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Fees

Platinum Medical Billing Service

All of the following included for one low fee:

  • Claim Submission
  • Accounts Receivable Posting
  • Follow-Up of Outstanding Claims
  • Insurance Verification
  • Authorization and Benefit Tracking

For more information about the Platinum Medical Billing Service, click here.

  • Standard Per-Claim Service Fee:  $3.99 per claim (minimum fee of $199.95 per month)

  • Platinum Service Annual Prepayment Options:

    • Purchase 1000 claims for $3650.00 ($3.65 per claim)

    • Money-Back Guarantee:  For information on our money-back guarantee, click here.

    • NOTE:  Under the Annual Prepayment Options, providers must use the number of claims submitted within one year of the date of purchase.
      • For providers who purchase a prepayment option when they first sign up and receive free claims as a promotional special, the one year time period begins to run after the months of free claims.
      • EXAMPLE:  Provider signs up and purchases a 1000 claim prepayment option on June 1st and receives 2 months free.  The one year time period begins to run on August 1st.  Any claims remaining that are not used by the following August 1st are lost as the prepayment option will have ended on July 31st.
      • For providers who purchase a renewal of a prepayment option, the one year time period begins to run the date your office runs out of claims under your current option.  EXAMPLE:  Your office is submitting claims under a 1000 claim prepayment option.  On June 1st you purchase a renwal as you are running out of claims.  Your office submits the last claim under the original prepayment option on June 7th.  The one year time period begins to run on June 7th and thus the claims purchased must be used by the following June 6th or be lost.
  • EAP Billing:
    • For payers that accept EAP claims via electronic claims (837P format) such as United Healthcare (Optum Beahvioral Health) and Cigna, we can submit the claims for our standard rates.
    • For payers that do NOT accept EAP billing via ANSI 837P claims (regular electronic claim submissions) but instead require you to complete a specific form with clinical information, your office will have to submit the EAP billing yourself on the form the payer mandates with the clinical documentation the payer requires.

Medisoft Network System:

  • Do you want to access your data 24 hours/day on MBP’s Medisoft Network whereby you can view your data and run reports?

  • Providers must own a licensed copy of Medisoft in order to access Medisoft on our network.

Set-Up Fee:

  • One-time set-up fee of $99.95

  • Set-up fee must be paid before MBP can enroll providers for electronic claims or electronic remittance advice.  Providers will be unable to submit patient information or billing prior to payment of the set-up fee.

PremiumPlus Medical Billing Service

  • Standard Per-Claim PremiumPlus Fee:  $ 2.89 per claim (minimum fee of $99.95 per month)

  • PremiumPlus Service Annual Prepayment Options:

    • 1000 claims for $2590.00 ($2.59 per claim)

    • 2500 claims for $5475.00 ($2.19 per claim)

    • Money-Back Guarantee:  For information on our money-back guarantee, click here.

    • NOTE:  Under the Annual Prepayment Options, providers must use the number of claims submitted within one year of the date of purchase.
      • For providers who purchase a prepayment option when they first sign up and receive free claims as a promotional special, the one year time period begins to run after the months of free claims.
      • EXAMPLE:  Provider signs up and purchases a 1000 claim prepayment option on June 1st and receives 2 months free.  The one year time period begins to run on August 1st.  Any claims remaining that are not used by the following August 1st are lost as the prepayment option will have ended on July 31st.
      • For providers who purchase a renewal of a prepayment option, the one year time period begins to run the date your office runs out of claims under your current option.  EXAMPLE:  Your office is submitting claims under a 1000 claim prepayment option.  On June 1st you purchase a renwal as you are running out of claims.  Your office submits the last claim under the original prepayment option on June 7th.  The one year time period begins to run on June 7th and thus the claims purchased must be used by the following June 6th or be lost.
  • EAP Billing:
    • For payers that accept EAP claims via electronic claims (837P format) such as United Healthcare (Optum Beahvioral Health) and Cigna, we can submit the claims for our standard rates.
    • For payers that do NOT accept EAP billing via ANSI 837P claims (regular electronic claim submissions) but instead require you to complete a specific form with clinical information, your office will have to submit the EAP billing yourself on the form the payer mandates with the clinical documentation the payer requires.

  • NOTE:  Fees for PremiumPlus Service include all accounts receivable posting:  insurance payments and patients payments.  Providers who cancel the PremiumPlus Service or downgrade to the Premium Service incur an Electronic Remittance Advice Cancellation Fee of $99.95.

Set-Up Fee:

  • One-time set-up fee of $99.95

  • Set-up fee must be paid before MBP can enroll providers for electronic claims or electronic remittance advice.  Providers will be unable to submit patient information or billing prior to payment of the set-up fee.

Premium Medical Billing Service

  Claim Submission

  • Standard Per-Claim Service Fee:  $2.45 per claim (minimum fee of $69.95 per month)

  • Premium Service Annual Prepayment Options:

    • Purchase 1000 claims for $2150.00 ($2.15 per claim)

    • Purchase 2500 claims for $4375.00 ($1.75 per claim)

    • Money-Back Guarantee:  For information on our money-back guarantee, click here.

    • NOTE:  Under the Annual Prepayment Options, providers must use the number of claims submitted within one year of the date of purchase.
      • For providers who purchase a prepayment option when they first sign up and receive free claims as a promotional special, the one year time period begins to run after the months of free claims.
      • EXAMPLE:  Provider signs up and purchases a 1000 claim prepayment option on June 1st and receives 2 months free.  The one year time period begins to run on August 1st.  Any claims remaining that are not used by the following August 1st are lost as the prepayment option will have ended on July 31st.
      • For providers who purchase a renewal of a prepayment option, the one year time period begins to run the date your office runs out of claims under your current option.  EXAMPLE:  Your office is submitting claims under a 1000 claim prepayment option.  On June 1st you purchase a renwal as you are running out of claims.  Your office submits the last claim under the original prepayment option on June 7th.  The one year time period begins to run on June 7th and thus the claims purchased must be used by the following June 6th or be lost.

