Frequently Asked Questions
At AdvancedMD Medical Billing, we believe complete transparency is the foundation of a successful RCM partnership. Below are answers to the most common questions we receive from physician practices, clinics, and Part B professional service providers.
General RCM & Practice Management
Q: What specific services do you offer?
A: We provide complete Revenue Cycle and Practice Management solutions exclusively for physician practices and clinics, focusing on Part B professional service providers—ensuring clean claims, faster payments, and reduced administrative burden.
Q: Do you offer custom‑made RCM solutions?
A: Yes. If your practice has unique requirements—whether related to billing software, credentialing workflows, prior authorizations, or patient inquiry handling—we build a tailored solution around your existing processes.
Q: Do you have your own billing software?
A: No, we do not operate proprietary software. Instead, we provide our clients with third‑party premium billing software for ease of use and flexibility.
Q: Can you provide other billing software if we prefer a different platform?
A: Absolutely. We maintain a list of various third‑party billing systems. You can choose the software you feel most comfortable with, and we will integrate and manage it for you.
Q: Will your team handle patient inquiries about their statements?
A: Yes. We take full responsibility for all patient communication—whether related to billing questions, statement clarifications, or payment disputes.
Q: What reports will I receive, and who manages my account?
A: You will be assigned a dedicated Account Manager, Team Lead, and support team. You will receive daily, weekly, and monthly statements on your practice’s financials, performance, and overall revenue health. You also get full, on‑demand access to the billing system to review our work.
Q: How do you handle insurance refund requests?
A: We first verify with the insurance provider whether the refund request is legitimate. If valid, we attempt to offset the amount against future payments. If the insurer refuses an adjustment, we notify your practice immediately so you can issue the refund.
Q: Which specialties do you cover for prior authorizations?
A: We offer authorization services across many specialties, including: Electrophysiology, Cardiovascular Disease, General Surgery, Psychiatry, Pediatrics, Podiatry, Internal Medicine, Gastroenterology, Dermatology, Family Practice, Mental Health, Counseling, Ophthalmology, Chiropractic, Oncology Radiology, Rheumatology, Urgent Care, Speech Therapy, Physical Therapy, and Occupational Therapy.
Q: Do you alert us when a patient’s authorization is about to expire?
A: Yes. We track expiration dates and notify you in advance. We begin the re‑authorization process before the current one expires to avoid treatment or payment delays.
Q: How long does prior authorization typically take?
A: Most authorizations take 7 to 14 business days to process, though timing depends on the specific payer.
Q: What if an authorization is denied by insurance?
A: You have the right to appeal. If you believe the denial was made in error, we help prepare and submit an appeal—especially when the service is medically necessary and well documented.
Q: Do you communicate with Primary Care Physicians for referral inquiries?
A: Yes. We contact PCP offices via calls and faxes, and we follow up consistently until the referral request is complete.
Q: How does your eligibility and benefits verification process work?
A: We request patient eligibility and benefit details from your scheduler two days prior to the appointment. We then email the benefit summary to you and upload the notes to your EMR system for easy access.
Q: What if we add patients the day before or on the same day as the appointment?
A: We adapt quickly. As soon as new patients appear on your scheduler, our team prioritizes verification to provide you coverage details before the patient is seen.
Q: What happens if a patient’s insurance is inactive or excludes specific services?
A: We immediately inform your practice of the issue. This allows your front desk to contact the patient before the appointment to discuss financial responsibility or reschedule, saving you from denied claims.
Q: Do you review medical records before coding claims?
A: Yes. We examine each medical record for the services rendered and assign the correct CPT, ICD, and HCPCS codes to ensure compliant, clean claim submission.
Q: Can I code the claims myself and have your team review them?
A: Absolutely. If you prefer to assign CPT/ICD codes, our team will audit your codes, provide feedback on compliance, add necessary modifiers, and highlight any areas needing correction to maximize reimbursement.
Q: Do you use CPT and ICD codes to review claim denials?
