Frequently Asked Billing Questions
A health insurance deductible is the amount you have to pay for medical expenses before your insurance starts paying. Once you’ve paid the full deductible amount, your insurance company will start paying for your medical expenses that are covered by your insurance. You can find out how much of your deductible you still have to pay by checking your Explanation of Benefits (EOB) or calling your plan provider.
The amount of money you can get from your secondary insurance depends on the plan. You can usually find this information online, but if you can’t, you should call your insurance provider to find out how much your secondary insurance will pay.
If you need pre-authorization for a medical procedure or medication, you must call your insurance provider and get an authorization number. This is important because if you don’t have an authorization number, your insurance company won’t pay for the procedure or medication.
If you want to know how much your insurance covers for a medical procedure or medication, you can contact your insurance provider directly and ask them to verify and confirm the amount.
Your Inovalon clearinghouse includes eligibility checking. We offer eligibility checking directly through HelloNote as well, please visit HelloNote Insurance Eligibility Checker for more information.
Please let us know the payerID# you need enrollments done for, and we will submit a request with the clearinghouse. You will get an email with instructions on how to proceed. This is usually done online to make it quick and simple.
EDI is an Electronic Data Interchange form that some insurances require in order for claims to be submitted electronically. If the insurance that you are billing requires this, then you must enroll before submitting claims. This application can take anywhere between 1 week to 4 weeks to approve depending on the insurance, so please submit the form as soon as possible.
ERA is the Electronic Remittance Advise that you get from the insurance after submitting a claim. This is an electronic version of the EOB (Explanation of Benefits). Most insurances have this available, and it makes viewing your EOBs very simple, and can import back into HelloNote for easy payment tracking. This application can take anywhere between 1 week to 4 weeks to approve depending on the insurance, so please submit the form as soon as possible.
Some insurances require you to be in-network with them in order to get reimbursed. This requires a contract to be made between you and the insurance company. If you are not credentialed with this patients insurance, you will not get reimbursed from the insurance company. Sometimes patients have Out of Network benefits which allow providers to get paid, even when not credentials. It is important to run eligibility checks to ensure reimbursement.
Out-of-network is when a provider or group have not signed a contract with the patients insurance. This allows providers to still get paid by the insurance when not credentialed.