Medical Billing Orientation: A Comprehensive Guide On What You Can Expect During Your Call

Topics Covered:

During the medical billing orientation call, we will review and verify the following essential information:

1. Primary Medical Billing Contact Information

   • Name, phone number, and email of the designated point of contact for medical billing inquiries. This individual will serve as the primary contact for all billing-related questions and patient-specific inquiries.

2. Facility Information

   • Service facility address and billing address for accurate claim submissions.

3. National Provider Identifiers (NPIs)

   • NPI 1. We will need the individual NPI for each provider that we will be billing for. 
   • NPI 2 (Group or facility NPI)

4. Tax Information

   • Tax ID

5. Medicare PTAN (Provider Transaction Access Number)

   • Required if you are a Medicare DME or Part B provider. Without a PTAN, you are unable to bill for Medicare patients.  

6. Assignment Status

   • Will you be accepting assignment or not accepting assignment for both Medicare and commercial claims?
   • Please refer to the attached article for more information: Accepting Assignment vs. Not Accepting Assignment: A Guide for Medicare and Commercial Carriers

7. Billing Services

   • Will your practice primarily be billing for sleep, TMD, oral surgery, or a combination of services?

8. Insurance Network Status

   • Are you in-network with any medical insurance companies?

Note: We will register you as out-of-network with five insurance companies. If you have a preference for any specific policies common in your area, please let us know. If no preference is provided, we will begin registering you with the major insurers: BCBS, Aetna, Cigna, UHC, and Tricare.

Documentation Required for Registration:

To complete your registration, please provide the following documentation:

• Provider's date of birth
• Provider's Social Security Number (SSN)
• A copy of the provider's dental license
• W9 form
• Office hours
• Nierman Medical Billing contract

Orientation Process:

Once all billing information is verified, we will guide you through our ticket-based system, where you can submit requests to your dedicated medical billing concierge. During this session, you will learn how to:

• Create and submit tickets
• Read and interpret ticket responses
• Determine the necessary next steps

As part of the orientation, we will review a mock verification ticket that will be completed prior to your call. This will serve as a practical demonstration of how to read and interpret verification forms. We will also explain which documents are required, how to upload them, and how to communicate directly with your concierge through the ticketing system.

Feel free to ask any questions during the call – we are here to ensure you are fully prepared and comfortable using the system!