Third Party Billing Solutions

HBCS’ sophisticated billing solution is capable of reducing “first pass” rejection rates to levels far better than industry benchmarks. HBCS provides primary and secondary billing services for a variety of healthcare organizations. Claims are submitted timely and accurately in the 837 format to insurance carriers through the use of our sophisticated web-based billing solution. Rejections are tracked and root-cause analysis is performed with our hospital clients to improve the overall health of the revenue cycle.

Our billing solution is designed to produce a high volume of transactions while focusing on passing edit validation consistently. Edits are worked and claims resubmitted within 24-48 hours of identification of errors. In addition, our billing process provides tracking and status updates on accounts until final disposition.

Primary Billing

HBCS provides initial claim submission to governmental and non-governmental third party payers. HBCS’ billing solution provides flexibility to healthcare organizations by accepting all bill file formats, including print images and non-standard formats and converts them to produce a compliant 837 format for submission through our web-based billing application. Rejections are worked and claims are re-submitted within hours of electronic responses back from insurance carriers. Monthly detailed reporting of this information to the hospital helps to improve the overall revenue cycle.

Claims are reviewed against standard industry edits (ANSI, CCI, LMRP), individual carrier edits and custom client edits to achieve a higher claim validation rate, and the highest clean claim submission rate for our members.

Secondary Billing

Billing secondary insurances can be time consuming and manually intensive. HBCS utilizes electronic automated claims and a national standard explanation of benefits for billing where appropriate to expedite the secondary billing process for our hospital clients.

Government Program Billing

Billing to government programs is performed for a variety of healthcare organizations and a comprehensive compliance program is in place to help guide the process. Also, a direct Medicare billing solution allows HBCS to submit claims hourly to the Intermediary (MAC) and correct edits on-line in our billing application within hours after submission. This can reduce the Medicare front-end claim process by two days. Extensive edits within the billing application including CCI and LMRP edits help prevent billing errors and provide a robust audit trail for every claim.

Workers' Compensation / Auto Insurance Billing

HBCS’ solution includes front-end processes that enable claims and supporting documentation to be submitted together preventing delays in the processing of claims. Our highly trained professional staff is well versed in the requirements for these types of claims.

Select a Solution:

Corporate Office

118 Lukens Drive

New Castle, DE 19720

(302) 552-8000

Massachusetts Office

701 Edgewater Drive

Wakefield, MA 01880

(781) 279-8465

Maryland Office

600 Beam Street

Salisbury, MD 21801-7803

(410) 219-5229

Energize your revenue cycle