Required Information
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The Basics of Medical Billing
We help you improve the efficiency of your office, and Increase The Cash Flow, by
explaining all the basics of medical insurance
billing in such simple terms that EVERYONE
can understand it! To put it lightly, "The Basics
of Medical Billing" is a must for any office
interested in
improving their
efficiency!

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Before You Begin
This is the list of required information you will need in order for us to process your claim. If you have any questions, you can contact us at 1-800-490-4299.

Once you have the following information, you can go directly to claim now, enter the information, and we will process your insurance claim.


Rehabilitation/detox facility
Name
Address
Phone number
Contact person

Patient
Name
Address
Date of birth
Sex
Dates of service

Insurance information
Insurance name
Address
Patient insurance ID number
Insured's name (if different from patient)
Patient relationship to Insured
Insured's insurance ID number
Group number of insurance (if there is one)
Insurance authorization number (if there is one)
Employer name of insured

Person filling out information:
Name
Phone number

Release form
Please print the following release form and submit to your rehabilitation facility. We will be contacting them for information needed to process your insurance claim.

Release of information form
I authorize                                                  (name of the facility) the release of any medical or other information needed for the submission of an insurance claim to my insurance carrier to Solutions Medical Billing Inc.

Patient's name:
Signature of authorized person:
Date:
Printed name:
If patient is a minor, relationship to patient:


Terms & Conditions
We agree to process and submit an insurance claim on your behalf to the insurance carrier you indicated on the required form by such indicated insurance carrier within 3 business days of receiving all necessary information and payment for our service. We do not guarantee payment will be made by the insurance carrier as it is the responsibility of the insured party to verify insurance benefits before submission of such claim. If this claim is required by the insurance carrier to be resubmitted with additional or corrected information, we will resubmit the claim up to three times at no additional charge. We are not responsible for contacting the insurance company for payment information. We process and submit claims with the information given to us by the patient and the facility and cannot guarantee the accuracy of that information.

Privacy Statement
Your personal information will be protected by the HIPAA Privacy Act. All information is kept confidential and secure. We will not release any information to anyone other than for the purposes of submitting the claim to your insurance carrier. Your information will not be traded or sold to anyone.

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