What to Look For in a Billing Company
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What to Look For in a Billing Company
Transcript of What to Look For in a Billing Company
Your Webinar will begin shortly
Come visit us...
www.curemd.com/uc14
What to look for in aBilling Company!
Fred MelroyDirector Billing Operations, CureMD
Presenter
Good Billing Is Just Process
Great Book is Check List Manifesto by Atul Gawande, MD.
Good Billing is Like Good Surgery or Any Activity in Life that
Requires Organization!
Life and Billing is Complicated but Steps in an Organized Manner
Make it Easy.
Visit the Billing Office and take a look around or at the least
check references.
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Denial Management!!!
Did billing have inaccurate coding?
Was claim complete?
Was there lack of supporting documentation?
Was there an eligibility problem?
One day turn around time for denials to be resubmitted.
Denials logged and reviewed?
Cure verifies payments for correctness using a product called
“right remit” does your billing company have something similar?
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The Cure Billing Process
Insurance Verification
Charge Entry Process
Claim Submission
Payment Posting
Denial Management
Payment verification, is your payment correct?
Appeal and Collection Process.
Reading and understanding reports.
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The Simple Facts
A billing company is just that and you are a medical practice.
Reputable firms use professional management to collect all
of your revenue.
They hire professionally trained folks who concentrate on
billing and collection (denial management).
They have the latest reimbursement information from CMS
and Commercial Insurance Companies.
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More Simple Facts
Operations are not interrupted by a staff person leaving as
they have plenty of backup.
Have the resources to hire quickly and get the right people
including a CPC or two.
Develop contacts at the various insurance companies.
Get better priority on computer issues.
Have effective relationships with EDI Carriers for data
transmission and eligibility.
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The Dilemma
Distributed environment lead towards inefficient, complex system results in
increased operating cost and important of all LOST REVENUE
Patient Scheduling Claims Scrubbing
Paper & ElectronicRemittance
Denied Claims
EMR/EHR
RegistrationSystem
ComplianceSystem
ClaimsManagement
Patient Demo Entry &Eligibility Verification
Medical NecessityEdits
The Revenue Cycle: Critical Billing Tasks
Payer Contracts
Pre-visit Front deskVisit
Post the Visit& Charge Entry
Billing & Collection
Reports &Analysis
Payer Rejections
Edits
Patient Service and Satisfaction
Compliance
Provider Credentials
Payer Requirement
Covered Benefits
Patient Appointment
Registration Eligibility
Pre-Auth Referrals
Prior Balances
Confirm Registration
Copy Insurance Card
Collect Payments
Medical Records
Documentation and Coding
Charge Entry
Select Payer
Produce Claim/Statements
A/R
Follow up
Payments &Rejections
Mail Claims/Statements
Cash Analysis &Reports
Measure & Rewards Targets
Contract Analysis
CureMD - Integrated All-in-One Solution
Patient Scheduling
Patient demo entry & Eligibility Verification
Medical Necessity Edits
Claims scrubbing
CureMDEHR
PM & RCM
Paper & Electronic Remittance
Denied Claims
Registration &
Scheduling
Clean Claim &
medical necessity Edits
Denial Management
What makes us stand apart in billing?
One system that ensures integrated clinical and improved
communication for the complete revenue cycle management.
All in one solution that works with your existing billing and
financial system ensuring:
HIPAA Compliance
Efficiency improvement
Maximum effectiveness
Ensuring clean claims for denials prevention
State of the art rejection and denial management
Reports that make sense and Monitor activity
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More income is lost in poor Revenue Cycle Managementthan you can achieve in rate increases
CureMD - Integrated All-in-One Solution
Straight 60 % reductions in operational and administrative cost incomparison to in-house billing
Staying up to date with financial health of your practice by havingaccess to multiple financial reports (24/7) in comparison to manualin-house reporting
Losing 2% of total Medicare revenue on e-prescribing and PQRSincentives
Losing 17% of all claims denied for timely filing, caused by delays inthe billing (Source AMA)
Efficient Denial Management enables you to track denied claims andwhat is being or can be done to get them paid. (MGMA reports that 7%-14% of all claims are denied because of easily correctable in–officeerrors)
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It is More Than Just Time
You still need to document the visit!
Does you System Check Codes or Prompt Needed Items.
Codes 99201-99215 should be used depending on the complexity
of the visit
For level 5 make sure the history meets the definition of comprehensive.
A new patient is a patient who has not received any professional
services (face to face) in the last three years.
This time includes those you see for a different Dx.
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Financial Reports
CureMD’s 24/7 access to different reports helps to stay updated with
your practices financial health
Some Numbers That Matter!
