Services

BILLING:

• Billing is sent fed ex either once or twice per week depending on size of practice. The billing is always done on the day it is received by us.
• The charge sheets (superbills) must have cpt codes and diagnosis in addition to all patient info (demographic and copies of front and back of insurance card). Copays should be written on superbill as well and how it was paid (check,cash..etc). All ORIGINAL EOB’s and denials should also be included. We suggest making copies for yourselves and/or we can mail them back to you once per month. These are scanned and shredded (unless they’re originals and you want them back) into our system so we will have access to them any time we need them. The reason we want originals is that we’ve encountered way too many problems with copies. They’re either missing pages, we can’t read them, or practices just forget to copy some of them. This results in us inquiring about payment to an insurance company when it is already paid. Upon entering all bills and eobs, a “batch report” will be emailed to your practice. This will include everything that was entered in this billing batch.
• All data is entered 100% correctly into the system (Note..this is the number ONE problem resulting in insurance denials).
• We correctly match up diagnosis to correlating procedures and add any modifiers if necessary.
• Claims are sent to insurance carriers electronically.
• Insurance pays.
• If insurance denies, it is immediately worked on. Most insurance denials are incorrect/terminated insurance info given by patient which is unverified by office. Denials are tagged and tracked into our system. For example, if we receive a denial for “Additional Information needed from provider” (this usually means that insurance is requesting notes for the denied date of service), each line item (charge) for the denied date of service will be tagged with that denial reason. We will then request the notes from your office and send them to insurance carrier. This “tag” will remain on the date of service until it is paid. These denials are also exported into a report which is run once per month for each practice. In this particular case, if the report showed this was still open, it would be followed up on and notated in the patient account.
• Patients receive bills for any copays,coinsurance or deductibles.
• Patient statements are sent once per month. If a patient fails to pay after receiving 2 statements, they will go to collection (upon physician/office approval).

REPORTING:

We are by far the best reporting medical billing company in the industry. We will break you down in every way imaginable:

• How much are you making per patient? If a group, how much is each physician making per patient and also what does the group average per patient?
• Charge and payment analysis per each physician (excel graph). This report tells you what each physicians average monthly charges and payments are. If a certain physician only brings in 3/4 of what he normally does for a particular month, a simple look at this graph will tell you that his last month’s charges were way down because he went on vacation, hence the reduced revenue for this month.
• Procedure code analysis. This report lets the practice know how many of each procedure code was billed in a certain date span and how much was collected for it. For example, a physician bills 200 99213’s in the month of March. He also collected $13k for 99213’s in March. This report will show that for EVERY procedure code. Another great thing about this report is that lets say you have an in-house lab that is costing the practice $50k / month to maintain. You will be able to see all of the labs being billed and collected for each month. Are you making money or losing money on labs? This report will tell you. You will also get this report in excel format.

• Payments broken down by insurance carrier. If the practice made $100k this month, this report will break down the $100k by insurance carrier.
• Reimbursement analysis. This report will tell you the average reimbursement for “X” procedure code for “Y” insurance carrier. As a physician you will be amazed at the differences in reimbursements offered by the different insurance carriers.
• Monthly Report. This software generated report gives you what your collection rate is. For instance, if your aging is currently $500k, how much is that in real money? Once you join us, we will be able to give you this info at all times. So, if you have a $250k aging with us and your determined collection rate is 50%, we can adequately tell you that you have $125k in real money outstanding. The way we find this out is that this report breaks down a certain month’s charges by a certain month’s payments. For example, lets take the month of May. May’s charges were $500k. It is now the month of July and most of May is paid. This report takes May’s payments (for dates of service in May ONLY) and divides them by May’s charges. This report does this for every month in the year. There might be some very small fluctuations in each month (some might have collection rates of 50%, some 48%). The results of this report give an accurate reflection of what cash is outstanding at all times in the practice.

These are just an example of the many reports we offer. Your practice will receive both these reports and a year to date status every month. You can also receive any report instantaneously 24/7 just by simply calling/e-mailing or texting us. We will break your practice down like no other medical billing company out there.

We also offer scheduling, insurance verification (must have scheduling for this) and EMR/EHR services (done through our software carrier, Criterions). Please feel free to call us on these. If you currently have your own EMR, no problem!. We currently have 2 clients that have their own EMR and we do their billing. You will have access to our software and your data at your disposal. If you’re interested in receiving at least a 15% boost in revenues, give us a call. Or call our references first….either way you’ll be glad that you did.