Revenue Cycle Management
MDofficeManager, a leading Medical Billing service company provides affordable, accurate, quick, and effective Medical Billing services to healthcare facilities throughout the USA. The revenue cycle management for medical practices has become more complicated than ever. With ever-changing insurance, company policies, government policies, compliance regulations and healthcare reforms, it has become difficult for physicians and their staff to keep pace. This results in incorrect or delayed filing of claims and poor reimbursements. Good medical billing services can help you streamline your revenue cycle & get better reimbursements, thus saving you precious time and effort and letting you concentrate on patient care!
With our premium medical billing services, collection rates will dramatically increase, as will your peace of mind. Also, processing costs are reduced by as much as 60%. We file both electronic claims & paper claims to over 1500 payers across the United States. We have certified medical billing experts at our disposal who focus only on billing, so unlike your front office staff, who have to take care of other things in your practice, we bill accurately, dropping the rejected claims rate to 1%-2% and not 20%.
Our Complete Medical Billing, Coding System and Credentialing includes the following:
Patient Registration and Verification We enter the patient demographic information and verify its accuracy.
Eligibility and Benefits Verification We check the benefits and eligibility of the patients before the provider renders service and records it in the Practice Management System.
Coding Coding for diagnosis, services rendered, and appropriate modifiers is verified and set.
Charge Posting Charge information is entered into the system for medical billing claim generation after a thorough reconciliation from both the provider’s office and MDofficeManager.
Claims Management E-claims and paper claims are generated and sent out to payers via a medical billing clearinghouse. Claim receipt acknowledgements are checked and unsent claims are re-filed. Payer responses are checked and processed.
Payment Posting ERAs and EOBs are processed and payments are posted into the system.
Denial Management Claims denied on EOBs are corrected and re-filed or appropriately appealed.
Reports Monthly billing summaries with collections, billables, and outstanding AR’s will be provided. Client-specific reports are also submitted monthly and/or yearly. You can generate 250+ different reports and see what we do anytime.
Credentialing/Re-credentialing Services We make sure your provider’s record is up to date with all insurance companies.
Clearinghouse or statement mailing Mailing there are NO added charges for these services. If you do not require all of the above services we also provide many options for shared services between your practice and MDofficeManager.
Patient Phone call management We provide toll free # to the practice and manage all patient phone calls related to bill, co-pay or deductible amount.
Revenue Cycle Management Services
MDofficeManager provides reimbursement solutions for healthcare providers. Our revenue cycle management’s knowledge-base encompasses proven methodologies & techniques that leverage continuous process innovation & technology. You can avail 100% transparency, 24/7 reports, and all industry updates such as the ever-changing payer environments, HIPAA compliance, RAC audits etc. In short, MDofficeManager is prominent among physicians for assisting them with unprecedented control over their finances.
Revenue Cycle Management is a critical part of the financial viability for any health care facility. Our comprehensive medical billing services help to maximize reimbursements, decrease denials, and increase profitability for your practice. Our qualified RCM team files the claims to payers for payment, ensures there is sufficient documentation & appropriately coded by a professional & certified coder, corrects any denied/rejected claims (if applicable), submits the appeal, and reports and documents any claims filing occurrences and trends for continued process improvement.
We provide full-service data entry. All claim information – superbill, patient information, copies of insurance cards – are sent to North American Healthcare Management Services. Our experienced staff will then enter all patient demographic and charge information. This is accomplished by sending the encounter forms to our office. Our billing staff will enter, submit and follow-up on all charges produced by the clinic. Your practice’s or clinic’s banking services can be configured so that payments are sent directly to your bank. The corresponding EOB’s and remittance advice can be sent to North American HMS where they are posted and scanned. You will receive scanned copies as well the original EOB.
A healthcare organization can exert some control over internal dynamics, such as provider productivity, patient volume and fees for services. However, it is more difficult to influence external factors, such as claim reviews by insurance companies, denials and responsible party payment collection. We understand the level of trust that is needed when partnering with an outsourcing company for your comprehensive medical billing. Our experienced and certified staff will provide an exceptional level of service, professionalism and personalized attention to earn your trust and to assist your practice in a seamless approach.
The revenue cycle includes all the administrative & clinical functions that contribute to the capture, management and collection of patient service revenue, according to the Healthcare Financial Management Association (HFMA).
Is your practice in good shape? Benchmarking is necessary to compare performance metrics to industry standards.
It is difficult to understand your accounting numbers without setting benchmarks.
Physicians keep juggling the numbers and keep wondering why the collection figures aren’t high enough or up to the expectations because they find it difficult to organize and manage multiple numbers. The best way is to analyze the practice needs and then get a desired output via a reporting structure.
MDofficeManager makes the phenomenon of financial “EXCELLENCE” more precise, practical and reachable. We use external and internal information for benchmarking, monitoring every loop hole, comparing to defined standards of MGMA, keeping track of variances and bringing and adjusting variances down to minimal accepted metrics.
Key Drivers to Control and Measure Best Practices
Days in AR: We compute the charges based on past months charges posted and work on understanding the deviation percentages.
Aging Buckets: Measuring percentages of AR in each instance of 0-30 days, 31-60 days and 61-90 days.
We collect and analyze periodic data which aids to keep practices healthy. Henceforth, the outcome is a better managed practice.
Roles of a Benchmarking Manager:
Date-wise aging review.
Watching re-aged claims not submitted
Practice progress & problems
Monitoring team activities.
Monitoring MTD quality.