Does Advanced Mobile Iv And Amiv bill patients in the Provider's name for services?
Advanced_Mobile_Iv_And_Amiv Franchise · 2023 FDDAnswer from 2023 FDD Document
- (1) Preparing Bills. Provider hereby appoints MSO as Provider's exclusive billing agent to perform the following Billing and Collection Services. With respect to all Professional Services furnished throughout the Term of this Agreement, MSO shall prepare and distribute/process, as agent for Provider and based on information pertinent to Professional Services rendered as supplied to MSO by Provider, all bills for Professional Services, including the billing and completion of reports and forms required by insurance companies and other third-Party payors, as applicable; respond to telephone inquiries from patients and payors concerning their bills; and diligently pursue collection of unpaid bills. All billings shall be in the name of Provider, shall use the billing numbers of Provider, and shall identify the provider of Professional Services, as required. MSO shall obtain and maintain all demographic and financial information and authorizations needed for billing and reimbursement for Professional Services rendered to Provider's patients.
- (a) Reasonable Assistance. Provider agrees to provide MSO with all necessary records, information and assistance to enable MSO to provide the Billing and Collections Services. Provider shall be responsible for ensuring the accuracy and completeness of coding associated with claims and for ensuring the medical necessity and appropriateness of the Professional Services for which a bill will be submitted. MSO shall have no liability or responsibility whatsoever regarding the accuracy or completeness of the coding or determinations regarding medical necessity. The Provider also agrees to promptly provide MSO all copies of all Explanation of Benefits forms received from third-party payors as well as records of payments received directly from patients.
Source: Item 23 — RECEIPTS (FDD pages 54–202)
What This Means (2023 FDD)
According to the 2023 Advanced Mobile Iv And Amiv Franchise Disclosure Document, the billing for professional services is handled by a Management Services Organization (MSO) acting as the Provider's exclusive billing agent. The MSO prepares and distributes bills based on information provided by the Provider, including completing necessary reports and forms for insurance companies and other third-party payers. The MSO also manages inquiries from patients and payers and diligently pursues the collection of unpaid bills.
Specifically, all billings must be in the name of the Provider and use the Provider's billing numbers, identifying the professional who rendered the services. The MSO is responsible for obtaining and maintaining all demographic and financial information needed for billing and reimbursement.
As an Advanced Mobile Iv And Amiv franchisee, you, as the Provider, must supply the MSO with all necessary records, information, and assistance to enable them to provide billing and collection services. You are responsible for ensuring the accuracy and completeness of coding associated with claims and the medical necessity of the services billed. You must also provide the MSO with copies of Explanation of Benefits forms and records of payments received directly from patients. This arrangement ensures that billing is conducted under the Provider's name and credentials while leveraging the MSO's expertise in billing and collections.