Frequently Asked Questions

Choosing a medical billing company is a big decision, and you may have some questions. Here are some of the most common ones; we are always available to speak with you should your question not be on the list.

General questions about billing, our company, and our services

New Medical Practice

Established Medical Practice with In-House Billing

Established Medical Practice with Outsourced Billing

General questions about billing, our company, and our services

1.    How does reducing my A/R days outstanding help my bottom line?

According to the MGMA, the average medical office has 52.32 days receivables outstanding, with 20 percent of A/R balances days past due. There is only a 50 percent recovery rate of the gross charge when an account has not paid within 90 days. That’s a lot of money to leave on the table! When you work with Y Risk HealthCare, we do everything in our power to collect that money and improve your A/R.

2.    My practice currently has a lot of problems with rejected claims. What can you do for us?

Glad you asked! The average number of rejected claims for a medical practice is 30 percent, and only 50 percent of these claims are ever resubmitted. We work these claims like a bulldog. We pursue all disputed and unpaid medical insurance claims with aggressive follow-up until there is a resolution.

Through our interactive tools, both you and we will know instantly what the status of a claim is and we can jump on it the very same day. Many claims are rejected because of improper coding or lack of supporting material; these problems are virtually eliminated by working with Y Risk HealthCare.

3.    Do you work with all kinds of specialties or just a select few?

As one of the larger medical billing companies, we work with all specialties in all locations, across the country.

4.    How quickly can I get up and running?

Our goal is to get the entire process in place for you within one week.

5.    How can you ensure fast carrier payout?

Our daily electronic claims submission leads to immediate carrier response. We offer among the fastest payouts in the industry – most within 10 to 14 days.

6.    Do you comply with HIPPA and OIG?

Absolutely! Y Risk HealthCare meets all HIPAA requirements and supports OIG resolutions.

7.    What if you’re not able to collect? Do we still have to pay you for your efforts?

Here’s the beauty of working with Y Risk HealthCare. Our success is tied to your success. We only charge you a percentage of the collections that result directly from our service. We’ll clearly establish a customized rate for your practice right from the very start.

8.    How about those start-up costs I hear about? What hidden costs should I expect?

Rest easy! Y Risk HealthCare never charges you for transfer fees, supplies, or any other start-up costs associated with our excellent medical billing services.

New Medical Practice

9.    I am starting a new medical practice and expect to have little volume to start with. Am I going to get the same level of service as established practices?

Every client, regardless of size, works with a dedicated account manager and a dedicated medical billing team. The client and our staff work on the same practice management and billing system which ensures that every client receives the same quality of service.

We welcome working with new medical practices because it gives us an opportunity to help you grow your practice, and we hope the relationship we build will translate into many years of business relationship.

10.  We are extremely busy setting up our new office. How quickly can we start billing through Y Risk HealthCare?

We can setup your account within 2-3 days. Once it is setup you can start entering visits right away, and we can start submitting them for reimbursement within 1 week (if your payer credentials are available). We also offer data entry services in case you don’t have an office staff.

11.  Wouldn’t I save money by doing the billing in-house?

That’s a common misconception. Actually, it can end up costing you far more money. Consider all your expenses with an in-house staff: salaries, benefits, taxes, hardware and software technology, continual training to keep up with the latest Medicare and insurance changes, retraining when the person you’ve come to rely on moves on from your practice. In the long run – and even the short run – you can often save more by outsourcing.

12.  I am currently researching medical billing services. What makes your stand out from the rest?

As a medical billing company we are dedicated to our customers and their success. After all, our success depends on yours. Here are some facts about Y Risk HealthCare and our services that you might find interesting.

  • We offer complete practice management system for FREE that allows YOU to monitor OUR performance 24/7
  • are electronically connected to over 4,000 payers, and have some of the best reimbursement time frames
  • We assign a dedicated account manager and team to work on your billing
  • We offer highly competitive rates
  • We DO NOT OUTSOURCE overseas and hire only within United States
  • We are a proud member of Better Business Bureau

Established Medical Practice with In-House Billing

13.  I’ve heard that it’s expensive to outsource. Why not just keep my billing in-house?

All too many practices just look at the bottom line without analyzing all the real costs of keeping billing in-house as opposed to outsourcing. The reality is, you could actually save significantly while increasing your collectibles.

