Revenue Cycle Outsourcing September 7, 2015September 7, 2015September 7, 2015...

Revenue Cycle OutsourcingRevenue Cycle OutsourcingApril 19, 2023April 19, 2023

www.nationalASCbilling.com

2CONFIDENTIALwww. nationalASCbilli ng. com

WeMeasureOurSuccessByWeMeasureOurSuccessByYourResultsYourResults

Revenue Cycle Management.

It’sallwedo.It’sallwethink about.Anditshows.

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Our MissionOur Mission

CONFIDENTIALwww. nationalASCbilli ng. com

““We are singularly focused on We are singularly focused on delivering the best results, providing delivering the best results, providing

exceptional customer service and exceptional customer service and building relationships with ambulatory building relationships with ambulatory

surgery centers and associated surgery centers and associated physician practices based on trust, physician practices based on trust,

performance and integrity.”performance and integrity.”

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OverviewOverview

• Who We AreWho We Are

• What We DoWhat We Do

• Why We Deliver the Best ResultsWhy We Deliver the Best Results

• What Our Clients SayWhat Our Clients Say

• SummarySummary


• Premier revenue cycle management company focused on the ASC Premier revenue cycle management company focused on the ASC market and their respective professional practicesmarket and their respective professional practices

• Named one of the world’s best outsourcing service providers in Named one of the world’s best outsourcing service providers in Fortune Magazine 2012 and 2013Fortune Magazine 2012 and 2013

• We code and bill for surgery centers and practices in 40+ statesWe code and bill for surgery centers and practices in 40+ states

• Management team is highly seasoned with deep billing expertiseManagement team is highly seasoned with deep billing expertise

• Cutting edge processes and technologiesCutting edge processes and technologies

• We significantly increase cash per case in compliant fashionWe significantly increase cash per case in compliant fashion

• Highest customer satisfaction rates in the industryHighest customer satisfaction rates in the industry

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Who We AreWho We Are


We Are the Revenue Cycle Experts … Just Ask Our ClientsWe Are the Revenue Cycle Experts … Just Ask Our Clients

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What We DoWhat We Do


• We provide the following We provide the following services for our clients:services for our clients:

• Complete revenue cycle Complete revenue cycle outsourcingoutsourcing

• Coding servicesCoding services

• Comprehensive coding Comprehensive coding and billing auditsand billing audits

• Managed care contract Managed care contract consultingconsulting

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Our Coding ExpertiseOur Coding Expertise


• Certified coders with extensive Certified coders with extensive experience in multi-specialty surgery experience in multi-specialty surgery codingcoding

• State of the art coding softwareState of the art coding software

• CCI editsCCI edits

• Checks ASC approved codesChecks ASC approved codes

• Local Medicare review policesLocal Medicare review polices

• State and carrier specific State and carrier specific requirementsrequirements

• Experts in identifying opportunities for Experts in identifying opportunities for missed revenue and trained to handle missed revenue and trained to handle complexities such as:complexities such as:

• Inappropriate bundlingInappropriate bundling

• Medical record documentation Medical record documentation requirementsrequirements

• Capturing all procedures in complex Capturing all procedures in complex casescases

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Our Billing ProcessOur Billing Process


• Reconciliation between OR Reconciliation between OR schedule and EDI reports dailyschedule and EDI reports daily

• All claims (except those requiring All claims (except those requiring attachments) are billed attachments) are billed electronically within 48 hours electronically within 48 hours from receipt of all source from receipt of all source documentationdocumentation

• EDI provider is ASC experienced EDI provider is ASC experienced and compliant with HIPAA and compliant with HIPAA transactions and 5010 code set transactions and 5010 code set requirementsrequirements

• Contract review takes place at Contract review takes place at time of billing and payment time of billing and payment postingposting

• Daily reconciliation of deposits Daily reconciliation of deposits received to bank transactions and received to bank transactions and system postingssystem postings

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Our A/R ProcessOur A/R Process


• Established relationships with Established relationships with carrierscarriers

• Experienced in handling out-of-Experienced in handling out-of-network claimsnetwork claims

• Superior reporting capabilitiesSuperior reporting capabilities• Spot trendsSpot trends• Monitor cash flowMonitor cash flow• Aging reports analyzed at least Aging reports analyzed at least

once a weekonce a week

• Aggressive and successful appeals Aggressive and successful appeals processprocess• Medical necessityMedical necessity• Usual and customary Usual and customary

reimbursementreimbursement• MedicareMedicare• Coordination of Benefits (COB)Coordination of Benefits (COB)

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Our Customer ServiceOur Customer Service


• Dedicated account Dedicated account representatives to take patient representatives to take patient calls and answer questionscalls and answer questions

• Patient statements sent weeklyPatient statements sent weekly

• Outbound calls made daily on Outbound calls made daily on delinquent balancesdelinquent balances

• Recommend high tech, web Recommend high tech, web based patient portals to allow based patient portals to allow online payment ability and online payment ability and access to account reviewaccess to account review

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Our Detailed ReportingOur Detailed Reporting


• Our cutting edge business Our cutting edge business intelligence software and intelligence software and analytical tools allow us to analytical tools allow us to provide you real time insights provide you real time insights into the performance of your into the performance of your surgery center, thus enabling us surgery center, thus enabling us to provide you with all of the key to provide you with all of the key reports you will wantreports you will want

• Missing information report sent Missing information report sent at least once per weekat least once per week

• Unbilled report generated each Unbilled report generated each monthmonth

• Cash sheets sent daily to reflect Cash sheets sent daily to reflect totals and projected collections totals and projected collections in relation to monthly goalin relation to monthly goal

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Managed Care Contract ConsultingManaged Care Contract Consulting


• Evaluate and assess current Evaluate and assess current and proposed managed care and proposed managed care contractscontracts

• Identify contract nuances and Identify contract nuances and educate billing team in order educate billing team in order to maximize reimbursementto maximize reimbursement

• Work with network managers Work with network managers on carrier updates and on carrier updates and communicate these updates communicate these updates with facility and billing teamwith facility and billing team

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Implementation and TransitionImplementation and Transition


New ClientOn site kick off meeting

Establish initialoperating procedures, communication processes, and plan for transition.

