RCM and Practice Management Services

We’ll customize a solution for your practice with the services below

Let’s face it, timely reimbursements are impacted by two main components: proper coding and accurate claims processing. When incorrect codes are used, your claims are rejected or underpaid which delays reimbursement and ultimately impacts your bottom line.

We can provide you with free analysis of your medical or dental procedure codes. Simply provide us with your superbill or list of all codes (CPT, HCPCS, or CDT). We will provide you with a professional code review report that details the status on each procedure code. This report also includes a financial summary showing any adverse effects on your cash flow, such as potential income loss, as a result of using incorrect codes.

There is more! We can also provide you with a free Practice Analysis report that calculates the real cost of your current billing operation. This can help you determine where you may cut expenses and if outsourcing your billing makes financial sense.

This analysis is based on the various direct and indirect costs incurred in processing medical claims, such as:

  • Labor Costs and Benefits
  • Error Processing
  • Administrative and Billing Costs
  • Rental Overhead
  • Supplies: Software, Hardware, Claim Forms, Postage, etc.
  • Time Value of Money
  • Systems Upgrades & Maintenance

We offer full Revenue Cycle Management and billing solutions. Our services include:

  • Processing primary, secondary, tertiary insurance claims.
  • Relentless follow up on insurance claims.
  • Payment posting to insurance and patient accounts.
  • Tracking of unpaid claims and providing additional documentation when necessary.
  • Notification regarding any “Incomplete Claims” which were unable to be processed.
  • Patient statements with online bill pay, payment plans, and autopay available.
  • Monthly and annual financial analysis and review of medical codes.
  • Comprehensive reports: We can provide you with highly detailed reports with colorful analysis charts and graphics tracking the status of every claim and showing the level of productivity of your practice.
 

We can provide hundreds of reports. See the examples below.

The waiting room is overflowing with patients, but unfortunately so is your A/R. Many Americans don’t have health insurance, and those who do still often pay 20 percent or a high deductible. Many providers don’t collect all the money owed to them and have too much of their receivables more than 90 days past due, often carrying tens of thousands of dollars on their books, knowing there’s a good chance they’ll never see this money.

WE CAN HELP!

Our payment processing solutions can include electronic patient statements, online bill pay, payment plans, and auto pay. Receive payment quickly and directly into your account! 

  • ELECTRONIC STATEMENTS
    No waiting for patients to receive a statement in the mail or write a check. Funds are deposited directly into your office’s bank account. No more excuses or late payments.
 
  • ONLINE BILL PAY
    Make it easy for patients to pay their statement with a variety of payment options.
 
  • STAY IN CONTROL
    Unpaid balances are identified and addressed. We can setup payment plans and autopay at your discretion to keep the revenue flowing while maintaining strong patient relationships.
 
  • SAFE AND SECURE
    Payments can be made safely and securely through online and on-site payment options.
 
  • AUTOMATIC & CONVENIENT
    Once everything is setup , collection of funds becomes automated. Our processing center does all the work and deposits go straight into your bank account.

In most practices a small percentage of claims do not get resolved and can be difficult to conclude

You typically follow up and make phone calls to the insurance companies but unfortunately receive marginal response. This small percentage of claims may remain uncollected for months! Since you are not setup as a collection agency to deal with these unpaid accounts, you’re often faced with two difficult choices:  write off the unpaid accounts or refer them to a hard-core collection agency, in which case your practice loses 35 to 50 percent of the value of the claim. Additionally, your practice will most likely lose the patient as a client. Harsh collection measures usually result in the loss of patient goodwill.

In summary, what we wish to provide you is an ability to close the book on every insurance claim by utilizing this service only on those specific claims requiring this type of additional effort. We will provide this at a fee which frankly is not possible for your staff or other companies to approach, especially when considering the impact and effectiveness of our national collection program.

  • RECOVER MONEY FASTER:
    Unlike other collection agencies, past-due accounts are instructed to pay you directly. You collect from both patients and insurance companies.
  • SAVE ON INTERNAL & COLLECTION COSTS:
    Reduce internal costs by as much as 30% and your collection costs by as much as 50% by using our collection system.
  • RETAIN CONTROL, PATIENT LOYALTY & GOODWILL:
    You decide when to start collection activity, when to stop, and how you want each account handled; diplomatically or intensively.

