Medical Billing Companies & Consultants in Worthington, MA

Overview

Pioneer Valley Billing Services is an independent medical billing firm in Worthington, in the hill towns of Western Massachusetts. Evelyn Voorhees owns and runs the company and has done billing work in the region since 1998. It serves medical practitioners who want to hand off the paperwork of insurance reimbursement without signing up for a large outsourcing contract. The firm recently hired more trained staff to keep up with a growing client base. It takes on practices anywhere in the United States, not only in the Pioneer Valley.

The core of the business is acting for the practice in its dealings with insurance carriers. The team prepares and submits claim paperwork, makes the follow-up calls, and tracks each claim and the payment that results. It also handles the long hold times and back-and-forth with payers that often slow reimbursement. The company stresses keeping a precise, professional and polite relationship with payers. Its staff keep working a problem until it is settled rather than handing it back to the provider.

Services

Full-service clients get a package that goes beyond basic claim submission. Key elements include:

• Preparing and submitting insurance claims
• Tracking claims and incoming payments
• Managing claim denials
• Billing and tracking patient co-pays
• Monitoring authorizations for managed care patients
• Eligibility checks and benefit verification calls
• Organizing patient accounts and ledgers

The firm also offers two narrower options. DIY Billing is for practices that would rather handle claims and receivables themselves on an online billing platform. Pioneer Valley Billing loads the client, provider and insurer data and supports the practice for the first 30 days. After that, the online vendor provides ongoing technical help and training. Fix-A-Claim is for single stubborn claims a practice has not been able to resolve. It is billed by the hour and needs no sign-up. The firm researches each problem claim and works it until it is resolved. It reports full success in cases where authorization, network rules and filing deadlines were all handled correctly.

How They Work With Clients

Each engagement starts with a program tailored to the practice. To get started, the provider supplies patients' insurance details, using forms the firm provides or the practice's own copies. The provider also supplies current managed care authorizations and its own credentials, such as NPI and taxpayer identification numbers. There is a one-time software setup charge that can be spread over several months. The company supplies all billing forms, pays postage, and says it has no hidden charges. Insurance payments go straight to the provider and the firm bills its fees separately, so practices keep direct control of their revenue.

The company also explains how it protects data. Information sent over the internet is encrypted, and all records and financial transactions are backed up off site. Clients communicate with the firm by phone, fax or email, and local clients can also meet in person.

Why Buyers Consider Them

Small and mid-sized practices comparing billing partners get the personal attention of an owner-run firm with more than two decades of experience in the region. They can also choose how much to hand over: full outsourcing, self-managed billing or help with a single claim. The company takes practices of any size. It aims to keep billing simple and help providers improve cash flow, so they can spend more of their time on patient care.