Do you provide a summary of your current ‘Accounts Receivable’?

Keeping your monthly AR under 1.5 times the monthly charges is our ideal target. Measuring Accounts Receivable (Days in AR): Days in AR = Total AR ÷ Avg. daily charges (Where: Avg. daily charges = total charges in last 6 mo ÷ no. of days in these 6 mo) As the AR days increase, cash flow to your healthcare organization decreases, thus we try to lowering your means to pay or hire better staffs and physicians. Also, it affects your group practice’s ability to invest in current gen tools and technology. So, higher your avg. AR days the more negative its impact on your ability to treat patients better.

Do you offer ‘Denial Management’ on your existing claims?

An Analytics’ survey found; “44% of the participating hospital executives indicated that they use revenue cycle management vendor solution to manage denials, while 31% use manual process and 18% use homegrown tools, but surprisingly, 7% are unsure about their denial practices.” Should the billing company be pursuing after your ‘denied’ claims or would it be better for the group practice to take responsibility? Whatever maybe your choice; a proven fact is, a dedicated medical billing company is more capable/efficient at managing payer denials than a medical practice.

Can you keep track of and make analysis of your ‘Rejected Claims’?

A research notes; “about 20 to 30 percent of the claims that are raised get rejected on a regular basis.” Another report suggests; “of these (rejected) claims, almost 80 percent are left unprocessed.” Considering these reports where true, you are seeing an avg. of tens of thousands of dollars lost due to rejections every year. Can a healthcare organization afford to face such loses? From sloppy documentation to issues such as up-coding/under-coding, there are numerous reasons why your claim could get rejected.

Can you offer a ‘Code Analysis’ based on your existing medical practice’s history?

Claim rejections, denials and low reimbursements are the primary causes of revenue undercuts in any healthcare organization. So, reports such as ‘top used codes’, ‘top paying codes’ and ‘most denied codes’ go a long way in keeping you updated on revenue flow. A company that can work out these details and also provide you with alternate solutions (codes) that could save you from a lot of trouble and some money will prove to be a resourceful billing partner. We are up-to-date with the industry’s latest tweaks & amendments On an added note; we are a billing company that ensures continual training & orientation of its staffs on the latest resource/updates in the industry, will give your organization an edge in revenue handling.

How good are you at ‘Contract Analysis’?

Coverage plans can change from state to state… At some states they could offer extended coverage (including even comprehensive healthcare issues), yet at other states they may only cover the program’s set ‘minimum requirements’ laid down by the federal governments. So, we have ability to demonstrate in-depth expertise on those contract’s pros & cons, can significantly influence your healthcare’s revenue flow in a positive way!

Can you billing company add value to your business with their ‘Fee Scheduling’ knowledge?

Medicare fee schedules are updated once every year, and when they do so, they bring a load of changes to your reimbursement values. So, it is mandatory of your chosen billing company to know the ‘widths’ and ‘depths’ of these Medicare updates. Check out medicare physician fee schedule for CPT codes in your city An example: Let’s say a doctor from California sees 1000 patients in a month, of those 1000 there are 500 patients who are billed under a single code, which is ‘CPT code: 99241’. Let’s say Medicare pays $150 per claim for that code… Hence, the total reimbursement you should receive will be 500 * $150 = $75,000. Now, let’s consider that Medicare has revised the fee schedule for this code to $100 instead of its previous $150. Then, during your next billing you would be left with a negative difference of a whopping $25,000 as reimbursement.