EHR Manager®

Cloud-based, HIPAA compliant and ONC Certified complete EHR. EHR Manager offers total reliability, maximum security and top of the line performance being on one of the largest cloud networks on the planet, Microsoft Azure. 

Great Features

  • Patient Portal
  • Interactive Online Scheduling 
  • Batch Eligibility Verification
  • Customizable Charting
  • Complete Electronic Medical Records
  • E-prescribe
  • Electronic Lab Procedures
  • Clinical Rules
  • Multi-user Support
  • Integration with MedOffice Medical Billing software
  • Powerful Reporting

Maximum Security

EHR Manager offers four nested levels of security:

  • Cloud Network – Microsoft’s Azure network.
  • Operating System – secure Linux operating system.
  • Application – user groups and security privileges.
  • SSL – encrypts the entire communication pipeline.

Data ownership

With EHR Manager, you have true and complete data ownership over your patients’ records. Using the backup option in your application administrative dashboard, you can download a complete copy of your EHR database to your hard drive for as many times as you want, for free, in addition to automated remote backup.

DentOffice®

Complete Dental Practice Management software. Download on-premises to your computer network or host on our cloud.

Features

  • Easy Scheduling
  • Chart & Prescribe
  • Treatment Plans
  • Insurance & Patient Billing
  • Scan, Import, and Store Images
  • Robust Reporting
  • Secure Messaging
  • HIPAA Compliance

Intuitive & Attractive Interface

 

In times of uncertainty your patients need to be certain they will always be taken care of.

Enjoy a telehealth system that was built with both your practice and your patients’ needs in mind. We believe that by helping you achieve your financial and managerial goals we help you provide the best patient outcomes possible.

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Most businesses put their livelihood on the line every night and don’t realize it. With businesses depending more and more on the data stored in their computers, proper backups are becoming much more critical.

Our Remote Backup service adds redundancy and security by backing up your data at an off-site location.  Never worry again about a hardware failure, software issues, natural disasters, or theft causing you to lose your data.  Backups run automatically on your desired schedule and can also be done on-demand, any time.

Our Backup System addresses three critical issues to successful offsite backup:

TimeOur RBS system ‘compresses’ the data prior to transfer.
ExpenseOur system leverages your existing Internet connection. A small annual fee will secure your files and put your mind at ease.
SecurityOur system utilizes multiple layers of access encryption and validation triggers.

Are you frustrated with credentialing or just too busy to do it yourself? Let us help you get this important process done right.

We are here to ensure that your practice obtains its insurance credentials quickly and correctly. We have the experience and knowledge you need to get through the process with the least amount of worry and at a competitive rate.

We take care of everything for you. Your office simply needs to fill out one application – and then leave the work to us!

  • Our staff of professionals handles every detail for you.
  • We update you regularly on progress until the process is over.
  • We track all applications submitted and maintain accurate records.
  • We guarantee complete security, confidentiality and accuracy.
 

We know how important credentialing is to your practice. Don’t waste your valuable time navigating through the maze of requirements. We care about each of our clients – and we would be happy to help you.

We are able to perform credentialing for all medical plans, specialties, hospitals and other facility privileges.

CodeMAXX manages your medical coding in accordance with the national standards (ICD, CPT, CMS, and HCPCS). CodeMAXX offers you peace of mind. Although medical staff may be trained on coding standards, the fact is, the codes are often changed or modified, or the requirements for using a specific code can differ from year to year. This jeopardizes not only your compliance but also your revenues because if a diagnosis or procedure code has been incorrectly assigned, you might end up with a denied claim or a decreased payment.

CODEMAXX SERVICES

CodeMAXX is a service that provides busy medical practices with access to certified professional coders who will code your encounter notes. CodeMAXX also provides you with the most up-to-date diagnosis codes (ICD), procedure codes (CPTs & HCPCS) and modifiers to insert into your billing software. Only by having the correct codes can you be sure that the insurance companies will pay you in a timely manner.

We provides medical transcription & data entry services to diverse healthcare providers – individual physicians, nursing homes, small and large hospitals. Our transcription process is secure and provides a quick & high-quality service while minimizing costs. We are committed to providing value and building a relationship of mutual benefit with our clients.

