WCH Medical Billing Contract changes coming up January 2015
Dear Clients, Effective January 1, 2015, WCH is making important changes to your existing billing agreement.
WCH will be sending out updated billing agreements to you for signatures in the beginning of the Yew Year. Below, we have included account terms changes as well as new amendments that represent and protect both parties. We would like for you to be familiar with these terms earlier so that many of your questions can be answered in advance.
The account terms changes include, but are not limited to, the following:
Client’s obligation to comply with WCH requests to perform random review of medical records
According to HHS/OIG “Compliance Program Guidance for Third-Party Medical Billing Companies” WCH performs random review of all and any records related to billing services and has a right to request such information from our clients. Client is obligated to provide WCH with all requested documentation including but not limited to signs in sheet, progress notes, progress reports and etc.
Benefit for you:
It’s another way WCH is protecting our clients against submission of erroneous claims to insurance companies. All claims must reflect the services performed at the time of the visit. Buy randomly selecting to review the medical records, we are checking that the claims we submit contain
accurate data.
Clients are responsible for providing all statement/documents resulting from WCH billing services to WCH within 5 days upon its receipt.
Any payments, EOB, patient’s statements, etc received by clients must be sent to WCH within 5 days.
Benefit for you:
WCH can start processing and appealing partially paid and denied claims much faster compare to previous time frame of 10 days. We will also post the payments faster and update your account to reflect the most current status.
Payment refunds for patient bills
WCH changes the terms of issuing patients checks back to you within 2 weeks compare to 30 days processing waiting time. Under the new agreement we will issues checks for patient payments that are processed through WCH, same day as WCH bi-weekly billing invoice is issued.
Benefit for you:
You will get your patients bills payments faster.
Termination clause for billing service
WCH is adding a 30 day termination clause to our billing service agreement. Either party has a right to terminate the agreement, for any or no reason, upon 30 days written notice. WCH is responsible to finish all work for a client and process all claims that have been submitted on their behalf. To fulfill this obligation WCH reserves 90 days upon the termination of agreement for most collection cases.
Charges for denied claims
WCH will charge $6.79 per claim that has been denied due to client’s fault or mistake. Client will not be charged for claims if the overall amount of problem claims will not exceed 1%.
Benefit for you:
These charges will motivate your office to reorganize your front desk operations and overall improve internal eligibility and authorization process.
It’s a Law! Clients must have direct communication with WCH Account Representatives
According to recommendations of OIG frequent communication between the billing company and the billing health care provider is fundamental to the success of any compliance process. Besides routine communication between WCH and clients’ office staff, WCH and billing health care professionals must have direct regular communication to gather and provide accurate billing information. Effective communication between a practitioner and WCH is a significant aspect of a practice’s efficiency, documentation improvement, medical claims processing, correct and potentially increased reimbursement and compliance.
Benefit for you:
You have only one license, and we are here to protect it. By having scheduled communication with your account representative you will be fully aware of all billing processes currently handled by WCH. You will know the status of claims, appeals, and reasons for denied claims and receive the latest healthcare updated from the insurance industry. Benefits all served to inform and protect you!
WCH compliance program
According to HHS/OIG “Compliance Program Guidance for Third-Party Medical Billing Companies” WCH maintains compliance plan as a service bureau. The compliance plan includes internal company policies, regulations, billing, coding and collection manual. This compliance plan is submitted every year to OMIG as required by the compliance office.
Benefit for you:
WCH provides service based on state regulations and internal protocols, all serving to protect and support our clients.
Contracted with Experian Credit Bureau to report all payers
As part of our commitment for excellence in cash flow management, WCH continues to work with Experian Credit Bureau to keep improving operation efficiency. Experian produces credit reports that measures and records company’s and its client’s payment habits to ensure that cash flow and revenue processes are up to date. All clients’ accounts are recorded by Experian in order to ensure constant cash follow so that WCH can meet its obligations to suppliers, customers and employees.
Signature on super bills
WCH will not accept any superbill that has not been signed by a rendering health care provider for billing
Benefit for you:
WCH is protecting you as a provider to make sure that we bill the services that you had performed.
Suspension of billing services for non-payment
In case a client defaults in payment to WCH for billing services, WCH has a right to suspend services until the full payment is received. The client will be informed of the suspension by their account representative or supervisor. WCH will resume billing services after payment in full amount is received and cleared by the bank.
The updated agreements will be sending out to our clients starting January 2015. Should you have any questions, please do not hesitate to contact your account representative. We appreciate your full cooperation in returning signed agreements to WCH in timely manner.
Starting January 2015 the late fee charge for no payment of billing invoice will be 35$.
Sincerely,
Anna Kim, WCH Legal Department
