Billing and Reimbursement Services
Certain circumstances present opportunity for completely outsourcing a practice’s billing office function. As circumstances vary each situation requires proper analysis before choosing this option.
Practices often already have staff and information systems, yet lack knowledge of proper policies, procedures and expectations. This service allows practices to maintain investment of both staff and information system, presuming both continue to provide appropriate levels of expected support, while receiving proper oversight from experienced, professional personnel.
Seminars are offered to enhance office staff and physicians’ knowledge of coding protocols and reimbursement issues. These training sessions may be tailored for a particular practice in their office or offered in general sessions at a variety of locations. We offer classes for the Certified Professional coder’s examination administered by the American Academy of Professional Coders.
Chart notes are reviewed to insure proper coding and documentation with recommendations for coding utilization and overlooked billing opportunities.
This process compares each practice’s process and procedures with those of one that is properly administered including, but not limited to, internal controls of cash, charge/payment capture and posting, staff responsibility and information system utilization.
Specific to determining the current state of a practice’s accounts receivable this process compares and contrast practices to ones of like specialty. Key areas compared include, but are not limited to, total accounts receivable per physician, accounts receivable ratio, accounts receivable aging and gross and net collection rates.
Although practices often presume reviewing fee schedules is a futile effort, much may be learned from performing such analysis. (e.g., payers not reimbursing according to contract, inappropriately set fees and more.)
Practices often find that investment in technology is expensive and intimidating. Thus a “time share” option provides practices the opportunity to minimize capital outlay while insuring access to quality software and receive advantage from economies of scale.