Chiropractic billing can be a real pain. Not only does billing take up a lot of time to file and follow up, which can seem like a full-time job, but mistakes in insurance billing affect your bottom line revenue. In fact, the average chiropractic office loses 3% of insurance collections due to delayed filing, unpaid claims, missed follow up on claims, and misfiled claims. 

That's where our professional insurance billing specialists come in! For a fraction of the cost of employing a full-time staff member to handle billing in office, our insurance billing specialists and industry-leading software can start saving you time and money by increasing your insurance collections and decreasing your stress.

"Within 30 days of working with platinum billing my collections began to spike and have only continued to improve. They work seamlessly with my office and are very easy for my staff to communicate with. It has been a great decision and the Platinum company continues to deliver a great product and great service."
— Dr. C.B.

Our Platinum System SMART Insurance Billing Solution saves chiropractors time and money and reduces the stress of insurance billing by combining advanced insurance billing software and experienced insurance billing specialists. Our insurance billing specialists use our innovative insurance billing system to validate insurance information, submit insurance claims, track payments and follow up with insurance carriers, as well post insurance payments. Our specialists will even follow up on reasons for claim denials and, whenever possible, take all necessary actions they can to minimize claim denials.

From individual eligibility inquiries with some insurance carriers to help with insurance credentialing, Platinum System's SMART Insurance management software and insurance billing specialists can help your chiropractic practice with a wide variety of insurance billing issues. Our SMART insurance management software includes an easy-to-use message center for communication between your office and our insurance specialists.

Our software and insurance billing specialists will ensure you have access to all your insurance billing information in real time. Have a question or concern about something in your billing paperwork? Our insurance billing specialists are always available to provide further details and updates or specific insurance case information. Wondering what actions are required to complete a particular billing? Our professional insurance billing specialists and cutting-edge insurance billing software will notify you of any required actions.

How much could you be saving with our Insurance Billing Service?



Insurance Billing Service Pricing Options

While on the SMART Billing program doctors can use the Platinum System at no charge including tech support fees. There are three options, pick the one that best suites your practice.

Option 1: 6% of paid claims

  • First three months: 6% of paid claims or minimum of $250 per month
  • Following months: 6% of paid claims or minimum of $299 per month
  • Clinic handles all P.I. and non-commercial paper claims
  • Clinic is responsible for Gateway EDI/TriZetto fee. Pricing between $70 and $125 (à la Carte; Essential and SMART packages)

Option 2: 7% of paid claims

  • First three months: 7% of paid claims or minimum of $250 per month
  • Following months: 7% of paid claims or minimum of $299 per month
  • All paper claims are included
  • Clinic is responsible for Gateway EDI/TriZetto fee. Pricing between $70 and $125 (à la Carte; Essential and SMART packages)

Option 3: 8% of paid claims

  • First three months: 8% of paid claims or minimum of $250 per month Following months: 8% of paid claims or minimum of $399
  • Additional doctors: add $100 per Doctor per month All paper claims are included
  • Platinum pays Gateway EDI/TriZetto fees 

 

Recent Insurance Billing Content from Our Blog

 

How We Achieved Less Than 1% Rejection Rate For $22 Million In Claims

The average chiropractic office loses at least 3% of insurance collections thanks to delayed filing or rejected claims. This certainly adds up over time and reduces a practice’s overall revenue. However, the expense of hiring staff to track billing also adds up, and isn’t always effective if the practice’s billing procedures aren’t up-to-date.

Platinum System processes over $22 million in claims per month on behalf of our clients, with less than a 1% rejection rate. Fewer rejected claims means that doctors are paid sooner, without the hassle of follow-up to appeal the rejection.

The Platinum System SMART Insurance Billing Solution equips our professionally trained and experienced specialists with an advanced insurance billing software module. READ MORE>>

 

Is Your Billing Process Costing You Too Much Time And Money?

Pardon the pun, but billing for chiropractic care can be a real pain in the neck. The amount of time it takes to file and follow up on billing often seems like a full-time job. Not to mention, billing mistakes are costly and affect your bottom line revenue. The average chiropractic office loses a minimum of 3% of insurance collections thanks to delayed filing, unpaid claims, claims that aren’t followed up on, and misfiled claims.

But what if your billing could be handled by professional billing specialists for a fraction of the cost of employing an in-office staff member? And what if these specialists saved you time and money, and for once you actually saw an increase rather than a decrease in your collections?

