Services & Business FAQs

ProClaims becomes an extension of each of our clients and processes each account according to each individual client’s guidelines: How much is billed; What services are billed for; Are residents and non-residents billed alike; How many invoices will be sent to the patient and will they be turned over to a collection agency? These are all client based, and we will process each claim for each client under these guidelines.

Our goal is to work with the patient on behalf of our client to obtain all information necessary to collect from the patient’s insurance. If the patient has a copay, deductible, or has to pay the entire invoiced amount, ProClaims will work to make this payment process as smooth and easy as possible. We understand the relationship between you and your patients and residents, and we work hard to maintain your fine reputation.

All billing representatives are kept current with Medicare and Medicaid policies and procedures through seminars, newsletters, and information provided on Medicare and Medicaid web sites. ProClaims also retains a nationally recognized Medicare consultant, who, among other provided services, holds on-site reviews to ensure billing practices are current and accurate. In addition, annual meetings can be held at our individual client’s office for a review of their account. General meetings, when warranted, are scheduled at ProClaims’ offices to advise all of our clients of any changes in Medicare and/or Medicaid billing procedures, or for any other mutual needs.

ProClaims complies with all HIPAA rules, regulations and requirements, and all ANSI requirements.

ProClaims will execute a Business Associate Agreement for all clients to maintain compliance with the law.

All claims are filed electronically to Medicare, Medicaid, and any and all major insurance companies that accept electronic filings, which expedites payment. If insurance companies do not accept electronic filings, claims are filed on paper (CMS-1500 forms). Patients without insurance, or those whose trip sheets contain incomplete billing information, will receive invoices in an attempt to gather the needed data, or for payment by the patient.

ProClaims does not negotiate any monies for our clients. All monies collected will be remitted to the client via a third party operated lock box. ProClaims will not have control of any funds received by the client.

ProClaims does not act as a collection agency for our clients. We consider this to be a conflict of interest.

ProClaims will forward all uncollectible bills to the client for its decision on collection action, and will provide any information requested by the client, or their designated collection agency, to make the collection process as easy as possible.

Successful billing begins with ambulance crews trained and educated in proper documentation of run reports. ProClaims will provide initial on-site training, if so requested, for all ambulance crews and supervisors. We are available for ongoing training in addition to both telephone and personal conferences as the needs arise.