Billing processes that are built around you
Implementation / Onboarding
we make the transition seamless
We have a strong track record of taking over existing accounts receivables and a system in place for making that transition seamlessly. A dedicated project manager will be assigned to manage the onboarding process and serve as your single point of contact during the conversion.
In accordance with your requirements, we can build an interface to EHR, LIS, RIS, or HIS. If you want to minimize technology changes, it won’t be necessary to change or implement our software because we’ll be able to connect to the solution you’re already using. On the other hand, if you aren’t using a software solution or want to upgrade, we can assist you in completing that installation.
we developed sophisticated workflow tools
Our solution integrates a mix of off-the-shelf and proprietary software. We don’t waste time or escalate costs by reinventing the wheel on straightforward matters such as submitting a claim. Instead, we enhanced the solution by developing sophisticated workflow tools that weren’t available or didn’t have the capacity to achieve our target levels of performance. This combination of commercial and proprietary systems delivers that performance and converts medical billing into a strategic asset.
Equally important, there are no interoperability issues to resolve. We can get the software up and running immediately, no matter which connection your system requires. Whether we’re dealing with LIS, RIS, PMS/EHR, or HIS, there are no compatibility complications. We can interface to virtually anything and can even export files in a “light interface.”
Updates run just as seamlessly, both on the technology side and in terms of changes to insurance company rules, procedures, and coding practices. We’ll update and integrate these on an ongoing basis by continually running denial reports and analyzing trends on your behalf. By keeping our solution in a state of constant development, we keep your medical practice or lab on top of the requirements that determine how quickly you book your receivables.
As your partner, we’re invested in your profitability
What happens when there is a denial? Where some companies might see an end to a claim, we see the beginning of research activity designed to resolve the problem and collect your money. Our procedure calls for team members to respond promptly to any denial by investigating newly introduced rule changes. In addition, we contact payers to determine what updates or corrections are necessary to appeal and overcome the denials.
That discovery process in turn sparks new training initiatives. As your partner, we’re invested in your profitability, and that carries over to investing in our team members’ continued education and professional development. It’s not enough to load new rules into our system. We take the additional, essential step of educating our staff about the changes and modifications so they’re prepared to manage them successfully going forward. And we make concurrent updates to our policies and procedures to ensure continuity as well as sustainable success in your collections. We also communicate any payer coding or policy changes to you so that you understand your business (as a true partner would) and so you can project cash flow reliably.
Each of these initiatives is a component of our overall client commitment: to search daily for new strategies and methods that will increase your revenue. That can mean anything from launching program improvements to implementing productivity enhancements that increase collectors’ output. At the same time, we monitor our technology and continuously develop new software modules and solutions to ensure that we keep pace with process innovations and increase collections.
The bottom line: by maintaining our focus on the revenue cycle, we optimize the value we’re able to deliver as your partner in profitability.
Our services and support
we partner with you and your team
There’s one additional factor that makes our solution work: the way we partner with you and your team. We’re as dedicated to remaining knowledgeable about the challenges you’re facing as we are to tracking current and emerging industry trends, developments, and changes. And we’re actively involved in communicating those changes to you so you can act on that information and use it to your financial and competitive advantage.
To learn the full scope of services and support we make available to your team, see the list below. In addition, we welcome your inquiries about such value-added services as consulting on fee schedules, patient balance billing rules and regulations, billing out of network, and credentialing/contracting. Contact us for more information.
- Coding consulting
- Coding from reports
- Coding auditing
- Coding feedback to clients and documentation support
Charges and Reconciliation
- Charge entry
- Claim submission,
- Clearinghouse and integration, clearinghouse reports
- Charge reconciliation w/client system or schedule
Payer Policies and Compliance
- Payer policy research
- Payer rules engine to ensure claims submitted correctly
- Billing compliance
Accounts Receivable management
- Complete AR management, follow up on all claims
- Denials and appeals management
- Denials reporting
- Explaining denials to clients
Front office support
- Billing coordination, getting updated or corrected demographic information from referring physicians
- Obtaining requisitions, face sheets, reports and other billing documentation
- Eligibility verification
- Benefits verification
- Pre-authorizations/pre-certifications, retro-authorizations
Payment Posting and Contract Compliance
- Payment posting
- Catching insurance underpayments
- Contract compliance enforcement (if applicable)
Patient Revenue Cycle Management
- Sending all patient statements
- Special patient balance billing procedures for out of network patients
- Handling all patient inquiries
- Patient balance negotiations
- Patient payment plans
- Automatic patient payment plan direct debit or credit card
- Patient pre-collections calls
- Patient registration/demographics entry
- Handling patient financial hardship applications
- Managing patient collections process
- Out-of-network patient negotiation 3-way with insurance companies
- Past due notifications
- Online submission of credit card payments for patient balances
Practice Setup and Consulting
- Payer registration
- Payer enrollment, credentialing, and contracting
- Contract consulting
- Contract negotiation
- Setting up electronic funds transfer (EFT) for clients with all payers eligible
- Fee schedule optimization
- Credit card merchant account for patient balances and credit card processing
- Electronic document management for archiving of all client billing documentation
Reporting, BI, Analysis, CRM
- Business intelligence
- Interfaces, HL7
Schedule Your Free Practice Consultation Today
We offer start-up support, fee-schedule optimization, benchmarking, network participation consulting, payer contracting and negotiations, and much more! Please contact us to find out how we can be your solution.
Call us at 1.888.422.5514 or use the contact form to send us an email.