Virginia Beach Medical Billing Services

Military families change the payer mix

Walk into any waiting room in Virginia Beach and plenty of the patients have a military ID. Naval Air Station Oceana and Dam Neck are inside the city, Naval Station Norfolk and Joint Expeditionary Base Little Creek are a short drive, and the retiree community that grew up around them stays on. That means TRICARE shows up on claims often here, and it brings its own authorization and referral habits.

A company whose clients are mostly commercial will fumble this. Ask about TRICARE specifically, and ask for an example of how it follows up on a denied referral. Practices near the bases that learn this early do better.

Military moves also mean patient turnover. A family arrives, enrolls, and leaves after two or three years, so a lot of your accounts have short lives. Prompt billing and prompt statements matter more than in a market where patients stay put.

One system sets the pace

Sentara Health is the big name in Hampton Roads. It runs hospitals across the region and has a health plan of its own, which makes it both a competitor and a payer for independent practices. Bon Secours and the Children's Hospital of The King's Daughters in Norfolk are the other major names. Old Dominion University, which now includes the former Eastern Virginia Medical School, now part of Old Dominion University, trains physicians in Norfolk, and some of them stay to practice nearby.

If you are independent, you likely depend on those hospitals for referrals and admissions, and you may be billing the system's plan as well. Billing staff should know how that plan treats outside providers. It is one of the questions that separates companies that have worked here from those that have only read about it.

What payers look like in Virginia Beach

The Blue plan is large, and Medicaid in Virginia largely runs through managed care plans with their own portals and prior authorization rules. The older population in Hampton Roads and the many retired service members bring a lot of Medicare, and Medicare Advantage is common. Self-insured employers are fewer than in a corporate headquarters town, but defense contractors and the city's hotel and tourism employers use a mix of plans.

Ask any company on your short list to describe how it works claims for each, in plain words, with names.

Norfolk, Chesapeake and the rest of the region

People in Virginia Beach cross city lines without noticing. A pediatrician in Virginia Beach may see patients from Chesapeake, and a surgeon may have an office in Norfolk and operate at a hospital in the city. For your billing company this changes nothing about price, since work is done remotely. It does change which hospital contracts and which facility billing matter.

The Oceanfront and the resort strip bring urgent care and occupational medicine work in the summer. Around Princess Anne Road and Town Center, medical offices fill with specialists and primary care. Find out if the company already bills a practice with seasonal swings in volume.

The bridge-tunnels split Hampton Roads into pieces, and patients often choose providers by which side of the water they live on. That keeps referral networks tight and makes a good reputation with the local hospitals worth a lot.

The shipyards and the port also employ many people, so occupational health and workers' compensation claims are part of the mix. Those follow different rules from health insurance claims, with their own forms and timelines. If you see injured workers, ask whether the company bills them regularly.

Questions for the shortlist

Start with TRICARE and Virginia Medicaid. Ask each company how many of its practices bill them, and what a denied referral looks like in its workflow.

Next, software. Which EHR does the company already work in? If it is not yours, who builds the connection and pays for it?

Then ask about the exit. If you leave, who owns your data, and in what format does it return? Look at the term and the notice period too. A long contract with a hard exit and no data return is where things go wrong, and short terms with clear notice are worth more than a small difference in fee.

Ask how denials get worked, who sees them and how often, and how the company reports results each month. Finally, find out where the staff sits and which of them are HIPAA-trained.

Behavioral health and therapy

Virginia Beach has a lot of counselors and behavioral health providers, many serving military families. Their billing involves time-based codes and plan-specific authorizations, plus credentialing with several payers at once. Credentialing in particular can stretch for months, and a company that does it well saves you real income.

Tell each firm what kind of practice you run. A company that is excellent at primary care may be weak on therapy, and you will not know until your claims show it.

Virginia Beach also has plenty of physical therapy and occupational health practices, which bill under rules that differ from physician offices. Visit limits come up constantly, and so do workers' compensation claims. If your practice looks like this, ask for a reference that does too.

Medical Billing Cost Costs in Virginia Beach

The cost of a medical billing company in Virginia Beach is most affected by the volume of bills a practice needs to process and collect.

Below are estimated costs for medical billing company costs in Virginia Beach:

Note: Prices subject to change. These costs are based on an average of Alluvit's Virginia Beach medical billing company research.

Medical Billing Companies in Virginia Beach, VA

• A Craig Medical Consulting LLC

  
  
  

  211 79th St # A
  Virginia Beach, 23451-1926

  (757) 513-8779

• Filing Cabinet Inc

  
  
  

  2609 Tarkill Run
  Virginia Beach, 23452-7749

  (757) 468-3753

• Leidos Inc

  
  
  

  2877 Guardian Ln # 300
  Virginia Beach, 23452-7330

  (571) 526-6000

• Leidos Inc

  
  
  

  2929 Sabre St # 100
  Virginia Beach, 23452-7449

  (571) 526-6000

Looking for a different city? Here are some nearby.

Other Virginia Beach business topics.

• Benefits Of Outsourcing Medical Billing