Golden West Medical Billing, Inc

Q) How long does it take to get started with GWMB?

A) We can start billing most insurance carriers immediately.  Medicare and Medicaid/Medi-Cal require special authorization and it usually takes 2-3 weeks before we can submit claims on your behalf.

Q) What information does our office need to provide GWMB?

A) We need your patient's demographics and insurance information, super-bills or charge sheets, and any EOBs that come to your office for posting purposes.

Q) How do we report insurance payments, provide daily bills, and patient information to GWMB?

A) Via fax, email (SSL connection), regular mail, or by courier. Most practices fax their superbills/charge sheets, EOBs, and all other documents to us using highly secured toll-free fax lines. We will provide your practice its own dedicated fax line at no additional cost. Your fax line will be available 24/7 and never busy. We also have the capability to directly download EOBs from many carries for posting and follow-up purposes.

Q)  Can you connect to my EMR/EHR and obtain the patient’s information, super-bills, and all other relevant documentation for billing purposes.

A) Yes, many of our clients use Practice Fusion, Office Ally, and many other EMR/EHR systems and give us look-up privileges, so we have access to the patient’s billing information and transfer the data into our billing software.

Please note that we will not use your software to submit your claims.

Q) How often should we send our new billing to GWMB?

A) We recommend that you send it daily or weekly to ensure consistent cash flow.

Q) How often will you submit our claims?

A) We submit most claims within 24-hours of receipt from your office.

Q) How often do you follow-up on my claims?

A) We aggressively follow-up on all claims immediately after the established time-frame for reimbursement has passed by.

Q) Where are the reimbursements sent?

A) All reimbursements come directly to your office or your banking institution via EFT. 

Q) How will you handle billing our patients?

A) We will bill your patients for any balance due. Your patients will receive a comprehensive billing statement with our telephone number to direct all billing questions to our call center. A self-addressed envelope with your practice name and address is included.

Q) How will you handle non-payments from patients?

A) We will contact the patients by phone or letters to resolve their billing issues (soft collections) and keep the provider updated as to the status of the payment. In the event that we are unable to effectuate a settlement within ninety days, we will recommend that the delinquent account be sent to a collection agency at the discretion of the medical provider.

Q) Do you verify patient benefits and eligibility?

A) Yes, at an additional charge of the monthly collectibles, we can verify and check your patient’s eligibility and benefits. You need to give us some basic patient and insurance information at least 24 to 48 hours prior to the scheduled appointment and we will fax or e-mail you back the information we obtain.

Q) How do you handle denials from insurance carriers?

A) We will review the denial to verify validity. If the denial is not valid we will appeal and resubmit the claim at no additional charge to the provider.

Q) Who does my billing at your office?

A) While anyone in the office can help you or your patients, your account will be assigned to a specific biller to assure consistency and accuracy of your billing but most importantly, to build a meaningful relationship and understanding of your practice and its needs.

Q) How do you charge for your services?

A) Our fee is based on the percentage of the revenue you collected as a result of our service throughout the month.

Q) Do you outsource my claims?

A) No, we do not outsource any claims to third party companies, all billing is done in Los Angeles, California.

Q) What if I decide to stop using your services?

A) Unlike other Billing Services, you are not tied to a long-term commitment. There are no cancellation fees, but we require a 30-day notice.

Q) What medical billing software do you use?

A) We use different software programs, it all depends on the type of billing that we are doing.

Q) Do you offer EMR/EHR, E-Rx, appointment schedulers, etc?

A) Although our software programs have these capabilities, we only focus on insurance and patient billing, claims follow-up, and all other Medical billing related services. However, when a client requires these services we will refer you to one of our software vendors.