SEAMO
Southeastern Ontario Academic Medical Organization
 

SEAMO Billing Services (SBS)


SEAMO Billing Services offers a full-service medical billing experience to our clients that focuses on timeliness and accuracy.  Since 2005, we have been providing a high level of service to specialists across multiple locations (KGH, HDH, PC, the community, etc.) and health encounter types (Inpatient, Emergency, Same Day Surgery, Outpatient Clinic, etc.).

An overview of SEAMO Billing Services is also available as a pdf document by clicking here.

Our Services

Billing services provided:

  • Assistance with physician OHIP registration
  • Entry of paper-based or electronic claim data
  • Identification of claim maximization opportunities
  • Leverage of existing electronic systems to automate claim creation
  • Upfront correction of missing or incorrect information
  • Validation and submission of claims
  • Follow-up on all rejected claims
  • Reconciliation and review of payments
  • Weekly review of all outstanding claims
  • Preparation of RAIs/documentation
  • Liaison with the Ministry of Health regarding billing issues
  • Ensuring security of patient data and full Health Insurance Portability & Accountability Act (HIPAA) compliance
  • Performing routine and ad hoc claim audits
  • Running routine, customized and ad hoc reports

Other billing services provided:

  • Private insurance invoicing
  • Invoicing directly to patients
  • Processing of Interim Federal Health program claims

SBS has cultivated a highly functional relationship with the OHIP office in Hamilton and we remain committed to working with our contacts to ensure we provide the most accurate billing practices possible.  Through this relationship, we have gained an intimate knowledge of the physician registration process.

Reporting Options

In order to meet our clients' individual needs, SBS offers a full range of regular reporting options in addition to monthly remittance advice reports.  We also provide regular departmental reports and direct support to SEAMO Management for accountability management purposes.

Service Delivery Target

SBS maintains a service delivery target of two weeks.

Data Sources and Privacy

SBS has the unique capability to leverage all electronic sources available to our team to automate claim creation.  We are the only billing service with this level of data access privilege, which allows us to offer a level of claim automation, claim maximization and claim auditing beyond any other billing service.  We are also the only billing service with a direct, real-time link to the Patient Care System, which automates the creation of health encounter data in our billing system and eliminates the need to enter patient demographics. 

Data sources currently available to our team include: 

  • HL7 Real-time interface to PCS
  • Patient Care System (QuadraMed)
  • Medical Records System (WinRecs)
  • KGH Data Warehouse (Decision One)
  • Several departmental databases

SBS is fully compliant with the Health Insurance Portability & Accountability Act (HIPAA) and all billing processes are protected within the KGH firewall and governed by KGH privacy policies and procedures.

Our Staff

We currently staff eight KGH-credentialed college-level certified billing clerks who have additional training in medical terminology and Microsoft Office.  Our billing clerks are trained and experienced in a multitude of specialties to ensure our expertise supports the multi-specialty environment in which health encounters are delivered.

Fees

SBS is a not-for-profit organization, financed through the fee charged to clients, 1% of the value of approved claims.  Our focus is to maximize your billing in a timely manner.  Our clients are never charged for rejected claims or unpaid claims.  This model ensures we're motivated to submit your claims to ensure both accuracy and completeness.

Location and Office Hours

SBS is located at 26 Barrie Street, Kingston, Ontario.  Our convenient location near the University and partner hospitals allows many of our clients to drop in whenever they have time to discuss billing issues or drop off claim documentation.  Our office hours are Monday to Friday, 7 am to 4 pm.  For contact information, please see our Contact Us webpage.