That scenario is not a pipedream, it’s entirely possible. When you combine specialists who have years of experience working with insurance collections for chiropractors plus the right software, billing isn’t such a pain in the neck anymore. READ MORE>>

 

How Much Could You Be Saving With A Better Billing Service? [Free Calculator]

Let’s face it, billing is time-consuming and often frustrating. The average office loses 3% of insurance collections due to unpaid claims, slow filing, unfollowed claims, and misfiled claims.

While every chiropractic doctor is aware of the challenges and lost revenue due to billing, it’s not always as clear what do about these problems.

How do you know when it’s time to invest in an outsourced billing company, or switch to a different one? And how can you be sure that investment is going to result in a positive ROI? READ MORE>>

 

Insurance Credentialing

Starting a new practice can be overwhelming. Picking a location, negotiating a lease, designing the office, getting contractors, ordering equipment and on and on. Now Platinum System is here to help take some of the burden.

Introducing the Platinum System Insurance Credentialing program. Let Platinum System get together the forms, do the follow up, track your progress and make sure you are ready to go when it's time to open. For only a $500 dollar one time pay Platinum System will take care of everything for you. In addition for a limited time the $500 dollar fee will be credited back when when you join our Insurance Billing Solution. This promotion basically makes your credentialing free as long as you use the Platinum System Insurance Billing Solution. READ MORE>>

 

Frequently Asked Questions

Do I need to use Platinum System in my clinic to get the Platinum Insurance Billing Service? 

Yes, you need to use Platinum System because the Platinum Insurance Billing Service works with the SMART Insurance Management software created by Platinum System and it is linked with your Platinum System.

Can I use my own clearing house and get the Platinum Outsource Billing Service?

No, you absolutely need to use Gateway EDI/TriZetto as your clearing house if you want to use our Platinum Insurance Billing Service. Platinum System has created a great business relationship with Gateway EDI/TriZetto and we work closely to make sure our clients get paid the most efficient manner.

Do I have to pay the clearing house Gateway EDI/TriZetto fees?

We have different options where you can pay the fees for the clearing house (see 6% or 7% option) and we have an all-inclusive package where we will take care of the enrollment with Gateway EDI/TriZetto and the package will also include the monthly fee for the clearing house (see 8% option).

What is Gateway EDI/TriZetto monthly fee?

Pricing between $70 and $125 (A la Carte; Essential and SMART packages). Call them at 800-969-3666 to find out which package will suit your needs the best.

What is the rate you charge? 

There are three billing options to choose from:

Option 1: 6% of paid claims

- First three months: 6% of paid claims or minimum of $250 per month
- Following months: 6% of paid claims or minimum of $299 per month
- Clinic handles all P.I. and non-commercial paper claims
- The Doctor is responsible for Gateway EDI/TriZetto fee. Pricing between $70 and $125 (à la Carte; Essential and SMART packages)

Option 2: 7% of paid claims

- First three months: 7% of paid claims or minimum of $250 per month
- Following months: 7% of paid claims or minimum of $299 per month
- All paper claims are included
- The Doctor is responsible for Gateway EDI/TriZetto fee. Pricing between $70 and $125 (à la Carte; Essential and SMART packages)

Option 3: 8% of paid claims 

- First three months: 8% of paid claims or minimum of $250 per month
- Following months: 8% of paid claims or minimum of $399
- Additional doctors: add $100 per Doctor per month
- All paper claims are included
- Platinum pays Gateway EDI/TriZetto fees

What do you mean by PAID claims? 

We mean the collected amount.

Is there a minimum charge to use the Outsource Billing Service?

There is a minimum charge of $299.00 per month after three months which represents a little more than $4,900.00 of PAID claims per month with option 6% ($4,200.00 for the first three month).

When does the 6%/7%/8% fee begin after signing the Agreement?

It begins for all payments posted in Platinum after signing the Agreement and also applies to payments posted for past submissions if applicable. However, the minimum fee will be charged starting the first month (see question #11) and the minimum of $250.00 or 6/7/8% of the Insurance Paid Claims for the following months (or $299/$399 starting the 4th month).

When does the 6%/7%/8% fee end after the agreement ends?

It ends 30 days after termination notice has been received and the last payments posted by our insurance specialist.

Is there a special rate if our Insurance Paid Claims are more than $25,000 per month?

If you receive $25,000 or more in Insurance Paid Claims for a particular month, you will automatically get a 1% discount from your original Agreement.

Is there setup/installation fee?

There is no setup/installation fee but the minimum fee for the first month ($250.00) needs to be prepaid at the subscription of the Outsource Insurance Billing Service Agreement. It will be deducted from the regular monthly fee of the first month (minimum of $250 or 6/7/8% of the Insurance Paid Claims). For example, if you subscribe on February 17th and you pay the minimum for your first month ($250.00) on that date, this payment will be used on March 5th. You will resume with the regular monthly payments on April 5th.

