Revenue Cycle Management
Set up According to functions:
-Customer Service & Correspondence
Physician Billing Specialists understands the billing procedures and policies of each client. Our personnel identify themselves as the client’s billing department and are trained in the client’s billing procedures. Calls from patients are sequentially routed to the next available representative resulting in an average patient wait time of less than 2 minutes.
-Charge/Payment Posting
The Physician Billing Specialists Entry & Client Deposits team enters charges daily from a variety of transfer methods. Charges are batched and carefully balanced prior to the client's daily closeout.
Ancillary Staff
Physician Billing Specialists also has, on staff and available, ancillary staff to service the needs of our clients. We have specialists in software programming, coding, physician fee schedules, and managed care contracting. Our ancillary staff specializes in solutions to meet specialized client requirements.
Additional Services include:
● Refund administration
● Procedure and Diagnosis coding and compliance
● