Medical Practice Management
We provide expert medical practice management services in the following areas:
- Medical Billing and Cash Flow Services
- Collections
-
Provider Applications and Set up
We prepare basic Medicare and Medicaid applications as well as certain other major insurance or
Managed Care applications. We also prepare re-credentialing applications with all payers and
hospitals. We maintain and update the provider CV and include it as necessary with these
applications. We advocate for our clients under "any willing provider" legislation where
appropriate. We provide the basic registration, assignment of benefits, release of information,
and waiver of liability forms as well as HIPAA-compliant procedures.
Return to top
-
Patient Registration
Our registration database has capability for a virtually limitless history of insurance carriers
as well as different primary insurers for members of the same family. Our attention to detail
and persistent follow up effort during the registration process insures timely, accurate claim
adjudication. This translates to quick cash turnaround for our clients. We also verify authorization
for outpatient treatment and maintain this information in our unique referral authorization tracking
checklist. We share this tracking information with our clients to insure that all services rendered
are paid. Our electronic communication capabilities minimize client effort and claims adjudication
time.
Return to top
-
Charge Entry and Claims Processing
- Charges are entered into our software from encounter sheets completed by the provider.
- Claims are prepared daily and transmitted electronically.
My staff is experienced in their specific client's attributes of procedural and diagnosis coding
as well as Medicare's correct coding initiative with respect to ICD/CPT agreement. Our software
and procedures can be customized to identify specific instances of compliance or denial risk.
For example, if a fourth or fifth digit level of specificity is required on a diagnosis code (such
as with ICD code 250.13 -- diabetes with ketoacidosis type I insulin dependent, uncontrolled), and
the physician has provided only three digits, then our staff will notify the physician of the need
for a more specific code before the claim is submitted for reimbursement. Additionally, we will review
your fee schedule to minimize your risk of underpayment (e.g. Medicare or Medicaid paying the lower of
cost or charges).
Return to top
-
Receipt Posting and Secondary Processing
All payments are remitted to a Post Office box in our locale. Deposits are prepared daily and reconciled
to your monthly bank statement. All checks are restrictively endorsed and deposited into your bank account
(where authorized signers are limited to your designees). This provides sound internal control while
allowing maximum productivity on our part. As part of our compliance program, we do not maintain escrow
accounts or become authorized check signers on our clients' accounts. Additionally, as part of a solid
internal control structure, our deposit preparation staff do not have access to receipt or adjustment
posting processes on the software.
Secondary claims and patient statements go out immediately after cash is posted. We generally do not wait
until month-end to process these bills. We additionally provide guidance to your practice staff on
collecting co-pays and deductibles at time of service. To this end we provide assistance to the practice
to obtain credit card capability, if desired. We include this credit card information on your customized
patient statements. For mail received that denies payment, we follow up immediately to resolve. Our
clients generally enjoy better than 96% cash receipt as compared to net charges.
Return to top
-
Month-End Closing
Productivity and aging reports, as well as trend analyses are available to the practice monthly (generally,
via e-mail). Deposits are reconciled to client bank statements where requested and review of the aging for
follow up also occurs at this time. Accounts that have no payment activity for 45 days are reviewed and
adjudicated.
Telephone inquiries concerning payment are directed to our toll-free number in Glenville, New York.
Any questions we receive related to patient care will be directed back to the practice.
Our fees range from 5% to 10% of cash receipts, depending on volume and complexity, and are in compliance
with the office of inspector general's guidance for medical billing companies.
Cash Flow Management, Compliance, and Collection Services are also provided on both per engagement and
contingency bases.
Return to top
-
We specialize in the recovery of outstanding dollars due to medical providers. Our Specific successes in overturning
medical necessity, lack of timely filing, pre-existing condition, and coverage termination denials as well as our low
fees makes us a logical choice for small to medium size hospitals and medical practices of almost any size.
We specialize in cash flow enhancement within compliance through the management of our clients' accounts receivable.
Techniques utilized in performing this management function include medical record review, billing, follow-up, CPT
coding review, collection, compliance assessment, write-off analysis and staffing/procedural review.
My expertise in the recovery of "dead" monies has created a demand for services as trainer of new and existing billing
and collection staff at hospitals and group practices.
Our area of specific expertise is in behavioral health. We have also performed the collection and billing function
for a variety of other providers (Oncologists, Internists, Gerontologists, etc.).
Our fees are dependent on volume. Many of our arrangements are in the 15% - 18% range.
Return to top
