Medical Billing Case Submission

Please fill out the necessary information to help with the medical billing claim submission. We will reach out to you if we need any additional information. If you are a new client, we will email you additional onboarding documents, HIPAA BAA, and credit card authorization form. We will need a credit card on file. The we will charge a transaction fee of $25 for each claim submitted and $375/per month/provider technology fee at the end of each month.


We offer our group discount to a professional medical billing platform. This software allows us to be effective and efficient. We will be able to send your claims electronically, receive electronic remittance advice immediately, be able to correct the claim rejections, receive explanation of benefits electronically, submit electronic attachments, and provide in-depth reporting. Most of all, we can work independently from your dental software. The medical billing software monthly subscription total cost per month is $375/provider.

a. medical billing software access $150/month/provider


b. eclaims provider enrollment $75/month/provider


c. clinical medical billing module $150/month


You also have the option to add on $50/month medical billing support. This service is for up to 5 cases per month, each dditional case $15/each.



Medical Billing Academy

division of Dental Claims Cleanup

1810 Erie Blvd., Syracuse, NY 13210

(800) 652-3431

https://dentalclaimscleanup.com/dental-medical-billing



Medical Billing Academy- Medical Billing Training Course ($4000 virtual 8 hr training)

1. one day online training for team (up to 12 attendees, $200 each additional attendee)

2. digital patient intake form

3. medical claim work flow template for the team

4. medical billing clinical digital intake form for the team

5. medical billing support subscription $50/month 5 cases, then $15/per case AFTER training

6. templates for letters of medical necessity

7. medical claim submission & follow-up fee after training

8. templated clinical notes



Do It Yourself AFTER training ($375/month/provider)

1. medical billing software access $150/month

2. eclaims provider enrollment $75/month

3. clinical medical billing module $150/month

4. medical billing support subscription $50/month 5 cases, then $15/per case


B. Outsource to Dental Claims Cleanup

1. medical billing service $2250/month for each provider

2. prorated fee for larger office (we use the dental claim volume for the office)

3. base of up to 50 claims, $20 per claim above the base of 50

4. Includes follow up on the claims and accounting of the EOB into dental software and send a statement


C. Pay Per Claim Medical Billing

1. service includes initial claim submission only @ $25/claim

2. follow up on claims by the office team

3. medical billing software subscription $375/month/provider

a. medical billing software access $150/month

b. e-claims provider enrollment $75/month

c. clinical medical billing module $150/month

d. medical billing support subscription $50/month/up to 5 cases, then $15/per case


Medical Billing Academy division of Dental Claims Cleanup 1810 Erie Blvd., Syracuse, NY 13210 (800) 652-3431 https://dentalclaimscleanup.com/dental-medical-billing
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History of Present Illness or Condition

Claim submission-filled out by office team

Patient intake-patient fills out

Do you have a history of any of the following?

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Describe what you do for the symptoms or condition, what has worked and whaat has not worked and why.


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Clinical exam

completed by Dentist or Dental Assistant


for cases- TMD, trauma, pain

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for cases- Pathology

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Diagnosis and Treatment Plan

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