Accurate Medical Billing & Audit (AMB) Founder & CEO David Martinez
David Martinez, CEO and Founder of AMB, LLC-(A Minority Owned Company), began his career over twenty nine (29) years ago as a dental claims processing trainee at Aetna Insurance Company. David rapidly earned the previously never offered invitation for medical, hospital, psychiatry, and orthodontia claim examining training. David earned top student and set new records of claim production and quality. David went on to become a top 10 examiner in the entire nationwide Aetna Insurance Company out of 3000 examiners, and set the record for the fastest to reach Senior Examiner rating.
David continued earning accolades within Aetna and was heavily recruited to other companies.
David went on to help develop billing, claims, and revenue recovery departments within some of the most prestigious IPA’s, Medical Groups, and MSO’s in Southern California. He was the driving force behind turnarounds that recouped and saved millions in cumulative dollars, he equipped teams with the knowledge and skills to outperform the status quo, and built the trust and confidence of customers and providers for both low- and high-profile entities. With experience spanning from risk pools, revenue recovery, legislation, and contract interpretation to all finance, medical coding, business, operations, and relevant IT, David provided and provides a 360-degree perspective of issues vital to success for people on all levels in order to ensure expectations are not only met, they are consistently surpassed.
A proven track record of progressive growth and comprehensive experience in all aspects of health insurance claims and billing management. Accurate Medical Billing & Audit is fully HIPAA certified.
Accurate Medical Billing And Audit is a proud and active member of American Medical Billing Association (AMBA), American Academy of Professional Coders (AAPC), Health Billing & Management Association (HMBA), Medical Group Management Association (MGMA), International Chiropractors Association of California (ICAC), California Chiropractic Association (CCA), San Bernardino County Medical Society, and Rancho Cucamonga Chamber of Commerce.
David is an approved lecturer for the ICAC for Continuing Education Credit Units (CEU) for Doctor’s, CEU’s.
David was recently awarded a preferred partner status with the San Bernardino County Medical Society.
David is a featured lecturer for Southern California University of Health Services.
Experienced in healthcare insurance and plan administration, patient screening and eligibility verification, claims negotiations, adjustments, and write-offs.
Extensive experience with Medicare, Medi-Cal, FFS, Capitation, HMO, PPO and traditional health insurance and managed care plans.
Proficient in the use of Medi-Tech, EZ-CAP, AthenaNet, Crystal Reports, MS Excel, MS Word, Outlook, PowerPoint.
Skilled in a full range of insurance and billing coding and methodologies: HCC, CPT, RVS, RBRVS, ADA, DRG, APC, Medi-Cal, Medicaid, Per Diem, HCPCS, P4P, ICD-9, ANSI 835, 837.
Now have you ever wondered if your office could be losing money due to inexperienced billing staff, inferior billing service; Outdated, non-compliant, or non-existent Electronic Health Record system (EHR, EMR); Non-existent, or inability to Electronically submit prescriptions (eRX)?
Here is quick way to determine: If whoever is doing your billing cannot answer these simple questions “off the cuff”, or the answer is wrong then more than likely you are losing money! (Contact me for the correct answers)
1. Explain what is COB (Coordination of Benefits); Hint: There is more than just one criteria or calculation.
2. What is your appeal process? Does the protocol differ with different products (HMO, PPO, etc).
3. What is capitation?
4. What is AB1455
5. What are the different types of Medicare (A,B,C,D)?
6. What is a Medicare Advantage Plan?
7. What is a Blue Cross local?
8. Do you post from the EOB?
9. Is the system Meaningful Use Certified? (HL7, HIPAA, CCHIT)
10. Are you ICD-10 ready?
We can provide Total Revenue Solutions to solve any “pain” you may be having.
- Online patient Credit Card processing
- 24/7 Web-Based Access
- Online Scheduler
- Real-Time Reporting
- Built-in Labs Interface
- Streamlined Patient Encounters
- HL7, HIPAA, CCHIT Certified
- Easy-to-Use, Intuitive Interface
We can and will provide REAL experience, REAL knowledge, REAL support and REAL results!
Your overhead will be lower, your cash flow will increase dramatically, and rejected claims will fall to about 2-3%. And, your patients will end up happier because you and your staff will finally have the time and energy to really care for them, not bill collecting or fighting with insurance companies.
David was consistently a top ten leader in production for claims examiners. He was the king of denials! He and his team knows the why’s and how’s insurance companies deny claims. We possess the “inside” information.
Confident in AMB’s ability to enhance your organization as well, upon request, a full copy of David’s impressive resume, which contains more detailed information on his professional history. Contact me at your earliest convenience for a free practice analysis.
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