Go-Live Process1-2 weeks

Process stabilized. Ongoing tracking and monitoring.

Transition2-4 weeks

Finalize detailed process design & migrate process.

Continuous QC>4 monthsContinuous quality and process improvement. Optimize productivity -All resulting in increased revenue and compliance.

Structured Account ManagementStructured Account Management

Process Management RigorProcess Management Rigor

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Client ServicesClient Services


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Why We Deliver the Best ResultsWhy We Deliver the Best Results


• Surgery SpecializationSurgery Specialization

• Deep Billing ExpertiseDeep Billing Expertise

• Seasoned Managed Care Seasoned Managed Care

Contract NegotiatorsContract Negotiators

• Specialized Certified Specialized Certified

CodersCoders

• Skilled Accounts Skilled Accounts

Receivable ExpertsReceivable Experts

• Seamless Transition Seamless Transition

• Strong Compliance FocusStrong Compliance Focus

• World Class Processes and World Class Processes and

TechnologyTechnology

• State of the Art ReportingState of the Art Reporting

• Unparalleled Customer Unparalleled Customer

ServiceService

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Ask Our ClientsAsk Our Clients


Revenue Cycle Expertise Led to 32 Percent Increase in CashRevenue Cycle Expertise Led to 32 Percent Increase in Cash

““NMBS’s dedication to and focus on maximizing revenue is evident in our cash NMBS’s dedication to and focus on maximizing revenue is evident in our cash

performance. Their combination of exceptional customer service, highly performance. Their combination of exceptional customer service, highly

knowledgeable staff and deep industry expertise has made NMBS our "go to" knowledgeable staff and deep industry expertise has made NMBS our "go to"

company for billing and coding. Most importantly, they increased our cash by 32 company for billing and coding. Most importantly, they increased our cash by 32

percent.”percent.”

President, ASC Management CompanyPresident, ASC Management CompanyAtlanta, GeorgiaAtlanta, Georgia

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Ask Our Clients cont.Ask Our Clients cont.


NMBS's Billing and Coding are Highly Superior to In-house ResourcesNMBS's Billing and Coding are Highly Superior to In-house Resources

““We were handling our billing and coding in-house and thought that things were We were handling our billing and coding in-house and thought that things were

fine. NMBS offered to do an analysis of our business office at no cost to us, so we fine. NMBS offered to do an analysis of our business office at no cost to us, so we

agreed. Upon reviewing the results, we were stunned to find out how much agreed. Upon reviewing the results, we were stunned to find out how much

revenue we lost due to the fact that we were improperly billing and coding revenue we lost due to the fact that we were improperly billing and coding

expensive implant charges. This process also taught us that it was virtually expensive implant charges. This process also taught us that it was virtually

impossible for our business office to employ specialized billers, coders and AR impossible for our business office to employ specialized billers, coders and AR

experts in the way that NMBS does. NMBS is purely focused on billing and coding, experts in the way that NMBS does. NMBS is purely focused on billing and coding,

and it shows. The results? NMBS increased our cash by 35%. We will never again and it shows. The results? NMBS increased our cash by 35%. We will never again

bring the billing back in-house.”bring the billing back in-house.”ASC AdministratorASC Administrator

Shreveport, LouisianaShreveport, Louisiana

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Ask Our Clients cont.Ask Our Clients cont.


NMBS’s Coding Expertise Identified and Captured Lost RevenueNMBS’s Coding Expertise Identified and Captured Lost Revenue

““NMBS’s coding audit identified that our previous billing partner was coding and NMBS’s coding audit identified that our previous billing partner was coding and

billing our claims improperly. We were actually losing money on some cases billing our claims improperly. We were actually losing money on some cases

because costly implant charges were not being coded and billed correctly. NMBS because costly implant charges were not being coded and billed correctly. NMBS

was able to go back and capture significant lost revenue. Their specialized, expert was able to go back and capture significant lost revenue. Their specialized, expert

coders have maximized our revenue and compliance.”coders have maximized our revenue and compliance.”

Medical DirectorMedical DirectorCleveland, OhioCleveland, Ohio

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SummarySummary


• We are the premier revenue cycle companyWe are the premier revenue cycle company

• Deep billing expertise and experienceDeep billing expertise and experience

• ““Bend over backwards” customer service mindsetBend over backwards” customer service mindset

• Exceptional resultsExceptional results

• Trusted, high integrity partnerTrusted, high integrity partner

• Loyal and happy clients – Please ask them!Loyal and happy clients – Please ask them!

16759 Main Street, Suite 220 ° St. Louis, MO 63040

Office 636-273-6711 ° www.nationalASCbilling.com ° Fax 636-821-2517

Revenue Cycle Management.Revenue Cycle Management.

It’s All We Do. It’s All We Think About.It’s All We Do. It’s All We Think About.

And It Shows.And It Shows.

Revenue Cycle Outsourcing September 7, 2015September 7, 2015September 7, 2015...

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