MDBillables & Practice Management Services: Medical billing and services
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This document provides information about medical billing services and outlines the benefits of outsourcing medical billing. It notes that current billing services only manage basic tasks and do not maximize revenue. Outsourcing to a specialized company can reduce costs per claim, increase payments and cash flow through more efficient billing practices, and ensure compliance with regulations. The company, MDBillables, offers various billing and revenue cycle management services to help practices increase collections and better manage their accounts receivable.
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MDBillables & Practice Management Services: Medical billing and services
- 1. PAGE 1 MDBillables MDBillables & Practice Services Medical Billing Services
- 2. PAGE 2 MDBillables Medical Billing Services • Billing services currently exist to manage medical practices. • These services relieve medical professionals of tedious detail work, but rarely do they offer a means to substantially maximize the practice's bottom line. • National statistics show only about 70% of insurance claims, initially submitted on paper, and are ever paid by insurance carriers. • Statistics indicate that it currently costs a medical practice between $8 - $10 per claim to process insurance for their patients. • Statistics show a 30% suspension/rejection rate for paper insurance claims. This doesn't mean that the claims are never paid. What it does mean is medical staff must hassle with insurance carriers over payment.
- 3. PAGE 3 MDBillables Market Status • 80 million plus baby boomers are aging and the recent health care reforms will cover more people. (The numbers of claims filed is expected to rise sharply). • There are over 1500 health care plans (Industry reports state that 35% of an average full time staff makes errors that cause payments to be delayed for up to 90 days). • Doctors today find themselves facing a myriad of rules and regulations from the federal government. (spending more time running the business) • Doctors are under pressure to automate patient charting using EMR/HER software.
- 4. PAGE 4 MDBillables Current Situation Patient volumes will increase, but revenue per case will decrease (Patient responsibility will soon be 3rd largest payer!) Growing revenue will be a must to gain greater leverage over costs More work will be forced onto physicians for reporting/metrics/compliance7% of claims are underpaid 65% of denials never get reworked 19.2% of claims get denied annually 9.37% of claims lost in transit It costs on average $25 - $30 to re-work & re-submit a previously denied claim
- 5. PAGE 5 MDBillables Medical Billing Process Provider Enrollment Insurance Follow-up Coding Process Charge Entry Payment Posting Denial Analysis Retro Audit Follow-up Patient Follow-up • Appointment Scheduling for Medical Providers • Coding • Patient Demographics & Charge Entry • Electronic & Paper Claims Transmission • Payment Posting • Denial Analysis • AR Analysis & Follow-up • Patient Billing & Collections • Aged AR & Retro- Audit Follow up for under paid and old claims.
- 6. PAGE 6 MDBillables Benefits of Outsourcing Billing • Rejection rate near zero • Payment time decreased to 5-21 days • Dramatic decrease in cost per claim (Decrease costs in postage, forms, and envelopes; Cost of money- Provider gets interest on his money instead of insurance co.). Increased cash flow – Billing space can be used for other functions – No more time spent on hold with insurance co. – No lost time due to sick days and vacations – Decrease personnel time to prepare claim and follow up with insurance co. if needed. – No lost time due to employee turnover and new employee orientation • Advise of rejection immediately (timely follow up on rejections including appeals) • Satisfy upcoming mandates of HIPAA • Claims filed within two business day • Annual Procedure Code Audit and Billing Cost Analysis • Utilize third party to increase collection rate and decrease accounts receivable • Billing specialist that stay current in Federal and state regulations and stay educated on health care industry by attending education seminars • Management reports to increase revenue and allow for more effective practice management
- 7. PAGE 7 MDBillables How we help to Increase Your Billing Revenue 1. Collect Payment Up-Front 2. Automate Billing Procedures 3. Maximize Payer Reimbursement 4. Minimize Denials 5. Monthly A/R Analysis 6. Keep Ahead of the Curve (regulations, policies, etc.) 7. Claim Bundling/Unbundling 8. Global Periods
- 8. PAGE 8 MDBillables MDBillable’s Role • MDBillables Billing Services • All-inclusive pricing • Software included • Free upgrades • Dedicated Account Manager • Customer Success Coach • Training & support • Pricing • Percentage of your monthly collections
- 9. PAGE 9 MDBillables MDBillables Services Portfolio PS for Revenue Cycle Consulting Services Business Intelligence
- 10. PAGE 10 MDBillables •mdbillables.com • (561) 409-0377 • miguel.rodriguez@mdbillables.com • (561) 320-0339 You manage your patients, we’ll help manage your practice
Editor's Notes
- We charge a percentage of net collections. Pricing may be as low as 4% depending upon your situation. Our pricing varies from 4-9% of your monthly collections. Your rate will be determined based on a number of factors, including your practice specialty, claim volume, and your monthly collections amount. Higher the collections the lower the percentage.
- Hopefully, you are going to all the things we are talking about today and it will help make ICD-10 transition smooth. However… Many experts are suggesting that you should expect to see a reduction in productivity and revenue for about three months of up to 50%. You’re a small business with bills to pay so you need to plan for a potential loss of revenue. If you can’t pay your rent, utilities, and employees, it will be hard to keep the doors open. The more prepared and well trained you are, the less impact ICD-10 should have, but you can’t predict how the transition will go with your payers. While your own staff may do fine, there could be delays with payers that you can’t do anything about. If you can set aside enough cash reserves (or qualify for a line of credit) before October, 2014 then you’ll be prepared for whatever happens.