Medical Practice Success Magazine Winter 2024/2025 | Page 15

Quick Claimers Medical Billing is able to reduce denials and get payments to providers quickly — just like the business name says .
BEHIND THE SCENES
MANAGING THE COMPLEXITY OF CLAIMS
When processing insurance claims , Cynthia is always acutely aware that patient health hangs in the balance . “ We have a process in place that when a claim comes in , our team registers patient demographics to ensure they can get approvals quickly .” The claim then goes to the biller and then to insurance , usually with a 48-hour turnaround .
“ We know the urgency of getting the claims out . When a claim is denied or we ’ re waiting to get payments in , we always practice with a sense of urgency . Patient health depends on our ability to work quickly and get things right the first time ,” she explained .
By double-checking that patient demographics were entered correctly before submitting claims to insurance companies ,
Quick Claimers Medical Billing is able to reduce denials and get payments to providers quickly — just like the business name says .
Beyond patient demographics , Cynthia and her team comb through the CPT codes to make sure everything was put into the system correctly . COMMUNICATION : THE KEY TO SOLVING PROBLEMS
With such a complex process and so many entities involved from start to finish , issues are sure to arise . To Villalobos , as long as clear communication is prioritized , most issues are nothing but a bump in the road . “ The first step to addressing a problem is acknowledging that it exists ,” she says .
If there ’ s an insurance company that is trying to get out of paying claims , the team looks at all the possible causes . Is it a credentialing issue ? Did the claim get billed wrong ? Or is it something that happened at another point in the claims process ? Digging into the details is the only way to find the root cause .
“ Let ’ s say it was a situation where the place the patient was seen had to do their due diligence and get authorization to be able to see the patient ,” she said . “ We just have to communicate with everyone .” Then , it becomes clear to all that it ’ s not a payment issue , and it has nothing to do with credentialing , but it ’ s actually something on the insurance company ’ s end . “ Once we can prove to the insurance company that it ’ s something they have to fix , they usually resolve it pretty quickly .”
Without the ability to comb through claims , identify the holdup , and communicate clearly with the party responsible for the fix , patients would face massive bills or a reduction in care .
FINDING A NICHE
In her nearly two-decade-long career , Villalobos has seen it all . Starting out as a biller , she ’ s worked her way up to a team lead with a bit of experience with many specialties . Since Quick Claimers Medical Billing works with physicians practicing all types of medicine , Villalobos and the rest of the team get the pleasure of working in a multitude of niches .
“ I started as a biller for infectious disease control , then dabbled a bit in pulmonology , then a bit of family medicine ,” she recalled . “ Finally , I found my niche because I started doing behavioral health and absolutely loved it .” Every part of the process — welcoming a new client , onboarding , credentialing , and billing — is old hat to Villalobos .
“ I don ’ t think people realize that there are so many steps in medical billing and coding , especially for a company like ours ,” she explained . She gets to guide providers through the entire process , helping their organizations find success along the way .
THE SATISFACTION OF SEEING PROVIDERS GROW
Villalobos loves the “ Sherlock Holmes ” aspect of her career ; she ’ s constantly digging into billing issues , identifying root causes , and working to solve those issues . “ It ’ s so rewarding to solve these complex problems ,” she said with a smile . “ Seeing all the claims we filed coming back paid clean brings an amazing sense of satisfaction .”
Her satisfaction doesn ’ t just come from a job well done by her team but also because it means the physicians they serve will grow and find success . “ We ’ ve worked with some providers for years , watching them grow from their first few clients to large , medical offices that work with tons of patients every day .”
When patients get to experience a painless claims process , they keep going back to that provider for the services and treatments they need . At the end of the day , Villalobos hard work is a win-win for everyone .
BEHIND-THE-SCENES OF HEALTHCARE
Next time you go to a doctor ’ s appointment , know that there are so many people involved who are committed to getting you the best health outcomes . It ’ s not just the providers who do your exam or provide your care ; people like Villalobos spend every day fighting for you to be able to get affordable medical care without hassle . And it brings those people immense joy to know the meaningful impact they have on patients and physicians all over the country .
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