If you do in-house billing, salary is generally only about 70% to 75% of your employee costs – adding in payroll taxes, FICA and insurance. You pay for your specialists sick days, vacation days, and family leave days. You pay for their training and re-training. You pay for turnover costs when they leave your practice, which most inevitably do. And, when your staff is under pressure during busy times, you also could pay for inadvertent medical billing and coding errors that leave money on the table.

Y Risk HealthCare provides a dedicated team of experts and we charge a small percentage only for what we collect on your behalf. When you add up the numbers, Y Risk HealthCare makes sense.

14.  I’m happy with my current staff. Will I need to let them go in order to work with you?

Not necessarily. You can switch their focus to supporting you with patient care – or with data entry — while we handle all your billing and collections. Of course, if saving costs is important to you, you can, indeed, let some of your staff go.

15.  We already have a system in place for billing. Can you transfer my patient data to your system?

In many cases, we can. We always work with your practice to come up with the best way of transferring data quickly and accurately.

16.  What is the start-up cost to switch billing from in-house to you?

There is a one time $495 enrollment fee. There are no other maintenance, support, or ongoing fees.

We’ve performed the EDI set-up many times and know exactly what information is needed. We take care of the entire process and make certain there is no revenue interruption. On the contrary, the vast majority of our clients see a revenue increase after they’ve switched billing to Y Risk HealthCare based on the speed and accuracy of our process.

17.  Right now, if I have a billing question, I just go out to my front desk and ask my staff. What if I can’t reach you?

That’s a common concern, of course. The fact is, thanks to our interactive patient management tools, you can get the answer you’re looking for in literally seconds. You can view insurance payer, verify your new patient’s insurance, set up new visits with comprehensive supplemental information, see which claims have been denied and why, and so much more. No need for one of your staff members to sort through files and make phone calls on your behalf – everything’s right at your fingertips.

Established Medical Practice with Outsourced Billing

18.  I’ve been working with another medical billing service for years. I’m not 100% satisfied, but is it really worth it to switch?

That’s up to you to decide, of course, but we believe the answer is an emphatic yes! Ask yourself these questions: do you know when your claims are sent and even if they’ve been sent? Can you check on the status of your claims online day or night, or do you need to wait for a cumbersome monthly report? Do they handle patient invoicing and collections? Are they communicating effectively with you? How fast are their collection times?

Y Risk HealthCare is an expert in getting your claims paid fast and to aggressively fight denials, with our highly-trained medical billing specialists and our state-of-the-art intuitive software. At a time when insurance carriers are using data mining to create virtually millions of edits to reduce payments and deny claims, you can’t afford anything less than the best in making sure you leave no money on the table. A very brief transition period can end up saving you tens of thousands of dollars down the line.

19.  Won’t it be confusing for some claims to be processed by our current firm and others by you? What can you do to alleviate this concern?

We’ve rarely had difficulty in navigating the transition; in fact, our system is set up to ensure that you continue to bill quickly and get paid. First, we set up your account in our system and file an ERA form to switch ERAs to us. This could take a month or two, so during that time, we use paper EOBs to enter payments.

We identify the new claims submitted by us because we assign a special ID to each claim that starts with Y RISK HEALTHCARE. We take great care to select and follow through only on claims processed by us during the transition period so there’s no confusion.

20.  What about our Medicare and Medicaid payments? How does that work during the switch?

First, we file an EDI application, which usually takes two to three weeks to process. In the meantime, you can enter charges into our system right away. Once we receive a confirmation of the EDI set-up, we release all the accumulated claims at once to the payer for fast payment.

21.  We already have a system in place with our current medical billing firm. Is there an easy way to just transfer patient data?

A lot depends on what system your current biller is using, and if that system allows export of data. In many cases you should be able to get at least an Excel file. Once you have the patient data we will work with your practice to come up with the best way of transferring data to our system quickly and accurately.

22.  What is the start-up cost to switch billing from them to you?

There is a one time $495 enrollment fee. There are no other maintenance, support, or ongoing fees.

We’ve performed the EDI set-up many times and know exactly what information is needed. We take care of the entire process and make certain there is no revenue interruption. On the contrary, the vast majority of our clients see a revenue increase after they’ve switched billing to Y Risk HealthCare based on the speed and accuracy of our process.

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