BILLING/SCOPE OF SERVICES:
Collection Policies
Work with practice to develop/revise a set of financial policies relating to co-pay collections, trigger-points for escalating collection efforts and write-off guidelines.
Fee Schedule Analysis
Conduct an initial and periodic reviews of the practice fee schedule; input revised fee schedule into practice management system.
Coding Analysis
Review of physician codes (random spot checks) is an available service to be provided on an "as-needed" basis. Current coding practices will be reviewed and compared to documentation; regular reporting of code distribution against regulatory norms; discussion with physicians to correct specific coding errors or recurring patterns.
Claims Entry
Collect patient billing information via paper superbill or EMR; implement scanning and process entry into Laser Fiche document imaging system; verify accuracy. Transfer information into Med/FM billing software.
Claims Filing
Submit electronic claims for all permissible payers; submit paper claims or statement billing when required. Collect additional documentation from practice as required for claims requiring supporting documentation. File secondary claims as required.
Payer Payment Follow-up
Follow-up with payers on all denied claims; determine cause of denial; correct and re-submit; gather required supporting documentation; follow-up to ensure timely payment.
Payment Analysis
Spot check review of payments to ensure that payments are in accordance with agreed upon terms of the managed care contract.
Patient Payment Follow-up
Follow-up with patients on all responsible balances; trigger escalation of collection efforts according to practice financial policies.
In-House Collections
After patients receive two statements and a pre-collect notice, they are then referred to our in-house collection agency. It's called SureCollect Claims Management. A letter is sent on the SureCollect letterhead to encourage payment by credit card or a call to set up a payment plan.
Contracted Collection Agency
If there is no response to the SureCollect letter, the practice will determine if the patient should be sent to the external collection agency or if the balance should be written off. Medical Billing Services has a long-standing relationship with one of the Midwest's leading collection agencies. If desired by the practice, Medical Billing Services will transition delinquent patient accounts with supporting documentation to the collection agency/attorney.
Payment Posting
All payments are logged into our accounting department and documentation is immediately scanned into our data imaging system for posting to the patient accounts. We always reconcile total daily receipts against payment log-in documentation and and against payments posted to patient account balances.
Payer Management
Work with payers on behalf of the practice to deal with overall issues related to denials, slow payments and incorrect payments.
Cash Management
Make deposits directly into the practice bank account.
Refund Processing
Implement refund process to third party payers and patients on an as-needed basis.
Reporting
Comprehensive reports are available at the end of every month. All practices have different reporting needs and this service is customized to meet the requirements of each client.
Provider Credentialing
Medical Billing Services will process credentialing paperwork with contracted care plans; follow-up with payers to expedite credentialing; maintain credentialing as needed.
"You Practice Medicine...We'll Do the Rest."
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Call or send an Email to Randy Schwager