Medisoft Network System:

  • Do you want to access your data 24 hours/day on MBP’s Medisoft Network whereby you can view your data and run reports?

  • The cost for Premium Service users is only $9.95 per month (providers must own a licensed copy of Medisoft for access to the Medisoft Network.

  • NOTE:  there is no network access fee for providers enrolled for the PremiumPlus or Platinum Service.

Set-Up Fee:

  • One-time set-up fee of $99.95

  • Set-up fee must be paid before MBP can enroll providers for electronic claims or electronic remittance advice.  Providers will be unable to submit patient information or billing prior to payment of the set-up fee.

Revenue Performance Advisor ERA Reports Option:

  • Search and view EOBs online with MBP’s Revenue Performance Advisor

  • View an EOB for a specific claim or a specific patient OR view an entire EOB
  • For Premium Service Providers only:  ERA Claim Fee:  19 Cents Per Claim (minimum fee of $24.95 per month)
    • No fee for providers enrolled for the PremiumPlus or Platinum Service

Medisoft Network Basic Service

  Claim Submission:

  • 47 cents per electronic claim (minimum fee of $79.95 per month)

  • 55 cents per paper claim

  •  Supplemental Claim Submission:

    • Claims are submitted on a weekly basis.  If your office requires a supplemental submission during the week, a supplemental submission fee of $9.95 applies besides the per-claim fee.

Set-Up Fee:

  • One-time set-up fee of $99.95

  • Set-up fee must be paid before MBP can enroll providers for electronic claims or electronic remittance advice.  Providers will be unable to submit patient information or billing prior to payment of the set-up fee.

Support:

  • MBP offers two support options for the software:  $24.95 per month for unlimited support through our Support Suite or $49.95 per incident.

  • MBP does not offer telephone support for the Medisoft Network.  All support is online via our Support Suite.

  • Support does not include training or data repair issues.  For any data issues, including possible corruption of data, you must purchase support from our Medisoft Reseller, Walker Tek Solutions.

Claim Scrubbing:

  • HIPAA Edits:  For only $7.95 per month the program will check to ensure that certain HIPAA required fields (such as birth date and relationship to insured) are properly populated.  For claims with errors you will receive a report of these claims so you can correct them prior to submission.  This reduces the number of denied claims, allowing you to get paid faster and allowing for more reimbursement.

  • Advanced Claim Scrubbing:  For only $19.95 per month the program will scrub the claims against CCI and Medicare Edits, CPT Edits and ICD edits.  This scrubbing will ensure you are using proper codes and modifiers.

Downgrade Fee:

  • For providers enrolled in our Premium or PremiumPlus Service, a fee of $799.95 applies for providers who want to downgrade to the Medisoft Network Basic Service.

Fees For All Levels of Service:

  Revenue Performance Advisor Portal/ Online Rejection Reporting System:

  • MBP utilizes an online system of providing reports from payers and clearinghouses to notify payers when claims reject electronically.

  • For our Basic Service Providers, the online system will also include claims that could not be submitted because they failed the HIPAA Edits or Advanced Claim Scrubbing (for providers enrolled for these options).

  • It is important to understand that when claims reject electronically they do not enter the payer’s claim adjudication system.  So, if you tried to check with a payer as to claim status, the payer would have no record of the claim.

  • There is a required fee of $11.95 per month for this service (providers cannot opt out of being enrolled for the Online Rejection Reporting System).

  • Through the Revenue Performance Advisor Portal providers will be able to track ALL claims submitted electronically.  Tracking of the claims will show when the claims were accepted by the clearinghouse, when they were accepted by the payer and if and why claims may have rejected.

Supplemental Tax ID Numbers:

  • If your practice submits claims using more than one Tax ID number, a supplemental fee of $29.95 per month per additional Tax ID is charged.

    • Example:  Your office uses an EIN to send to most payers but you use the provider’s personal Social Security number to submit to select payers.

Additional Medisoft Network User Fees:

  • For practices with access to our Medisoft Network, your access is for one person to access your data.

  • If your office needs more than one person accessing accessing your data at one time, you can purchase an additional user license for $159.95.

  • In addition, there is a fee of $4.95 per month for each additional user accessing the Medisoft Network.

Reports

  • For all reports that providers request MBP to provide, a fee of $5.95 per report is assessed.
  • There is NO fee for reports provided as part of the PremiumPlus or Platinum Service on a monthly basis.
  • There is NO fee for the Claim Submission Report automatically provided to all providers immediately after claims are submitted.

Authorization and Benefit Tracking:

  • Do you have claims deny because you do not have a valid referral or treatment plan on file?

  • Do you have claims deny because a patient has used their benefits for the year?

  • MBP’s authorization tracking service will track the number of visits allowed under a treatment plan OR the end date of a referral to ensure you do not treat patients beyond the authorized number of visits or the end date of a referral.

  • On a weekly basis MBP will email you two reports showing you referrals and authorizations about to expire.  See the below examples:

  • MBP’s benefit tracking service will track the number of patient visits allowed per year OR the maximum dollar amount allowed under the patient’s coverage per year.

  • For more informatoin about the Authorization and Benefit Tracking Service, visit:  Authorization and Benefit Tracking

  • Fee:  $29.95 per month ( free for providers enrolled for the Platinum Medical Billing Service)

  • This service is not available for Medisoft Network Basic Service providers.