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Terms Related to Processing Medical Bills
The following are some terms that are related to processing medical bills:

Beneficiary: In relation to processing medical bills, a beneficiary is someone who is covered by a health insurance policy.

Capitation: Capitation is how much policyholders or their employers are required to pay a health insurance agency. This amount is not based on how often the policy is actually used.

Coinsurance: Coinsurance, often referred to as co-payment, is how much a person needs to pay toward medical bills before the health insurance agency will help cover expenses. Coinsurance is commonly represented by a certain percentage. In some cases there is a flat fee required whenever a beneficiary visits a hospital or medical office, though this amount is usually small.

Exclusion: Exclusions are parts of health insurance policies that outline specific items that are not covered by the plan. This may include certain things like plastic surgery that is deemed medically unnecessary.

Guaranteed Issue: A guaranteed issue insurance policy is one that grants coverage to an individual without regard to their income, age, current health, and similar factors. A guaranteed issue policy will continue to remain in effect so long as the policyholders continue to pay for it.

Medical Underwriting: Medical underwriting refers to health insurance companies determining an individual’s eligibility, or ineligibility, for coverage. This is also how the cost of the policy is determined.

Primary Care Provider: A primary care provider, or PCP, is the main healthcare physician that an individual visits. PCPs are usually general practitioners, not specialists.

Reasonable and Customary Fees: Reasonable and customary fees are essentially the average cost for medical services in a certain location. The amount that an insurance policy will pay for office visits, hospital care, and other medical services will be based on this amount.

Rider: A rider is a change of an insurance policy that typically alters included benefits or payment amounts.

Stop-loss: Stop-loss occurs when the policyholder has covered all deductions, co-payments, and other fees and the insurance company is paying for the entirety of all claims that are included on the policy.

American Medical Billing Association
Make sure you choose only the most reputable provider of medical bill processing services for your business or practice. Keep your patients happy and grow your businesses with help from our members.
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STANDARD LISTINGS:   MEDICAL-BILL-PROCESSING IN/NEAR BUFFALO
for Most Medical Billing & Devices Inc Write review for this local business
93 Harvard Pl, Buffalo, NY 14209
(716) 883-6317  
Healthcare Solutions WNY Write review for this local business
2875 Union Rd Ste 8, Buffalo, NY 14227
(716) 651-0911  
Maxim Management Services LLC Write review for this local business
3085 Harlem Rd Ste 350, Buffalo, NY 14225
(716) 844-5600  
Computerized Ofc Management Write review for this local business
905 Harlem Rd Ste 1, Buffalo, NY 14224
(716) 827-1810  
Mk Associates Write review for this local business
1299 Union Rd Ste 7, Buffalo, NY 14224
(716) 677-9050  
Easymed Management Svcs LLC Write review for this local business
1312 French Rd, Depew, NY 14043
(716) 668-7633  
Healthtec Solutions Inc Write review for this local business
3950 E Robinson Rd Ste 305, Buffalo, NY 14228
(716) 639-0155  
Practice Management Center Write review for this local business
908 Niagara Falls Blvd, North Tonawanda, NY 14120
(716) 692-3302  
Compliance Billing Technology Inc Write review for this local business
149 Tanglewood Dr W, Orchard Park, NY 14127
(716) 662-5919  
Rem Disability Management Group Write review for this local business
1625 Buffalo Ave Ste 1V, Niagara Falls, NY 14303
(716) 285-5710  
Niagara Falls Memorial Medical Center Write review for this local business
621 10th St, Niagara Falls, NY 14301
(716) 282-1419  
Electronic Health Claim Svce Write review for this local business
10660 Miland Rd, Clarence Center, NY 14032
(716) 741-8549  
Med-Ex Billing Write review for this local business
8020 E Main Rd, Le Roy, NY 14482
(585) 768-2192  
Genesee Valley Medical Billing Write review for this local business
44 Red Jacket St, Dansville, NY 14437
(585) 335-2194  
Beyond Basics Medical Billing Service Write review for this local business
18 Hiram Way, Honeoye Falls, NY 14472
(585) 624-7890  
Eastman Dental Write review for this local business
625 Elmwood Ave, Rochester, NY 14620
(585) 275-5051  
Greenside Medical Billing Write review for this local business
25 Greenside Ln, Rochester, NY 14617
(585) 342-4212  
Physician Billi Write review for this local business
1 E Main St Ste 221, North East, PA 16428
(814) 725-0555  
Warren Medical Billing Group Write review for this local business
10 Plumber St, Warren, PA 16365
(814) 726-3335  
Thomas Joseph M Write review for this local business
2131 Bernwood Dr, Erie, PA 16510
(814) 899-6989  
Advanced Billing & Secretarial Services Write review for this local business
Erie, PA 16563
(814) 899-9925  
Mednet Resources Write review for this local business
3212 Cherry St, Erie, PA 16508
(814) 864-9932  
Thomas Joseph M Write review for this local business
3930 Amherst Rd, Erie, PA 16506
(814) 833-0624  
If you work for a hospital or doctors office that does not have a medical bill processing department, then you might want to outsource those services to professional processors that have years of experience. You can find several medical bill processing companies in the directory and online, but you need to know what questions to ask them to help you choose the one that is best for you. Ask the processors how long they have been in business. If the processors have several years of experience in the health care industry, then they should be familiar with industry regulations. They should have a system that lets them charge individuals and private health care insurance companies for surgery, hospital stays, medicine, and procedures. Ask the company if they have equipment that will let them input the health care expenses into their system and print up the bills in a timely manner so that your business can get payment for the medical procedures that you provide your patients. While you need to be sure that you are getting processors that can give you all of the medical bill processing services that you need, you also want to pick someone with a good price. Ask the companies to give you a written price quote. When you have several quotes, you can compare them to determine which ones will help you save the most money. After all, if you have to pay a lot to outsource your billing, then you might have to charge your patients more money, which will make your company less competitive.



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