For Advanced Mobile Iv And Amiv, who prepares and distributes bills for professional services?
Advanced_Mobile_Iv_And_Amiv Franchise · 2023 FDDAnswer from 2023 FDD Document
ecifically bound by | | | any medical protocols and procedures and does not influence the Provider’s | | | medical decisions. | | | | | B. Billing and Collection Services. “Collections” shall mean, for any applicable period, | | | all cash or cash equivalents received during such period for Professional Services rendered | | | by or on behalf of Provider—whether globally or separately billed, whether received by | | | Provider or by MSO on behalf of Provider pursuant to this Agreement, and whether | | | received in cash from patients, private or prepaid insurance, other third-Party payors or any | | | other source, including any amounts received after expiration or termination of this | |
FRANCHISEE and Its Owners
| Agreement for Professional Services rendered during the Term of this Agreement. In the | |
|---|---|
| event Provider or MSO, as the case may be, contracts with a collection agency to collect | |
| any such amounts, Collections shall include the net amount received by Provider after | |
| deducting the fees of the collection agency. Accordingly, MSO shall provide Provider with | |
| billing and collections services (the “Billing and Collections Services”) and shall have | |
| rights and obligations with regard to such services are as follows. | (1) Preparing Bills. Provider hereby appoints MSO as Provider’s exclusive billing agent to perform the following Billing and Collection Services. |
Source: Item 23 — RECEIPTS (FDD pages 54–202)
What This Means (2023 FDD)
According to the 2023 Franchise Disclosure Document, Advanced Mobile IV and AMIV franchisees appoint MSO (the Management Services Organization) as their exclusive billing agent. MSO is responsible for preparing, distributing, and processing all bills for professional services on behalf of the franchisee, based on the information the franchisee provides about the services rendered. This includes handling billing and reports for insurance companies and other third-party payers, responding to billing inquiries from patients and payers, and pursuing unpaid bills. All billings are done in the franchisee's name, using their billing numbers, and identifying the provider of professional services. MSO also obtains and maintains all necessary demographic and financial information for billing and reimbursement.
However, the franchisee is responsible for providing MSO with all necessary records, information, and assistance to enable MSO to provide billing and collection services. The franchisee must ensure the accuracy and completeness of coding associated with claims and the medical necessity and appropriateness of the professional services billed. MSO bears no liability for coding accuracy or medical necessity determinations. The franchisee must also promptly provide MSO with copies of Explanation of Benefits forms received from third-party payers and records of payments received directly from patients.
MSO uses a scheduling and billing software managed by the franchise system, and the franchisee grants MSO the right to use this software to facilitate medical claims and payment collection. All patient information provided by the franchisee to MSO is kept confidential and disclosed only to parties necessary to process and submit claims. The franchisee acknowledges that submitting false, fraudulent, or misleading data to the government or commercial payers is prohibited.