A: Yes. For every denial, we analyze the codes and modifiers used, make necessary adjustments, and resubmit the claim with corrected coding to secure payment.
Q: What is your turnaround time for coding?
A: We typically code claims within 24 hours of the practitioner signing off on the medical records.
Q: Will you file claims in my practice’s best interest?
A: Yes. We handle both paper and electronic claim submissions to the clearinghouse, and we manage denials aggressively to maximize your revenue.
Q: Will my team have full access to see payment and claim details?
A: Yes. We support complete transparency. Upon request, your team will have full access to the billing system to view claims, payments, and generate reports at any time.
Q: Who is our point of contact for billing and collections questions?
A: A professional account manager is assigned to your practice and is available by direct phone and email.
Q: How often do you provide billing and collection status updates?
A: You will receive daily email assessments of billing and collections activity. A weekly summarized report is also provided.
Q: How frequently do you work on denials and rejections?
A: We work on clearinghouse rejections, payer denials, and appeals daily. A weekly summary report is shared with your practice.
Q: What specific reports will you deliver?
A: Our reporting package includes: Monthly Financials, Missing Claim Tracking, Monthly Aging (AR) Numbers, Missing Information Reports, and any other billing report on demand.
Q: Do you send statements to my patients?
A: Yes. Patients receive regular statements according to a billing cycle that we customize to your practice’s preferences.
Q: What if my patients have questions about their bills? Who do they contact?
A: Our experienced customer service specialists handle all patient inquiries regarding invoices and payments. Your patients never need to chase you down.
Q: Will you review my patients’ statements, and what outcome should I expect?
A: Yes. We review each patient’s statement, the date(s) of service, procedures rendered, and outstanding balances—whether due from the patient or the payer.
Q: Do you update Coordination of Benefits (COB) with payers?
A: No. COB updates can only be initiated by the patient (due to payer rules). However, we guide your patient on exactly what to tell the payer to resolve the issue.
Q: How often do you send reminder calls to patients?
A: We first send billing statements via the clearinghouse on a 28‑day cycle per your practice policy. If patients do not respond, we then call or leave voicemails as a friendly reminder. For persistent non‑payment, we compile statements and return them to you for potential recovery agency handoff.
Q: Where do patient calls get routed?
A: Your patients can call us from 8:00 AM to 5:00 PM (your local time zone) . Their calls route directly to our head office, where a patient help desk specialist provides immediate assistance.
Q: What is the credentialing process, and how do I become participating with insurers?
A: Medical credentialing is the verification of a physician’s qualifications, licenses, and work history to ensure accuracy within insurance systems. We help you contract with top payers so you can join their health plans.
Q: Which insurance companies will you enroll my practice with?
A: We enroll you with the maximum number of insurance companies within your state, including setting up EFTs (Electronic Funds Transfer) and EDI (Electronic Data Interchange) for automated payments.
Q: How long does credentialing take?
A: Credentialing typically requires 3 to 6 months, depending entirely on the availability and speed of each insurance panel.
Q: What is the process for provider credentialing?
A: It involves submitting your documentation and CAQH profile to payers, who then verify your credentials and abilities. We manage the entire submission, follow‑up, and re‑attestation process for you.
Q: Can I add a new physician to an existing group?
A: Yes. Simply provide us with the new physician’s information, and we will submit the addition to each insurance company on your behalf.
Q: What is a Virtual Medical Assistant, and how does it differ from your RCM services?
A: A Virtual Medical Assistant (VMA) is a remote, non‑clinical staff member who handles administrative tasks that don’t require a medical license. While our RCM team focuses on billing, coding, and collections, VMAs support your front office and clinical workflows—freeing your in‑house team to focus on patient care.
Q: What specific tasks can your Virtual Medical Assistants perform?
A: Our VMAs are trained to handle:
Patient scheduling – appointment booking, rescheduling, cancellations, and confirmation calls.
Inbound/outbound patient calls – answering basic questions, routing clinical issues to your nurses, and collecting patient demographics.
Insurance verification – performing eligibility checks and documenting benefits (often as a pre‑step to our full verification service).