Will you help me with the credentialing?

Yes we can help you with the credentialing (get the forms, completion of the forms, follow-up with the payers, etc.) If you want the service, the setup/ installation fee will be $500 rather than $250. It will be deducted from the regular monthly fee of the first 2 months (minimum of $250 or 6/7/8% of the Insurance Paid Claims).

How frequently will you do my insurance billing?

The frequency will depend of the number of claims you have to process per week.

How frequently will you do my insurance payment posting?

The frequency will depend of the number of ERAs and EOBs you have to post per week.

Will you do the follow up with our insurance carriers?

We will do all follow up calls with your insurance carriers but the calls requiring medical information from the doctor himself.

Will you do the follow up with our insurance carriers if the payment goes directly to the patient?

If you are a non-participating provider (out of network), it generally means payment will go to the patient. It is appropriate for patients who have paid for their services in full so they may be reimbursed by their insurance. Since the payments and EOBs are not sent to the clinic, we cannot do follow up with your non-participating carriers. However, we will generate insurance claims to accommodate the patients.

If you are a participating provider but does not accept the assignment, there is no guarantee the payments will go to you. If the clinic is not directly receiving the payments, we will unfortunately not be able to follow up on these claims.

Will you do our claims denials management?

To the best of their capacity, our billing specialists will find the reasons for denials and, when possible, they will do all necessary and legal actions to minimize the claims denials. Our billing specialists will notify you if further actions are needed.

Will you do our eligibility checks?

Our billing specialists can check patient eligibility on Gateway EDI/TriZetto portal for insurance carriers that offer it. The verification is done on demand when we connect to do your insurance billing and payment posting. However, if you need information quickly, it is better to check eligibility on your end through the payer website for more accuracy and no charge. If you want to use the eligibility feature on Gateway EDI/TriZetto portal a charge of $0.26 per inquiry for non-participating payer and Medicare will be charged. There is also a package with unlimited eligibility checks at $21/month/provider. For clients on 8% option, Platinum charges an administrative fee of $5/month + $0.26 per inquiry for non-participating payer and Medicare.

Do you collect any fees from the personal injury claims we have that are settled between us and the attorney/insurance company?

You can choose to handle your own personal injury claims if you wish. These claims are usually billed either by statement or superbill by the office. Our insurance specialist is not involved in this submission process. In addition, the transactions are billed without insurance portion so the payments you get from the attorney are posted as a patient payment. We don't collect any fees because our Insurance specialist is not involved in the process. 

If the office bills these claims on HCFA forms, you do the payment posting as an insurance payment and our insurance specialist is not involved at all, we don't collect any fees. A special setup will be required. If you want Platinum System to bill your personal injury claims, we will collect 7% fees. We will also print and mail the chart notes that must be sent along, do the payment posting as an insurance payment and any follow up for denials.

Can we handle personal injury claims in the office but not the commercial paper billing claims?

No, if your clinic chooses to handle personal injury claims billed on HCFA forms in the office, you must handle all paper claims.

What happens when HCFA forms need to be used?

When claims cannot be submitted electronically and Gateway EDI/TriZetto can’t send them on paper, because the payer will not accept paper forms printed by a clearing house, or SOAP notes must be sent along with the HCFA form, our billing specialists will create a billing task pertaining to HCFA forms to be printed by your office. HCFA forms only need to be inserted in the printer, click on print and mail the forms.

What happens if we do not want to print the HFCAs forms from our office?

If the clinic does not want to be involved at all in the process of printing and sending HCFA forms and other documentation (like the SOAP/Chart notes) that might be required by the Insurance companies, Platinum System can handle these additional tasks. In this particular situation, the rate will be 7% of the paid claims instead of 6%. In the all-inclusive package, which costs 8% of the paid claims, paper claims are included. If your clinic chooses to handle your paper claims in the office, the rate remains 8%, however, it will not be applied on the amount collected from paper claims.

What about the monthly Service Contract I am paying for my Platinum System?

If you are paying a monthly fee for your Service Contract this fee will be canceled as long as you use our Insurance Billing Service.

How does the ongoing insurance billing work?

We will regularly connect to your dedicated billing computer (see Mandatory Requirements) to do your claims submissions, post your insurance payments, handle your rejected claims and manage the insurance billing tasks. The electronic claims files will be uploaded to Gateway EDI/TriZetto and any payers that accept paper claims from Gateway EDI/TriZetto will be dropped at the office. If you need to print paper claims in your office, our billing specialists will prepare the claims and send them out for you if you choose the option to include paper claims.

