Do you need to consider outsourcing billing?


By Dave H. Perkins


If your organization is faced with one or more of the following issues then the chances are we can help you, then you should consider outsourcing your billing:

  • Need to Focus more on Patients: You find yourself having to divert
    time and attention away from your patients to deal with technical issues.
    You need to simplify.
  • Collections are Low: You have a high level of dissatisfaction with the
    effectiveness of your current billing and collections process yet can’t seem
    to get your hands on what needs improving. Professional certified
    coders can make sure all procedures have the correct CPT and ICD codes
    and modifiers to ensure maximum reimbursement for the services you
    provide.
  • Not capturing all of your charges? Do you have a good way to know
    all of the services you provide are actually billed? Surgery charges?
    Outpatient services? Hospital patient visits? In-Hospital consults?
    Office Visits and ancillary procedures? We can help by providing the
    tools you need to bill EVERY service in a timely manner.
  • You Need a New Practice Management System or Computer
    Upgrade:
    You know you need to replace your existing practice
    automation system(s) however you are losing sleep just thinking of the
    time, expense, and risks involved with selecting the right solution and
    then successfully implementing that solution.
  • You are considering going to Electronic Health Records at some
    time and you don’t think your current practice management system has a
    complimentary EHR/EMR.
  • You fear the loss of vital practice data: How can you really know
    your data is protected from Internet viruses, “hackers”, environmental
    disasters or Acts of God?
    Off-site hosting of your essential computerized
    records gives you assurance that it is safe. Secure hosting sites with
    hourly automated backups and on-site IT service protects you like you
    never could be with an in-house server.
  • You don’t want to deal with technical issues or problems. “The
    server is down AGAIN”.
    If you had rather spend your time in patient
    care rather than computer care, you should consider outsourcing. With a
    hosted-managed off-site server solution, all you would have to have in
    your office would be workstation terminals, printers for relatively low
    volume on-demand printing, and possibly scanners for scanning patient
    documents at time of service.
  • You Have Staffing Issues: You are experiencing issues with either high
    staff turnover and/or it is simply taking too much time to manage the
    billing office.
  • Your Billing Costs are Too High: If you are concerned that your billing
    and collections related expenses are higher than they ought to be.
    Training and support fees, upgrade fees, software license fees are
    ongoing.
  • You are concerned about capital expenditures at a time of
    uncertainty:
    Recent changes in health care, including the ARRA 2009
    and the “Health Care Reform” in 2010 have complicated your business to
    the point you don’t know what to do and could use the expertise of
    experts with knowledge of these changes in legislation and their impact
    on your practice. You’re not sure if now is the best time to spend more
    money on capital equipment, systems, or staff, when you don’t know
    what the future holds.
  • Are you in “compliance” with CMS, OIG, HIPAA, “Red Flag Rule”?
    eHealthTech’s commitment to “compliance” is evident in every aspect of
    our operations. While our primary goal is to achieve the highest possible
    reimbursement to which our clients are legally and ethically entitled to,
    we always work in a manner that fully complies with both the letter and
    the spirit of all applicable guidelines and regulations.

The Compliance Program is under the direction of the eHealthTech Compliance Manager, who oversees quality from the original medical record through the coding process and ultimately through billing and collections. This written plan incorporates the guidelines defined by the “Compliance for Third Party Billing Companies” from the Office of the Inspector General (“OIG”) of the Department of Health and Human Services (“DHHS”), the Center for Medicare and Medicaid Services (“CMS”), and specialty organizations . A key component of compliance is correct coding for all services. eHealthTech’s professional coders are all Certified and members of AHIMA. To ensure they are informed regarding the latest changes in coding guidelines, each is required to earn continued medical education (“CME”) credits throughout the year. eHealthTech subscribes to industry newsletters, including Medicare Part B News to stay abreast of upcoming changes in coding and reimbursement. The plan is maintained as needs evolve and management ensures eHealthTech is continually following its own written program.


eHealthTech’s clients may rest assured that their billing is being handled accurately, professionally, ethically, and in complete compliance with the above-referenced regulations and guidelines at all times. Our account managers regularly review accounts with our coders and auditors to improve communications and fine-tune processes to continually improve data quality and integrity and keep our clients fully informed through regularly scheduled meetings and notices.


