sapon" <asapon@wrshealth.com></asapon@wrshealth.com> </pvanzuuk@wrshealth.com>
- 1st Formula - 6%, 5.5%, 5% of the actual monthly insurance posting.
|
Month |
Insurance Posting |
6% |
5.5% |
5% |
|
January |
$ 200,000.00 |
$ 12,000.00 |
$ 11,000.00 |
$ 10,000.00 |
|
February |
$ 200,000.00 |
$ 12,000.00 |
$ 11,000.00 |
$ 10,000.00 |
|
March |
$ 200,000.00 |
$ 12,000.00 |
$ 11,000.00 |
$ 10,000.00 |
|
April |
$ 200,000.00 |
$ 12,000.00 |
$ 11,000.00 |
$ 10,000.00 |
|
May |
$ 200,000.00 |
$ 12,000.00 |
$ 11,000.00 |
$ 10,000.00 |
|
June |
$ 200,000.00 |
$ 12,000.00 |
$ 11,000.00 |
$ 10,000.00 |
- 2nd Formula - 6%, 5.5%, 5% of the estimated monthly insurance posting.
|
Month |
Charge Amount |
40% Allowable Estimated Ins Posting |
6% of Estimated Insurance Payment |
5.5% of Estimated Insurance Payment |
5% of Estimated Insurance Payment |
|
January |
$ 200,000.00 |
$ 80,000.00 |
$ 4,800.00 |
$ 4,400.00 |
$ 4,000.00 |
|
February |
$ 200,000.00 |
$ 80,000.00 |
$ 4,800.00 |
$ 4,400.00 |
$ 4,000.00 |
|
March |
$ 200,000.00 |
$ 80,000.00 |
$ 4,800.00 |
$ 4,400.00 |
$ 4,000.00 |
|
April |
$ 200,000.00 |
$ 80,000.00 |
$ 4,800.00 |
$ 4,400.00 |
$ 4,000.00 |
|
May |
$ 200,000.00 |
$ 80,000.00 |
$ 4,800.00 |
$ 4,400.00 |
$ 4,000.00 |
|
June |
$ 200,000.00 |
$ 80,000.00 |
$ 4,800.00 |
$ 4,400.00 |
$ 4,000.00 |
D. Other Items
- Understanding of the different domains. Claims Creation, Rejections, Payment Posting, Denial Management, Aging, Reports (overview).
- Know the practice specialty (ENT, Psych, Family Medicine, etc). If the practice wants to meet to discuss specifics, send an email to "Anthea Sapon" <asapon@wrshealth.com> so that I can join the call to address any in-depth inquiries related to billing. </asapon@wrshealth.com>
- Know how many full-time and part-time providers. Finance will ask this.
E. Complete the attached Billing Service Agreement.
- Once completed, send an email to "Patti Van Zuuk" <pvanzuuk@wrshealth.com> for approval, cc "Anthea Sapon" <asapon@wrshealth.com></asapon@wrshealth.com> </pvanzuuk@wrshealth.com>
- Make sure to inform the practice to email the SIGNED complete copy of the billing contract to "your" WRS email address.
- Once the signed contract is received, forward the email to "Patti Van Zuuk" <pvanzuuk@wrshealth.com> for approval, cc "Anthea Sapon" <asapon@wrshealth.com> . We will then assign a Billing Manager for the practice. </asapon@wrshealth.com> </pvanzuuk@wrshealth.com>