A Billing agent provides several important services:
Billing expertise. They understand medical billing rules and coding requirements, helping ensure claims are submitted accurately and that physicians receive the maximum reimbursement to which they are entitled.
Management of multiple payer types. In addition to provincial health insurance claims, they can process claims for:
Out-of-province patients
The Interim Federal Health Program (IFH)
Private insurance companies
Direct patient billing arrangements
Claims correction and resubmission. They can identify missing information, obtain updated patient details such as version codes, correct rejected claims, and resubmit them promptly.
Advice on new billing situations. When physicians introduce new services or programs—such as telemedicine services or refugee health care—a billing agent can provide guidance on billing requirements and registration processes.
Revenue recovery. By reducing billing errors, tracking unpaid claims, and ensuring all eligible services are billed appropriately, a billing agent may increase collections enough to offset or exceed the cost of their services.