Category: Billing Service

Five Tips for Selecting a Private Pay Billing and Collections Partner

May 14, 2018 Posted on Categories Billing Service, Billing Software

By Bruce Gehring, Allegiance Group

Are you struggling trying to collect your private pay balances?

If so, you are not alone. Outstanding private pay balances can create problems for business small and large. Your staff gets too busy to mail statements or make collection calls.  And in the back of your mind you know the longer a balance goes unpaid, the harder it will be to collect. Where can you turn for help?

Consider using a billing and collection partner.  They can help you get your statements mailed on time and can generate several touches to remind your client of their outstanding private pay balance which results in you collecting more cash faster using fewer resources from your office.

Here are the five areas you should consider when selecting a partner:

  1. EXPERIENCE

You will want an industry leader, so make certain the company is experienced in collecting outstanding balances in the HME/DME industry and can show results.

  1. PHILOSOPHY

The growth of your business depends on repeat customers. Any partner is an extension of your reputation, so make certain your clients will be treated with respect.

The biggest tools that billing and collection companies use to reach out to your clients are invoices and phone calls.  Ask for a copy of their invoice and phone scripts. As you review them, ask yourself the following questions:

Invoices

  • Are the invoices clear and easy to understand?
  • Are they printed in color?
  • Do they send out paper statements? Electronic? Both?
  • Can you easily access a copy of the statement?

Telephone calls

  • Will your clients receive a recorded message, or talk to a representative?
  • Do you like the tone of voice they will use with your clients?
  • Can they take payments over the phone or online? Do they direct your clients to your website to make payments?
  • Can you access a recording of the call if your client has a question?
  • Do the telephone representatives receive ongoing training?

Note: The company’s timeline should be flexible to meet the needs of your business.

  1. SERVICES/INTEGRATION

Integrations streamline the flow of data so your client services team will have current information to better serve your patient.

  • Is their billing system integrated with your insurance processing software?
  • Do they use an Application Program Interface (API)? Ask how it works, ie, “How often are payments/charges posted?”
  • Can the company securely store the credit card and banking information you collect at the time of service?
  • Do they offer a payment portal with your look and feel?
  • What reporting is available to track their performance?
  1. FEES

When you compare costs, here’s what to expect:

  • For accounts less than 90 days old, a flat fee per piece to cover printing, supplies and mailing costs.
  • For accounts 90 – 360 days old, a percentage (10-30 percent) of the collected amount.
  • For accounts more than 360 days old, contingency fees can range from 25 to 50 percent and are based on factors such as how many times the client has been contacted, the age of the outstanding balance, etc.
  1. REFERENCES

Take the time to check the company’s references.  The comments will probably be positive, but you can still find out how a vendor will work with you by asking the right questions:

  • Does the company respond to your calls and emails in a timely fashion?
  • Has the company met their goals or service level agreements?
  • Can you track the collection results through ad-hoc reports, or do you have to wait for them to send you a report?
  • Have you had a client issue with the company? If so, was it resolved to your satisfaction?

Why take the time to go through this process? 

Here are a few of the benefits of hiring a billing and collections partner:

  • You can stay focused on your business
  • You can apply your billing guidelines automatically
  • Your business can improve its cash flow
  • Your staff can spend time on activities to increase the bottom line
  • Your patients enjoy a variety of payment options with a payment portal

If you have any questions how a billing or collections partner can help your business, please contact Bruce Gehring at bgehring@allegiance-group.com or 913-338-4790 x202.

 

ALERT: Watch Your Net Revenue Carefully – CMS Changes are Draining Profitability for DME Businesses

September 21, 2016 Posted on Categories AR Review, Billing Service, CMS, DME

On July 1, 2016, the changes that CMS implemented to the durable medical equipment and prosthetics, orthotics and supplies (DMEPOS) went into full (100%) effect.

The impact of these fee changes on DME businesses cannot be overstated. While DME businesses are putting in just as much work to serve just as many patients, they are seeing their reimbursement rates drop by up to 50% overnight.

As a business owner, this is the time to look very closely at your business expenses to make sure you have minimized them. Without business process cost reductions, you will very likely end 2016 with a loss, even if it appears that your revenue is increasing.

Now is the time to pay careful attention not just to your gross revenues, but your net revenues based on reimbursement. That is where you will see the significance of CMS’s recent changes.

In an effort to support the DME industry, Bonafide is offering complimentary A/R reviews and advice to support each and every DME operator in maximizing their reimbursement rates this year and beyond to avoid the crippling effects of these fee changes.

Contact the team at Bonafide today to discuss our proven solution in securing years of future business success for your business.

