Services

Medical Billing (Complete Billing Cycle)

Legacy Medical Billing and Coding assumes responsibility for all phases of the billing cycle allowing practitioners to focus on patient treatment. We prepare and transmit claims, including secondary and tertiary, either electronically, by mail or by fax. Our multi-level scrubbing tools ensure claim accuracy. Payer adjudication is closely monitored with rigorous follow-up. We check for billing compliance, assign payer payments, generate patient statements, initiate appeals, and arrange for collections as needed.

Medical Coding

ICD-10 and CPT codes are constantly changing. In 2021 alone there were 819 combined changes, including all the new Evaluation and Management (E/M) rules! Not staying up to date on changes will result in loss of revenue. Consequently, Legacy’s certified coders participate in monthly continuing education courses and review quarterly changes from Center for Medicare Services (CMS). We are committed to maintaining awareness and compliancy with all aspects of medical coding.

Verification of Benefits

Verification of benefits (VOB) is an important, yet an often time-consuming, chore. Many patients do not realize that practitioners provide their services on “credit,” with the expectation that their bills will be accepted and paid by insurers. Verifying benefits not only helps the patient know what to expect in terms of out-of-pocket expenses, it also provides the practitioner with a level of certainty they will be paid for services rendered. VOB also allows the practitioners to collect upfront any copayments, coinsurance, deductible, or other cost-sharing expenses.

Credentialing

Credentialing can be tricky. Stacks of paperwork and endless applications can be overwhelming, but our dedicated team and your personal project manager will ensure that your credentialing process is done right the first time. Whether you need a state license, paneling with insurance carriers, or affiliation with a hospital, the Legacy Team is here to assist!

Our services include:

Commercial Insurance Provider Enrollment and Credentialing (ie. Aetna, Premera, First Choice, Regence, Cigna, BCBS, and many more)
Medicare and Medicaid Provider Enrollment and Credentialing
Medicare and Medicaid Revalidation
PECOS
CAQH Registration
NPI Registration
Hospital Privileging

In-House Consultation

The world of medical billing and coding changes daily. Even if you do not need our full services, you may have questions about the process, coding something specifically, a denial, or any number of issues that require quick and reliable resolution. We can help your team find resources, establish procedures and protocols, generate appeals, and more.

Patient Education

Early patient involvement and education is key to managing their health. Many patients are unfamiliar with common medical terminology and generally unsure of the benefits available to them under their policy. We strongly encourage advising patients of their benefits prior to services, and to have them also call their insurance carrier to understand the benefits available to them. To help patients understand common medical terminology please refer to our Patient Education Page for a short video.

Personal Injury Claim Management

Many providers shy away from Personal Injury (PI) claims. However, seeing PI patients is as easy as submitting a W-9. Legacy has dedicated itself to helping providers treat injured patients and receive payment for their services. Legacy can help set up systems to track PI claims, ensure payment, provide appeals, contact the Insurance Commissioner, liaison with attorneys, and more. We have working relationships with several claims’ adjustors, lawyers, and other professionals nationwide.

Attorney Consultation & Chart Auditing

Attorneys and practitioners often work in conjunction to obtain an optimal outcome for the patient. Sometimes it is necessary for a certified coder to review the medical record confirming the highest level of specificity was billed and paid accordingly. We take exceptional pride in our ability to get PI claims paid.

Notary Public

Notary Public services are available to our full-service clients at no additional fee. Both in-person and electronic services are available.