Billing and Collection Services

Billing Service Components

We offer a number of different service components, depending on the practice and its needs. The following is not a complete list, rather an example of the core services provided to our clients.

Core Billing Services Description

  • ICD9 coding from super bills, tickets, hospital cards
  • Regular Coding Updates to ensure compliance with new regulations
  • Data entry into computer system and transmission of appropriate forms to all carriers.
  • Where ever possible, transmission of data is paperless, compliant with new HIPAA regulations.
  • Collections of outstanding charges from all carriers beginning at 35 days after claim submission. Follow up may be electronically, via phone or provider rep, where appropriate.
  • Collections of outstanding balances from patients, as specified by the client.
  • Collection and submission of encounter data (capitated plans only).
  • Daily and Monthly reports on physician and practice productivity and financial health.
  • Monthly Status meetings to discuss strategic, financial and/or specific account-related questions
  • We provide individual design of superbills and other office forms to our clients free of charge. All forms are designed to maximize efficiency within the practice and are updated as needed.
  • Specialized reports as requested by practice, such as patient base analysis, carrier profitability, referral analysis, physician incentive analysis etc. are free of charge and can be delivered electronically in universally acceptable format (MS Excel, Lotus 123, MS Access or other).
  • Based on comparable practices we have worked with, we offer review of office systems, recommend alternatives if desired and see you through the training phase with your staff.
  • Staff performance feedback through denial management systems, which we discuss wit the practice during monthly meetings. Denials are broken down by category to enable early problem intervention and to create objective performance standards of team members within the practice and your PRS.
  • Managed Care contract review and decision support to the practice is integral to successful negotiated contracts. Your data is available to you in any format, any time with any parameters to help you strategize.

Consulting Services

Consulting Services Components

Our consulting services center around the set up and optimization of the medical practice. Again, the scope and deliverable is individually tailored to the practice's needs. However, following are some examples of client projects, that are one-time engagements rather ongoing.

Key Consulting Services Components

  • Risk and cost analysis for billing process alternatives
  • Design and implementation of in-house system
  • Design and implementation of staffing models for complete restructuring
  • Development and implementation of policies and procedures to prevent cash leakage, maximize efficiency and provide objective performance measurements for in-house collections
  • Extensive or very intensive and subject matter specific staff training
  • Design of management reports relating to reports other than revenue cycle related (e.g. strategic pricing, inventory reporting)
  • Strategic planning
  • Cash Acceleration Programs