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Q. How am I legally
entitled to be paid for the technical component
of the test?
A. Our in-office diagnostic procedures
have been approved by national health law.
Leasing our medical technician and equipment
for each test, while overseeing the procedure
in your office, entitles you to reimbursement
for the technical components of the tests.
Q.Will this count against
my treatment allowance with insurance companies?
A. Insurance companies typically
list diagnostics under an allowance separate
from treatment coverage.
Q.What do the technical
and professional components mean?
A. The technical component is the
actual performance of the test. The professional
component is the interpretation of the diagnostic
test by a board-certified neurologist or
radiologist, who will generate a report
of findings.
Q.What insurance covers
diagnostic testing?
A. All PPOs, solid P.I. cases on
a lien, P.I. with Med-Pay and P.I.P. cases,
and worker's compensation.
Q. How quickly can
you begin testing?
A. 2-3 days.
Q. What is the average
turnaround time for reimbursements?
A. Insurance companies vary, but
on the average, it ranges from 4-12 weeks.
Q. Do the reimbursements
vary for different healthcare professionals?
A. There is a preset reimbursement
allowance for diagnostic exams, and it is
usually consistent for all ordering physicians.
(M.D., D.C., D.O., D.P.M.)
Q. Do we need to verify
coverage to perform the tests?
A. Yes, in the states where pre-authorization
is required, Proactive Medical Diagnostics
will assist you in verifying coverage.
The Right Answers for
the Right Questions
What does the company
bill out for their professional services?
It is often overlooked but later realized
that not all companies bill for services
in an ethical manner. Make sure you are
comfortable with their billing procedures
and practices.
What services and support
do they provide to assure you and your patients
get the most out of the testing.
Look for services such as patient scheduling
assistance, insurance verification on your
behald, billing services and support and
claims and appeals. These ancillary services
are important components of a superior company.
What are their limitations
as to Medicare and Medicaid?
Look for a company that will accommodate
the needs of your practice and all of your
patients.
Are there contractual
commitments, testing quotas or financial
obligations?
A solid company should provide services
without limitations, exceptions and ongoing
fees.
What are their policies
on billing patients?
Find out in advance from the company versus
later from your patients.
Ask for documents,
references, credentials and ask questions.
Your patients will appreciate it and a quality
company will expect it!
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