Below is a sample of the scope of work generally used in our billing and intake contracts.
Section 1: The scope of work to be provided by Kamato Group is outlined below:
- Set up a MCPlus billing/EHR account for the Provider.
- Perform data entry tasks to transfer established patients into MCPlus account.
- Prepare, submit, and track electronic billing registration and electronic EOB (ERA) enrollment forms.
- Provide software training for applicable modules and on-line calendar (if applicable).
- Activate and maintain a secure Hushmail email account for our use for the duration of the Provider’s contract with Kamato Group.
- Verify new intake patient insurance benefits and eligibility.
- Convey detailed insurance benefit information to the Provider and the patient. Attach Provider’s specific “new patient intake” forms to benefit notification welcome email.
- Input new intake patient set up data including name, address, contact information, and insurance benefit details in Provider’s account. Update patient files as needed.
- Submit primary and secondary insurance and other claims electronically or by paper (if applicable).
- Track claims and follow-up with insurance companies and benefit plan entities as needed. This applies to unpaid claims with submission dates >3 weeks.
- Resolve claim issues and resubmit claims. The Provider’s account will be reviewed by the account manager a minimum of four (4) times per week for claim issue alerts, i.e. denied claims reflected on an EOB or submitted claims that have not been accepted by the clearinghouse.
- Track authorizations and notify provider of needed renewals.
- Enter payments received from all sources.
- Balance patient accounts.
- Produce paper patient statements monthly. Mail patient statements after review and approval by the Provider.
- Serve as the direct point of contact via email with patients regarding their accounts.
- Provide monthly billing activity reports, and other reports as needed, to the Provider.
- Maintain confidentiality as per HIPAA requirements.
Below is a sample of the scope of work generally used in our credentialing contracts.
Section 1: The scope of work to be provided by Kamato Group LLC is outlined below:
- Secure a Type 1 and/or Type 2 NPI for Provider, if applicable.
- Request, complete, and submit insurance panel applications with applicable documents.
- Track applications and provide additional information as needed.
- Prepare, submit, and track EFT enrollment forms.
- Create/update Provider’s CAQH and/or ProviderSource file.
- Create web portal access for all insurance plans; set up Provider’s Payspan, Availity, and Navinet accounts.
- Transfer to Provider upon completion of application process: web portal usernames and passwords, and assigned provider ID numbers.
- Maintain confidentiality and security with regard to applicant’s data.