Billing Process

With our streamlined and efficient billing process and our resolution of all your patients’ billing concerns, you and your staff will be able to focus on patient care rather than your billing.

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  After enrollment with Cen-Tex Medical Claims is complete and a service agreement is signed, we will decide together how your billing information is transmitted. We offer a weekly courier service in the Austin metro area for large providers. For small providers or providers outside of the Austin metro area, we can provide you with three options for transferring your billing data to us:

  • We will provide you with labels to mail the information to us
  • You may fax the information to us
  • You may email the information via encrypted email, we use Send inc. for our email encryption. You must have a scanner for this option to work well

  Necessary billing information includes:

  • List of daily services performed with CPT code
  • Patient diagnosis
  • Copies of patient demographic information (first visit only)
  • List of any patient payments received
  • Copies of all Explanation of Benefit forms (EOBs) and other correspondence received with payments from carriers
  • Copies of any authorizations received
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  With our complete insurance verification, you'll know on your patient’s initial visit what their benefits are. This will include copays, deductible, any restrictions to coverage, and authorization requirements. In most cases, we are able to set up the initial authorization, if required.

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  We will submit your claims within the next business week.

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  If we require additional information to file your claims, we will contact you and must hold the claims until we have complete data. We will know the same day of submission whether any of the claims contained any errors requiring re-submission.

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  After each filing, we will send you a billing report verifying the date of submission of all claims specifying the patient's name and total amount of the claim, a deposit report showing all insurance and/or patient payments, as well as an update/info needed form, noting if we need information from you to file claims, reminders for authorizations, annual maximums, and other informational items for your review.

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  Your office will have no paperwork to complete between the time the services are provided and the time you receive the payment from the insurance company.

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  All checks will be mailed directly to the provider's office from the insurance company. Cen-Tex Medical Claims will not receive any payments directly. You are responsible for sending us any and all insurance Explanation of Benefit forms as well as a record of patient payments received either by mail or at time of visit. In order to help track your authorizations, we also need copies of patient’s authorizations.

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  Your office should retain a duplicate copy of all billing information. Therefore, at no time will our billing center possess data that is not simultaneously maintained in your own office. If you furnish us with the original explanation of benefits forms and/or billing forms, we will return the originals to you for you to store in-house per insurance regulations and we will maintain copies in our office.

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  We will invoice your office on a monthly basis for services provided the previous month. Under our comprehensive billing services, you are not billed until after you have received the payments.

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  We will talk with your patients concerning any questions they may have about their insurance coverage and/or payments, their billing statement, balance owed, etc. This will enable you to concentrate on their therapy and remove the billing aspect from your relationship with your patient.

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  We will review all your patient accounts on a semi-monthly basis and give you a summarized report noting balances due from insurance and from patients. We will mail statements to your patients with our contact information for any questions they may have. These statements may have a series of collection notes to increase patient payments on past due balances.