We offer In-Network and Out-of-Network medical billing services to surgeons and surgical assistants. We work with firms of all sizes to include individuals in a solo practice up to moderate sized groups.  

Building out the Claim

F5 Surgical is a claim processor.  A claim processor is an agent or firm who manages the claim itself from the beginning to the end.  This includes highly important front-end work of setting up the claim.  The industry is laden with the term medical billing, which defines a person who pushes the submit button on a software package.  For a surgical practice to process claims against the health insurance contracts it has arranged, it should be partnered with a claims processor who understands the importance of the entire process.

Patient Interaction

All participants in the healthcare experience understand that costs are incurred at the patient level. The patient knows this as well as the insurance carrier. A large focus of our service is partnering with your office staff to determine the patient eligibility including patient remaining deductible costs.

We recommend that the patient cover the basic costs of care based on their residual deductibles and cost share at the time of service.

Insurance Carrier Billing

All claims coded are billed to the insurance carrier within 24 hours. We do not hold claims or try to wait out deductibles. Some practices believe that they can avoid the frank conversations with a patient and play this game of roulette. If the claim is properly set up and a payment has been received prior to the service for a remaining deductible or cost share, the insurance fills out the remaining portion of the claim.

Claim Follow Up

Accounts receivable is where many practices and billers flounder. Most claim errors result from data entry errors or claims submitted against policies that are inactive or have no coverage.

All claims are closely followed up beginning at 14-day post billing. Each outstanding claim moves through a sophisticated AR process to determine the initial reason for denial and the necessary data to repair the claim.

We review the ongoing model to determine if gaps exist that can be closed for future claims processed.