Fees

PremiumPlus Medical Billing Service

• Standard Per-Claim PremiumPlus Fee:  $ 2.89 per claim (minimum fee of $99.95 per month)

• PremiumPlus Service Annual Prepayment Options:

  • 1000 claims for $2590.00 ($2.59 per claim)

  • 2500 claims for $5475.00 ($2.19 per claim)

  • Money-Back Guarantee:  For information on our money-back guarantee, click here.

  • NOTE:  Under the Annual Prepayment Options, providers must use the number of claims submitted within one year of the date of purchase.
    • For providers who purchase a prepayment option when they first sign up and receive free claims as a promotional special, the one year time period begins to run after the months of free claims.
    • EXAMPLE:  Provider signs up and purchases a 1000 claim prepayment option on June 1st and receives 2 months free.  The one year time period begins to run on August 1st.  Any claims remaining that are not used by the following August 1st are lost as the prepayment option will have ended on July 31st.
    • For providers who purchase a renewal of a prepayment option, the one year time period begins to run the date your office runs out of claims under your current option.  EXAMPLE:  Your office is submitting claims under a 1000 claim prepayment option.  On June 1st you purchase a renwal as you are running out of claims.  Your office submits the last claim under the original prepayment option on June 7th.  The one year time period begins to run on June 7th and thus the claims purchased must be used by the following June 6th or be lost.
• Optional Services:
  • Insurance Verification Service.  For new patients and for patients who change insurance, MBPros can verify the patient’s eligibility and benefits.
    • Fee–$7.95 per verification
  • On-Demand Follow-Up Service.  For claims that deny in error on an EOB OR remain outstanding after 30 days from submission, upon request MBPros can follow up with the payers, either by calling the payer or filing required appeals for claims that deny in error.
    • Fee–$12.95 per claim followed up upon.
• Calculate Your Savings and Your Per Claim Cost
  • Are you currently using a billing service charging a percentage?  STOP overpaying.
  • With our PremiumPlus Service and our optional insurance verification and on-demand service, you can SAVE compared to a billing service charging a percentage.
  • Calculate your per-claim and monthly costs using MBPros at http://www.mbpros.com/save.  By using this form you can also calculate your monthly costs using a billing service charging a percentage to see how much you can save.   Only 2-3% of claims require follow up so the form can automatically calculate 3% of claims requiring follow up (although you can change this number on the form).
    • For example, if your office submits on average 20 claims per week and requires 1 verification per week, you would pay on average $3.74 per claim to MBPros (assuming you choose our standard per claim rate).  If you are reimbused on average $80 per visit and you are paying another billing service 7% of the amount paid, you would SAVE $1852 per year by using our PremiumPlus Full Service (including insurance verifications and follow-up).
    • Using the above example, if you instead would choose our 1000 claim PremiumPlus prepayment option, you would pay only $3.44 per claim on average to MBPros and save over $2100 per year compared to a billing service charging a percentage.
• EAP Billing:
  • For payers that accept EAP claims via electronic claims (837P format) such as United Healthcare (Optum Beahvioral Health) and Cigna, we can submit the claims for our standard rates.
  • For payers that do NOT accept EAP billing via ANSI 837P claims (regular electronic claim submissions) but instead require you to complete a specific form with clinical information, your office will have to submit the EAP billing yourself on the form the payer mandates with the clinical documentation the payer requires.

• NOTE:  Fees for PremiumPlus Service include all accounts receivable posting:  insurance payments and patients payments. 

Premium Medical Billing Service

  Claim Submission

• Standard Per-Claim Service Fee:  $2.45 per claim (minimum fee of $69.95 per month)

• Premium Service Annual Prepayment Options:

  • Purchase 1000 claims for $2150.00 ($2.15 per claim)

  • Purchase 2500 claims for $4375.00 ($1.75 per claim)

  • Money-Back Guarantee:  For information on our money-back guarantee, click here.