End Denied Claims through Correct Practice Management Systems

March 28, 2016 Posted on Categories Billing Service, Practice Management Software

By Michelle Tohill

 

Maintaining a healthy business practice that profits while at the same time keeps your patients physically healthy can be a difficult task. Because keeping people well requires immediate attention in most cases, your staff may become preoccupied and busy. Businesses can only thrive if overhead, costs, and profits are sustained.

It is necessary to collect maximum reimbursements in order to continue providing exceptional healthcare to your patients. To ensure high cash flow and ongoing profits, practices must have consistent, high levels of reimbursement. Without it, your business will be impacted in multiple ways. You may have to cut or underpay employees which results in poor service. Under-reimbursed practices can create high levels of stress that can be extremely detrimental to the entire business.

One way to guarantee your business remains in the black is to minimize claims denials. An American Medical Association study attempted to estimate how much reworked claims can cost a practice. The results showed that medical offices waste about $14,600 each year on rectifying denied claims through appeals, phone calls, and troubleshooting.

Most practices are already aware of the hindrances that come with successfully submitting claims from their billing department.

Here is some advice on how to avoid losing $14,600 each year:

 

Regular Updates:

It is essential for employees to stay updated on any insurance policy changes that could affect patient’s coverage. Your billing department must be attentive for insurance policies regarding diagnostic codes and procedures. Signing up for insurance company emails and newsletters can be beneficial for staying informed. Having good practice management systems in place can also be helpful. These software systems should automatically update new changes on a regular basis in order to guarantee you have all the information for gaining reimbursements.

 

Investigate:

All denied claims should be investigated to determine why exactly it was denied. One of the most basic reasons claims are rejected is due to the code referenced being incomplete, invalid, or not matching the treatment stated by the physician. As mentioned before, many of these problems can easily be avoided through regular updates. These small coding mistakes can cost your practice thousands of dollars. Other causes for denied claims include timing issues, pre-authorization/authorization mistakes, and authorization period discrepancies. These problems are usually due to the patient not having the correct referral, failing to pay on time, or losing their insurance coverage. Having a practice management system in place can make investigations into denied claims much easier. Leaving denied claims as denied can cost you millions in profit.

 

Always Recheck Your Work:

Proof-checking your work can be monotonous and prolonging, but rechecking your claims can prevent potential errors. Spending time on this initiative can save time in the future and prevent substantial money loss. Allow your billing department enough time to double check claims or make sure your practice management system notifies you of errors.

 

Billing Comprehension:

Management should fully understand your practice’s billing process. This means being able to follow billing statuses and reports and relating them to the health of your company. Acquiring great technology and providing effective communication are important in achieving this goal.

These four tips can considerably assist practices in reducing or eliminating denied claims. As a result, you begin to receive the maximum reimbursement for your work.

How to Reduce ICD-10 Denials

October 16, 2015 Posted on Categories Billing Service, ICD-10

by Michelle Tohill

As you well know, ICD-10 went into effect Oct. 1. Many of you are already submitting claims using the new coding system. In the next few weeks, you’ll find out how well you’re doing based on the number of successful reimbursements compared to rejections.

Avoid costly delays and irritation by following these five steps to reduce ICD-10 claim denials:film Despicable Me 3

1. Review/work claim rejections daily
With the new standards, it’s important to review and work your rejections on a  daily basis. This is good practice regardless of the situation, but with so much change in the system, it is more important than ever to stay on top of your claims.

2. Documentation is essential
Now is the time to make sure that your documentation is completely buttoned up so that you can justify every claim and also quickly correct any errors that you make that result in claim rejection.

3. Education & knowledge on ICD-10 medical billing standards
Hopefully you have good billing software and a billing team that is helping through this transition, but even the best systems and software can’t beat taking the time to really learn the new ICD-10 coding system to reduce errors and eliminate rejections.

4. Avoid using the “Unspecified” ICD-10 codes
This is a red flag, and will likely result in claim denial. If you absolutely must code with an “unspecified” code, provide needed detail associated with the ICD-10 and documentation aiding in meeting medical necessity.

5. Become familiar with the LCD guidelines
Local coverage determination (LCD) guidelines vary from region to region, making it critical that your medical billing software and billing team are familiar with which region applies to the specific care being claimed. Not following LCD guidelines will result in unequivocal claim denial.

Most of these tips are things I recommended before Oct. 1, but now they are even more important. At Bonafide, our software-only customers have the benefit of utilizing our updated software. Of course, our billing customers have the added benefit of our expert team of billers. Let us know if you need some help reducing your medical billing claims!

 

Michelle Tohill is Director of Revenue Cycle Management of Bonafide Management Systems and oversees all billing programs and processes. Her specialty is conducting AR audits to expose inefficient billing practices that fail to fully reimburse physicians for their work. She conducts AR audits and provides Bonafide customers with training and consulting on how to improve every aspect of billing and practice management to maximize revenue.

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805-908-2333 info@bonafide.com
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