How you will get the information for our patients?

Since we are not part of your staff, we will not communicate directly with your patients to get supplemental information or to validate Member IDs or insurance carriers. However, if there is a need to do so, we will send a message to the CA that the information missing so the CA can verify or obtain the information. The SMART Insurance Management software greatly simplifies the data entry of the patient insurance information required to submit insurance claims. It works mainly with insurance tasks assigned to different parties so it brings your attention solely to tasks that require an immediate action on your side. In addition, the SMART Insurance Management software directs you step-by-step in all aspects involving your input especially with the creation of a new patient file. Indeed, specific screens have been added. If mandatory information is missing, tasks will be added so we are assured to get everything that we need before processing the first submission and to not delay submissions.

When can I start?

If you already use Platinum System in your clinic, if you already have Gateway EDI/TriZetto as clearing house and if you have a free computer that can be used by our insurance billing specialist we will be able to start as soon as we have your agreement signed. If you are not currently using Platinum System in your office: The process takes between 30 - 60 days, depending on your cooperation, with data entry and returning necessary information to Platinum and Gateway EDI/TriZetto.

Do you do the insurance billing directly from our Platinum System?

Yes and no. We have created the SMART Insurance Management software to simplify the data entry of the patient insurance information and to generate insurance tasks when information is missing or wrong. It is closely linked to Platinum System as used in the clinic. The insurance billing information is exchanged in real time between SMART software and Platinum System. Our insurance specialists will generate claims submissions through Platinum System as well as payment postings, but the insurance billing management as well as the entry of the insurance information will be done through the SMART Insurance Management software.

Will I be able to follow my submitted claims?

You will get all your reports in real time and they are accessible whenever you want. Our insurance specialists will also be available to provide you with further details or specific insurance case information as you need it. The SMART Insurance Management software includes a great message center that allows for easy communication between the office and our insurance specialists.

How will you take control of my system to do the billing?

We will need to have access to a dedicated insurance billing computer in your clinic. This computer needs to be free at all times so our insurance specialists can handle insurance information validation, insurance claims submissions, insurance payments posting in transactions ledgers, follow up with insurance carriers, claims denials management, etc. If you have a dedicated server that is not used by your staff, we could use it instead of a dedicated insurance billing computer. On the dedicated insurance billing computer (or free server), we will install Remote Utilities or equivalent software in order to access your Platinum System remotely so we won’t need to contact you each time we want to connect to process your insurance claims. Again, this computer can only be used by your Platinum System Billing Specialist.

What happens if I refer a new client for the Insurance Billing Service?

You can refer a client to the Insurance Billing Service via our referral program, which offers you a twenty-five (25%) percent discount up to a maximum discount of $500 off the following months invoice after signing a Billing Service Agreement between PSCR and every new client you refer. Referrals will be paid after the new clients have been in the billing program for 3 months.

What is the process to enroll with Gateway EDI/TriZetto?

To enroll with Gateway EDI/TriZetto, call 800-969-3666. You will need to decide which package you want and will also need to enroll for paper claims and Electronic Payment Remittance (ERA). Please note that only the SMART package includes the paper claims. With all other options there will be a charge of $0.68 per claim for paper submission. As soon as you start the enrollment process, Gateway EDI/TriZetto will contact us. We will monitor the enrollment process closely and will make sure it is completed as quickly as possible so we can start doing your billing without wasting time.

Please understand that it can take up to 8 weeks before you start getting ERAs from some payers. Meanwhile, the explanation of benefit will be mailed to the clinic or can be downloaded from your current Clearing House portal. If you chose our all-inclusive package, we will take care of the enrollment with Gateway EDI/TriZetto.

Who will respond to insurance carrier notes requests?

Our billing specialists will respond to insurance carrier requests to get patient SOAP notes if we handle your paper billing claims. Otherwise, we will pass the request on to you.

Who will turn off insurance coverage when exhausted?

You will receive a billing questionnaire that will be used to establish the basic rules. Our billing specialists will act according to the answers you provide to each question. If there is an exceptional situation, you will be consulted.

Will you read insurance carriers' emails and bulletins?

All emails and bulletins sent by insurance carriers can be forwarded to our billing specialists. We will read them cautiously and will convey to you all information that requires your prompt attention.

Will you attend insurance carriers' webinars?

Yes, our billing specialists will attend webinars if needed.

What do we do with checks and paper EOBs mailed to the office?

If you receive check and paper EOBs by mail, you will need to scan them and place a copy in a specific folder. We will take care of the rest.

Are you ready to supercharge your insurance collections?

Try Platinum's Insurance Billing Service today!