Transcription Services Provided:

  • Emergency room transcription
  • Acute care transcription
  • Admission note transcription
  • Surgical report transcription
  • Discharge summary transcription

Our Transcriptionists Handle Diverse Reports:

  • Progress reports
  • Physical examination reports
  • Pathology reports
  • Radiology reports
  • Autopsy reports
  • Labor and delivery reports

Benefits of Outsourcing Transcription:

  • Increased Focus on Core Health Care Areas
  • Secure Service
  • Lower Personnel Costs
  • More Business Focus on Higher Priority Issues
  • Increased Productivity and Efficiency
  • Free Up Management Time
  • Quality Assurance
  • HIPAA-Compliant 
  • Files Are Delivered in a Variety of Formats – DOC, RTF, HTML, XML and PDF
  • Highly Trained personnel

Scanning and Storing Historical Records – Get rid of the old medical records that are costing you money to keep stored. We scan these documents and store them on digital media for our clients to access and retrieve easily any time.

 

Here are a few benefits of this service:

  • Avoids the expense of excessive storage space
  • Speed up the process of finding records
  • More efficient way of filing
  • We can scan and archive your medical records daily
  • We can teach you how to scan, archive, and manage your own records in-house.

As a well-care service provider, we manage your outreach program to help maintain communication with your patients. Our public relations service is designed to increase patient loyalty and promote referrals. Our service consists of letters, postcards, and emails to remind patients of their need for various services, such as check-ups, testing, immunizations, etc. We can also send greeting and birthday cards. We maintain a positive relationship with your clients that goes beyond treatment in your office.

The program provides the following benefits:

  • Promotes and Maintains Patient Relationships
  • Keeps Office Staff Focused on Helping Care For Patients
  • Builds the Medical Practice and Increases Profits
  • Complements Any Existing Customer Care Programs
  • Pays For Itself As Patients Respond To The Program
  • Gives The Doctor More Time To Be A Doctor 

 

Check out some samples:

The federal government has implemented the Recovery Audit Contract (RAC), a control process intended to weed out the large volume of fraudulent medical claims. To accomplish this, the government hired private auditing companies to perform audits on medical records and claims billing in all 50 states. Audits may cover any provider who bills fee-for-service Medicare, Medicaid, or commercial insurance programs. The audits will check for evidence of fraud by examining three common indicators of fraud:

1) coding inconsistencies;
2) documentation to support the medical necessity of the services provided; and
3) overpayments or underpayments to providers.

This is a critical procedure for all medical practices. If your practice’s claims & records are audited and any of the three inconsistencies are found, you will be required to pay back not only the overpayment but also interest. In addition, appeals have not been successful. And the auditing companies will continue to audit your practice every 45 days until they find no further evidence of fraud.

The RAC program has identified billions of dollars in overpayments throughout all 50 states.

Why take a risk in your practice? Begin using our MD Audit Shield services to eliminate the chances of an audit proving inconsistencies in your billing. While nothing will keep the government from auditing your practice, our MD Audit Shield service will at least protect your practice in several ways. MD Audit Shield takes the following steps to ensure your compliance:

  • It reviews 50 records at random from your billing to check if any improper coding and non-compliance issues with Medicare/Medicaid appear.
  • It specifies what corrective actions are needed to comply with codes.
  • It performs any necessary changes to put you in compliance.
  • It stands behind you with assistance in the event you are audited.

Please contact us today to prepare for RAC auditing. Our services are professional and affordable!

How Does HIPAA Affect Your Practice? How to Become Compliant?

As a health care provider it is important to implement HIPAA standards and keep policies current, as well as provide annual training to employees. It is advisable that you create forms informing your patients about office policies in regard to their medical information. Such forms should include:

  • Where their files are stored
  • Who has access to their files
  • Name, address, and contact information of your billing service
  • Name of the healthcare clearinghouse claims are processed through
  • Method of transmission of claims

Our company can help you establish HIPAA Compliance:

  • Create Employee and Patient Forms
  • Establish Employee Computer Policy
  • Disaster Recovery Plan
  • Off Site Data Backup
  • Contingency Operations Plan
  • Annual HIPAA Training
  • Employee Computer Monitoring Software

Please contact our office for information on HIPAA compliance.

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