Our processes for billing each of our clients assures that complete revenue capture occurs by maintaining a master list of all patients seen in any practice and assuring that each patient has had charges posted commensurate with services rendered. These logs are reconciled each day giving the client the assurance they need that all services rendered result in revenue billed. All claims produced are reconciled against claims leaving our system to assure that all claims produced are billed in a timely manner. We also use work queues in our practice management system to assure timely completion of follow up for claims that are not paid by third parties after initial billing. The work queues are established by client, by payer and track each time a claim is touched and the effectiveness of each step in the rebilling process.
On the cash side of the equation each client maintains a bank lockbox where deposits are made. This deposit capture is communicated to payment posters in our office who must reconcile payments in our practice management system against payments received by the bank. This same process follows through for every piece of paper correspondence, every denial and every third party communication received related to a client’s accounts receivable. This assures both us and our clients that nothing is “lost” and gives our client the peace of mind that when you outsource your billing, you have not lost control of the process.
Our coders must pass a comprehensive exam and demonstrate both experience and excellence before being hired. New coding staff is audited 100% for accuracy and opportunities to enhance and focus on potential knowledge deficits. They continue to be audited on an ongoing basis to ensure consistent excellence in their performance.
Monthly meetings provide coding staff with the opportunity to learn from each other, review ongoing chart audits and keep the team up to date on recent industry trends, ensuring the most knowledgeable team possible.
Throughout the month, weekly coding tips are distributed to coders internally and in many cases to our clients for those trends noticed in the everyday operations.
Our secure client web site access provides “Ask a Coder” text box as a resource for our clients coding or documentation questions within 24 business hours.
Coding Feedback for Compliance and documentation excellence.
All new clients receive an initial review of their coding and documentation to identify problems that could put our clients at risk for compliance violations by federal and local payers and assists in maximizing reimbursement through proper coding.
Feedback is provided for physician documentation deficiencies that might have a negative impact on the client. Coders utilize e-mail, written memorandum and monthly meeting presence with clients to enhance feedback.
Reporting on CPT code frequencies by physician and group ensure any change in coding or documentation standards is quickly identified and resolved.
We also employ a Certified Professional Coder who is an AHIMA certified ICD10 trainer, giving us the ability to prepare your practice for ICD-10 and keep you involved and get you prepared for ICD10 changes.
Billing and Collections
Our practice management system monitors the charge to reimbursement process at each step to insure the fastest payment possible utilizing key functions:
- User defined posting edits to insure accurate charge posting.
- User defined claims edit functions for CCI and payer specific coding guidelines to reduce claims denials before they occur.
- Electronic claims submission with accept/reject and eligibility verification within 24 hours of submission to insure invoices are sent to the responsible payer.
- Electronic claims status remits and transmittals for prompt, electronic resolution to outstanding claims.
Our employees are accountable for meeting A/R performance benchmarks and A/R Day goals for each clients account. Web-based patient and client access to information 24/7 through our secure site.
Our collection policies are reviewed and approved by each client to insure aligning client objectives with maximization of patient revenue.
Reports we provide include:
E&M Distribution Analysis
Cash Reconciliation Reporting
A/R performance Summary and Benchmarking
Management Narrative on top payer issues/topics
Productivity any way you slice it
- Standards of conduct, policies and procedures
- Designation of a compliance officer
- Compliance training & education
- Confidential reporting for compliance concerns
- Auditing & Monitoring
- Disciplinary guidelines for compliance infractions
- Procedures for handling compliance problems
- Accounts Payable processing
- General Ledger & Financial Statements
- Cost analysis by CPT/RVU
- Payroll & Benefit plans
- Budgeting & Planning
- Internal process management (patient flow, paper flow, process reengineering)
- Start Ups
- Evaluate & offer alternatives to physician compensation formulas
- Payer contract negotiation & credentialing
- Operational assessments
- Strategic Planning
- Existing contract reimbursement audits
- Staff Training & Development