What is MSO required to collect from Advanced Mobile Iv And Amiv's patients, when applicable?
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.
- (b) Systems Access. MSO currently maintains a license to use a scheduling and billing software managed by the MSO's franchise system. Provider hereby grants to MSO the right to use the management software to facilitate the submission of medical claims and collection of payments. All patient information and data provided by the Provider to MSO shall be kept confidential and shall only be disclosed to Parties necessary to successfully process and submit claims on behalf of the Provider.
- (c) Provider Acknowledgements. Provider acknowledges and agrees to the following:
- (1) The submission of false, fraudulent or misleading data, information, or statements to the government and/or commercial
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, MSO (Management Services Organization) acts as the exclusive billing agent for the Provider (franchisee). MSO is responsible for preparing and processing all bills for professional services rendered, based on information provided by the franchisee. This includes billing and completing reports and forms required by insurance companies and other third-party payers. MSO also handles telephone inquiries from patients and payers regarding their bills and diligently pursues the collection of unpaid bills. All billings must be in the name of the Provider, use the Provider's billing numbers, and identify the provider of professional services. MSO is required to obtain and maintain all demographic and financial information and authorizations needed for billing and reimbursement for professional services rendered to the franchisee's patients.
Advanced Mobile Iv And Amiv requires the franchisee to provide MSO with all necessary records, information, and assistance to enable MSO to provide billing and collections services. The franchisee is 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. The franchisee must also promptly provide MSO with copies of all Explanation of Benefits forms received from third-party payers, as well as records of payments received directly from patients.
MSO maintains a license to use scheduling and billing software managed by the MSO's franchise system. The franchisee grants MSO the right to use this management software to facilitate the submission of medical claims and collection of payments. All patient information and data provided by the franchisee to MSO must be kept confidential and disclosed only to parties necessary to successfully process and submit claims on behalf of the franchisee. The franchisee acknowledges that the submission of false, fraudulent, or misleading data, information, or statements to the government and/or commercial payers is prohibited.