Referral tracking – calling PCP offices, faxing forms, and following up until referrals are secured.
EMR data entry – updating patient charts, scanning documents, and entering lab results under your supervision.
Prior authorization support – gathering initial documentation and submitting requests (which our dedicated auth team then reviews).
Patient payment collection – taking credit card payments over the phone and posting them to your system.
Patient scheduling – appointment booking, rescheduling, cancellations, and confirmation calls.
Inbound/outbound patient calls – answering basic questions, routing clinical issues to your nurses, and collecting patient demographics.
Insurance verification – performing eligibility checks and documenting benefits (often as a pre‑step to our full verification service).
Referral tracking – calling PCP offices, faxing forms, and following up until referrals are secured.
EMR data entry – updating patient charts, scanning documents, and entering lab results under your supervision.
Prior authorization support – gathering initial documentation and submitting requests (which our dedicated auth team then reviews).
Patient payment collection – taking credit card payments over the phone and posting them to your system.
Q: Will the Virtual Medical Assistant be dedicated to my practice only?
A: Yes. We assign a dedicated VMA (or a small team, depending on your volume) who learns your specific workflows, EMR shortcuts, and patient communication style. You get consistency, not a random person every day.
Q: How do I ensure patient data remains secure with a remote assistant?
A: All our VMAs are HIPAA‑trained and work from secure, monitored environments. They access your systems via encrypted VPNs, and we sign Business Associate Agreements (BAAs) for every practice. We also offer screen‑recording and audit logs upon request.
Q: Can the Virtual Medical Assistant handle both clinical and billing calls?
A: VMAs are non‑clinical—they cannot give medical advice, triage symptoms, or discuss lab results. However, they can handle billing questions if you choose to integrate them with your RCM workflows. Alternatively, we can keep billing calls routed to our Patient Help Desk (see above) while VMAs focus on scheduling and admin.
Q: How many hours per week do I need to commit?
A: We offer flexible models:
As‑needed – pay by the hour with no long‑term contract.
Part‑time – e.g., 20 hours/week, usually mornings.
Full‑time – 40 hours/week, fully dedicated.
Most small practices start with 20–30 hours and adjust after 60 days.
As‑needed – pay by the hour with no long‑term contract.
Part‑time – e.g., 20 hours/week, usually mornings.
Full‑time – 40 hours/week, fully dedicated.
Most small practices start with 20–30 hours and adjust after 60 days.
Q: Can the Virtual Medical Assistant work in my time zone?
A: Absolutely. We match the VMA’s schedule to your practice hours (e.g., 8 AM – 5 PM Eastern Time). Overlap with your in‑office staff is optional but recommended for training.
Q: How quickly can I get a Virtual Medical Assistant started?
A: Typically within 5 to 10 business days. We use the first 3 days for HIPAA orientation, EMR access setup, and workflow shadowing. You provide a simple task list and credentials; we handle the rest.
Q: Do you offer a trial period for the Virtual Medical Assistant?
A: Yes. We offer a 14‑day risk‑free trial at a reduced rate. If you’re not satisfied, you pay nothing for the trial. This is separate from our $3 billing starter plan.
Q: How is the Virtual Medical Assistant billed?
A: We bill monthly in arrears based on actual hours logged (rounded to 15‑minute increments). There are no setup fees, software license fees, or hidden costs. You receive a detailed timesheet each week.
Q: What if I already use an RCM company for billing—can I still hire just the Virtual Medical Assistant for front office tasks?
A: Yes. Our VMA service is completely standalone. You can use any billing company (including none) and still leverage a VMA for scheduling, calls, data entry, and referrals. We integrate with whatever EMR or practice management system you already have.
Q: Will the Virtual Medical Assistant help reduce my no‑show rate?
A: Absolutely. VMAs send appointment reminders (calls, texts, or emails based on your preference), confirm the day before, and fill cancelled slots from a waitlist. Practices typically see a 20‑30% reduction in no‑shows within the first two months.