Can you manage my billing if I don’t use an EHR?

Yes. We can assist in the security setup for transmission (scanning, emailing, etc.) as well.

How do you manage account management? Do you assign a specific person for “point of contact” or?

Yes, we assign all accounts to an Account Manager with a team of resources supporting them to service your account.

Do you provide credentialing “only” as a service?

Yes, depending on the volume we can provide a quote for this as a Per Panel or Per Month flat fee retainer basis. If the volume is less than 5 panels, we typically refer these out to a partner.

Do you have any collection agencies you work with if I have a client in my practice with unpaid balances?

Yes, we leverage a primary one called CSS (Creditors Collection Service). We can work with others (assuming standard industry workflow) if you have a preference.

Do I get paid directly by my clients and/or insurance companies or do you collect funds on my behalf and then deposit money into my account for funds I am owed?

We can do both. We can change address and perform banking for all your deposits (insurance, patients, etc.) or you can receive them directly at your office. Either way, there is a banking procedure that must be performed so we are managing and tracking all banking funds and posting timely into the patient account balances.

Are you able to run client statements on my behalf and send them out to clients for balances owed on their accounts? If so, how often do you send them and how does my client receive that information?

Yes, we can do electronic and mail statements. Mail statements cost $1/statement for postage/processing. Send statements for 3 consecutive months following insurance payment and/or last patient payment.

What EHR do you use?

Kareo but we will utilize customer EMR/PM as well pending requirements.

Does it scrub the claims?

Yes, we have 3 Tiers. 1st, internally with Q/A oversight from senior leads, 2nd, system and

custom billing rules in Kareo, and 3rd, the clearinghouse for any additional initial checks as well.

What do you need from us on the day-to-day services?

If submitting claims via Simple Practice, medical record notes need to be completed and signed off preferably daily to keep revenue flowing. Any patient payments, and copays at the time of service if not posted by your staff, we need provided on a log sheet daily; paper checks and EOBs from any insurance carrier we would need copies of as you receive; our goal would be to transition all paperwork to EFT and ERA going forward asap.

For the transition?

We do 2 working sessions to review your current status of AR (backlog, denials, etc.) plus current workflows related to closing out medical record notes (timeliness), etc. Typically 1 to 1.5 hours per session.

How often do you bill? Are there any disruptions (I.e. holidays, weekends)?

We send claims daily every workday of the week. If you require weekends due to heavy volume, we can discuss an addendum, but the Saturday and Sunday would go out on Monday otherwise.

What is the payment schedule and process?

We run month-end reports on 1st day of the following month of service and invoice out according to the contract X % of Collections due in Net 15. We require an ACH draft from either a business checking or credit card.

What is your tracking process?

We do AR audits weekly so any/all claims in denial or delayed state are reviewed & escalated if required.

What is your acceptance rate?

Our overall claims acceptance rate is 97.6% with a denial rate of just under 2.3%. The critical factor to this rate is customers’ accurate and timely information along with our 3-tier approach as described above. We have some customers exceeding this acceptance rate due to the accuracy of data and eligibility.

Are there any limitations on billing volume?

No, we have a large highly scalable onshore and offshore business model that includes “bench” ability to scale up/down. Your team will be assigned a Senior Account Manager who handles our team on the back-end so keeps it simple for your staff to interact with only one team member.

Do you outsource any of the work?

No, we own the onshore resources and offshore resources and facilities.