  • NOTE:  Under the Annual Prepayment Options, providers must use the number of claims submitted within one year of the date of purchase.
  • • For providers who purchase a prepayment option when they first sign up and receive free claims as a promotional special, the one year time period begins to run after the months of free claims.
    • EXAMPLE:  Provider signs up and purchases a 1000 claim prepayment option on June 1st and receives 2 months free.  The one year time period begins to run on August 1st.  Any claims remaining that are not used by the following August 1st are lost as the prepayment option will have ended on July 31st.
    • For providers who purchase a renewal of a prepayment option, the one year time period begins to run the date your office runs out of claims under your current option.  EXAMPLE:  Your office is submitting claims under a 1000 claim prepayment option.  On June 1st you purchase a renwal as you are running out of claims.  Your office submits the last claim under the original prepayment option on June 7th.  The one year time period begins to run on June 7th and thus the claims purchased must be used by the following June 6th or be lost.

Fees For All Levels of Service:

  ClaimMD Clearinghouse Access:

• Do you want to access online the ClaimMD clearinghousse portal to view claims submitted electronically by MBPros, view ERAs (electronic EOBs) and check eligibility?  We offer OPTIONAL ClaimMD portal access as follows with the below fees charged directly by ClaimMD to your office:
  • Unlimited:  $100 per month
  • Small Volume:  $50 per month for up to 100 transactions
  • Basic:  $25 per month plus 30 cents per transaction
  • MBPros Monthly Credit:
    • To help providers with the above fees, we will provide a monthly credit on your invoices with us:
      • $20/month credit for practices that choose the Unlimited option.
      • $10/month credit for practices that choose the Small Volume or Basic Option
  • For detailed ClaimMD pricing, visit:  http://www.claim.md/pricing.
  • No Portal Access:  For providers who do not want access to the ClaimMD clearinghouse, MBPros charges an $11.95/month clearinghouse fee.
• For more information about ClaimMD, including video demos of various aspects of their portal, visit:  https://docs.claim.md/docs/en/quick-start-guide
• Note:  This does not apply to TherapyNotes users.  Because all claim and payment information is inside TherapyNotes, you will access the ClaimMD clearinghouse billing history and ERAs directly inside TherapyNotes.
  

Supplemental Tax ID Numbers:

• If your practice submits claims using more than one Tax ID number, a supplemental fee of $29.95 per month per additional Tax ID is charged.

  • Example:  Your office uses an EIN to send to most payers but you use the provider’s personal Social Security number to submit to select payers.

Additional Medisoft Network User Fees:

• For practices with access to our Medisoft Network, your access is for one person to access your data.

• If your office needs more than one person accessing accessing your data at one time, you can purchase an additional user license for $159.95.

• In addition, there is a fee of $4.95 per month for each additional user accessing the Medisoft Network.

Reports

• For all reports that providers request MBP to provide, a fee of $5.95 per report is assessed.
• There is NO fee for reports provided as part of the PremiumPlus Service on a monthly basis.
• There is NO fee for the Claim Submission Report automatically provided to all providers immediately after claims are submitted.

Authorization and Benefit Tracking:

• Do you have claims deny because you do not have a valid referral or treatment plan on file?

• Do you have claims deny because a patient has used their benefits for the year?

• MBP’s authorization tracking service will track the number of visits allowed under a treatment plan OR the end date of a referral to ensure you do not treat patients beyond the authorized number of visits or the end date of a referral.

• On a weekly basis MBP will email you two reports showing you referrals and authorizations about to expire.  See the below examples:

  • 14_Day_Future_Expired_Treatment_Authorization_Worksheet.pdf

  • Expired_Treatmen_0Authorization_Worksheet.pdf

• MBP’s benefit tracking service will track the number of patient visits allowed per year OR the maximum dollar amount allowed under the patient’s coverage per year.

• For more informatoin about the Authorization and Benefit Tracking Service, visit:  Authorization and Benefit Tracking

• Fee:  $29.95 per month

• This service is not available for Medisoft Network Basic Service providers.