ACS is dedicated to providing three main benefits to you.

1) Increased insurance claim payments

2) Faster insurance claim response

3) Lowered costs for handling and processing insurance claims

The insurance industry is very highly regulated. However, given the current climate in the medical field, it is extremely difficult for almost any practice to enforce these regulations upon the industry. Contrary to general belief, the insurance regulators are in most cases reactive, not proactive.

Virtually all states have legislation in place requiring insurance companies to pay or deny claims within 30, 45 or 60 days. Yet, billions of dollars in claims are not paid or denied within these legal requirements. Most importantly, a very small percentage of claims submitted on behalf of your practice fall into this area. We want to address this problem.

ACS processes your claims immediately, and follows up within a very few days any requests for additional, corrected, or re-submittal information. The result is over 95% of claims we handle on your behalf are resolved within 30 days. That small percentage of claims not resolved is very difficult to conclude, as we file tracers and even make phone calls with marginal if any response from the companies.

What we wish to provide to your practice is a tool to pursue and effectively resolve 100% of these insurance claims - at a minimal cost.

Our collections have developed a program specifically designed to utilize the states insurance laws and regulations to force insurance companies to meet the legal requirements governing them.

Insurance resolution: Persuading an answer from the insurance company that either closes a claim or provides the practice better information from the payer to close the claim. There are four types of resolution:

1) cash

2) denial from the payer (which allows the provider to bill secondary insurance, re-bill the primary with differing coding or information, or convert to self-pay)

3) Information from payer that no claim is on file (which allows provider to re-submit the claim, attaching ACS”s correspondence to achieve maximum efficiency) and,

4) Suspension of action on the claim for whatever other reasons the payer might have.

The major point to all of these is that NOTHING happens without some kind of response from the insurance company. It is the lack of a response, not the response itself, which is the problem. Therefore, response generation is exactly what our program provides.

WHY?

Three major reasons:

1) Being a licensed collection service, we are required by the FDCPA to include a "Federally Mandated Dispute Clause". This clause states that all portions of this claim shall be assumed valid unless disputed in writing within 30 days of receiving this notice. The payer is not only put on notice legally but forced to deny or pay or deny within 30 days or lose not only the right to dispute the claim but also be obligated to pay 100% of the claim. Also, being a licensed collection service provides a very strong paper trail of non-compliance with state legislation and regulations.

2) Because of the changes in the mix of payers (HMO=s, Managed Care, etc.), our collection service has designed specific communications for insurance companies that have all the necessary information for them to process the claim. Our collection service has the ability to touch every claim every 10 days, for a fixed fee, that is impossible for the provider or its billing service to match. We will contact the payer up to five times requesting payment or denial.

3) We are a collection a service. Most claims offices personnel address UB92 or  HCFA forms, and are not authorized to deal with third party communications. These are dealt with by supervisory personnel on an emergency basis.