The list below is representative of the billing services we provide. Each item
in the list links to a detailed description of that aspect of our service,
so you can examine them in whatever order you wish. Alternatively, you can
simply scroll down the page to read about them all.
- Provide Health·e·Finances, our practice management
software, at no additional charge.
- Train physicians and staff to use our user friendly system.
- Our state of the art practice management system has its own dedicated
section of this site, where you can
see screen shots and read a complete
description of its features.
We've developed this system ourselves, so we can provide it to you
as part of our standard service package.
- Train front desk staff on proper procedures necessary for reimbursement.
- Reimbursement starts at your front desk, especially in today's HIPAA
billing environment. If your staff isn't taking the correct
steps when scheduling and registering patients, you're losing revenue. There are
certain things that simply cannot be corrected after the fact.
Your front desk must check eligibility, confirm copay amounts, referral
information, and Primary Care Physician before the visit.
If this information is not correctly recorded, your chances of collecting payment for your services drop
dramatically. It is vital that your practice be able to directly access
the databases of local insurers to be absolutely certain that the information
patients provide is in fact correct.
We will see that your office has the proper tools to perform
these tasks for your major payors and that your staff is trained to properly use
them, and is cognizant of its utmost importance.
This is just a small part of the front desk training we perform.
- Develop and maintain a fee schedule.
- The fees paid by insurances are constantly changing. Many will pay the
lesser of the fee charged or their set allowance. However, you do not want
to overprice your services, as it will have a detrimental effect on your
patients who pay out of pocket.
We will work with you to strike a balance between the
two issues, and will make sure your fee schedule is modified when payors
change their reimbursement allowances.
- Design an encounter form (superbill), and update it in response to changing industry standards.
- Your encounter form is essential to your day to day operation.
When billing electronically, in most cases it serves as the only medical
record a payor uses to determine reimbursement.
A poorly designed encounter can be a significant source of lost revenue. We
will work with you to custom design an encounter form that will guarantee
that you are properly reimbursed for services rendered.
- Expert coding and data entry of encounters.
- Your cash flow is greatly dependent on the majority of your claims being
submitted cleanly and accurately, so that they are accepted on the first
submission. Insurers today employ computer programs to adjudicate claims,
without an actual person ever viewing the medical record.
Your reimbursement is dependent on properly associating
diagnosis codes to procedures to minimize down-coding and denials.
None of this is possible without accurate data entry of encounters.
One of the leading sources of patient dissatisfaction is improperly
entered claims which lead to patients receiving bills for services that
should have been covered. Our experienced coders and conscientious
data entry personnel will reduce denials and improve patient relations.
- Electronically bill primary, secondary, and tertiary payors (paper bill if necessary).
Patient retention is a essential to a healthy practice.
As more and more patients pick up secondary and tertiary coverage, it becomes
necessary to shoulder the burden of crossover billing to remain competitive.
Most patients are frustrated by the complexity of secondary and
We can electronically submit most claims directly to networks of insurers,
which increases your
cash on hand. Paper claims can take as long as 60 days to be paid, while the
average electronic claim is paid in 15 days. Electronic submission also cuts
error rates in half by skipping the second data entry step that paper claims
must pass through when they are entered into the payor's system. Those
claims that require attachments are automatically dropped to paper.
- Post remittances.
- Accurately recording of the amounts paid per line line item is
essential to clean and simple crossover billing, whether the recipient be an
insurance company or the patient. Collecting all the information from a remit
makes answering subsequent patient questions much simpler.
- Adjudicate denials, correcting and resubmitting where possible.
The key to a profitable practice is properly processing denied or pended
claims. This must be accomplished in a timely fashion because
payors allow providers a limited window for claims resubmission.
Insurers couch denial reasons in vague and often misleading verbiage.
The ability to quickly determine which
denials can be corrected and resubmitted (most can be), as well as precisely
what corrections or attachments are necessary is invaluable. This only comes
with years of experience.
Knowing when a denial should be disputed, and what information is required
when directly interacting with the payor is a value that is not offered by most
billing services. We have a successful track record of lobbying payors to
change their policies to be more consistent with accepted community standards.
- Bill missed appointment and late copay penalties.
Copays should be collected at the time of visit, as research has shown that
the collection percentage drops dramatically when patients are billed for
In order to encourage patients to pay in the office, many practices now
charge an additional fee to anyone who must be billed for their copay.
This has proven to be very effective.
We can also easily track missed appointments, and promptly bill patients
for your lost productivity.
- Balance bill patients, if permitted.
- We send out attractive and professional bills quickly.
We will posting a scan of a sample bill here shortly.
- Manage delinquent patient accounts per office policy.
We have the flexibility to allow each office to manage collections per
individual policies and procedures. Physicians can have as much or as
little involvement in the collections process as they desire.
- Directly handle patient billing inquiries.
A busy office can be inundated by frequent patient billing questions, and is
not always best equipped to properly answer them. We free up your front desk
staff to concentrate on scheduling appointments and servicing patients who
are in the office. All patient billing inquiries are directly handled by our
experienced professional staff, who can quickly provide the correct
information. This increases both patient satisfaction and office efficiency.
- Provide complete daily, monthly, and yearly on-line reporting of practice activity.
In order to effectively manage your business, it is vital that you be able
to accurately measure its performance in real time. We give you the
tools you need to track your productivity,
reimbursement by payor, and days in accounts receivable. This allows you
to quickly spot problems and respond while the issues are still manageable.
These reports are available in your own personalized section of our website,
so you can access them at any time with the click of a mouse.
A sample of our reports will be posted here shortly.
- Monthly status meetings with providers to ensure services are rendered in a manner that will maximize reimbursement.
Monthly meetings help ensure that you are kept up to date on issues specific
to your practice. We will bring you copies of the latest insurance bulletins,
information on how your practice compares to national standards on coding,
days in accounts receivable and managing self-pay accounts. If we don't
have the answer on hand to any question you may have, we will perform any
necessary research to get it for you.