For more information on how eHealthTech Marketing, LLC can benefit your practice, please contact me.


For another article on this topic, please visit:  Software Advice


Dave H. Perkins
President
eHealthTech Marketing, LLC
www.ehealthtech.com
Phone: (601) 573-1826
Fax: (601) 898-4404

Medical Billing Bank Lockbox

Why a bank lockbox is the best way for a medical practice to handle payments and correspondence.


If you want to maintain a consistant office address for all insurance companies and patients to send payments and correspondence  with the least “hassle”, consider the benefits of using a bank lock-box operations.


What it is a Lock-Box?

The lock-box is a physical Post Office address, maintained usually by a bank, which has an associated depository checking account tied to it.


What is it for?

The receipt of payments in the form of paper checks and correspondence, including insurance company “Explanation of Benefits” (EOB’s).


Why would you use it?

a)      Protects you from fraud and embezzlement by office or third-party billing staff.    The bank has a fiduciary relationship and must be insured for this purpose.    You will be more protected from mishandling of funds, if those funds are handled by an independent fiduciary.


b)      the bank performs all “clerical” tasks such as opening the mail, removal of staples and clips, scanning of contents of the lock-box, making the bank deposits on a daily basis.


c)      the bank deposits the payments every day into your designated depository account, providing you with access to either the original bank deposit slips and checks, or with web-based access to the scanned images of these documents over the bank’s lockbox management system.


d)      Deposits are made much sooner than would be the case if payments were made directly to the practice’s office address.


e)      the bank’s staff can be relied upon to do the required work EVERY DAY, without concern for your own employees missing work or not being able to take off to go to the bank to make the deposit.


f)        your office staff does not have to tak the time to open the mail, copy the checks, make out the deposit slips, and transmit or deliver the contents to the bank to deposit or to the billing service to bill.


g)      the lock-box address can remain as the remittance address with all insurance companies in spite of changes of physical address by the medical practice.    This assures no interruption of cash flow or delay in receiving important notices from insurance companies, should the practice relocate or open additional offices.   Since the lock-box address doesn’t change, you would not have to submit “change of address” applications to every payor.


h)      The final and perhaps most important consideration of using a lock-box is …


to ensure a smooth transition, should you change from one billing service to another, or from a billing service to in-house, where you must ensure as of a specific date that all of the contents of the lock-box stop being delivered or transmitted to one party and begin being delivered or transmitted to a new party.   All you have to do is send a letter to the lock-box administrator, with your instructions.


How much does it cost?

The cost varies from bank to bank.   However, they usually charge a base rate, plus $.xx per check deposited.    You will need to provide enough details to your bank to get their best rates, which usually get lower with higher volume.   Check with several banks before making your choice.   The better lock-box operations offer web-portal access to both the scanned images of all lock-box contents to a third-party billing service or office.    They also offer on-line banking access to the depository account to confirm deposits.

Plastic Reconstructive Surgeons New Rules

How CMS’ new rules regarding consults will affect the way Plastic and Reconstuctive Surgeons bill for office and hospital visits to patients in the Emergency Department, for Inpatients, and patients in “Observation”


Unfortunately for us who bill multiple payors for these services is the fact that Medicare has eliminated the consult codes, but  the other insurance companies have not not, at least not yet.   So you don’t use consult codes for Medicare and the Medicare alternative companies, but  you do use them for others?   Are your doctors going to make the decision of which code to use depending upon whether the patient has Medicare or not?  This gets even more complex when Medicare is primary and requires the new codes, but another payor is secondary and they do not use the new codes and you must bill differently for the same procedure(s) to each payor.


I am instructing my clients to continue to use the consultation documentation requirements for all consults, including requiring the referring physician name and NPI in case the patient has another primary insurance.


An excellent “flow chart” has been developed to help providers determine the appropriate E&M codes to use for what used to be a “consult”.   See  www.emuniversity.com/consultinfo.html

Jackson MS – Outsource your Medical Billing

Why choose eHealthTech as your business services partner? The short answer is that we can almost certainly improve your bottom line results (often dramatically so) while simultaneously reducing the amount of time and energy that you have to devote to running the day-to-day affairs of your business. You get to spend more time with your patients and you make more money in the process……….read more