In this section we have all the answers to some of the most frequent questions we receive. If you don’t see an answer to your question here, don’t worry, you can always get in touch with us directly by sending us an email here and we will get back to you as soon as possible.
How do I know how long it takes to get paid on claims?
The average reimbursement expectation is 30-90 days.
How do I know where my claim is once it gets sent to the insurance company?
UMB has a medical claims portal whereby your claim is tracked throughout each phase of the claim and reimbursement process.
Should I do my own insurance verification?
You should do your own Insurance Verification only when you have an experienced and qualified person to verify insurance. Insurance verification is the first step of the medical billing cycle and the place where most mistakes occur when verifications are done in-house. UMB offers the service of Insurance Verification because of the complexity of understanding the multitude of insurance policies and the criteria of each insurance payer source. UMB has a data base of insurance payer histories, insurance policies and criteria by which your determination of accepting a patient’s insurance is a viable option.
Should I do my own utilization review?
You should do your own Utilization Review only when you have an experienced and qualified person to represent your company as the expert on the medical necessity and qualification by which the insurance company will determine if your patient will be authorized to receive services, continued services, and when your patient will be discharged from your facility. Utilization Review is a skilled position and complex position in an organization. UMB provides expert Utilization Review services that have a unprecedented history in maintaining your patient’s services and working with the Insurance Payer Source to maximize your patient’s reimbursable services and healthcare plan and is the first step of the medical billing cycles.
What happens if a claim gets denied?
Denials of Insurance Claims are a part of the medical billing and reimbursement process. UMB challenges the insurance payer source by presenting the medical necessity by which your patient qualifies for services. UMB Utilization Review Staff and medical professionals relentlessly advocate for your patient, reviewing medical records, and answering to and requesting Doctor-To-Doctor reviews, wherein UMB shines in presenting the medical criteria and the medical necessity required for your denial to be reversed.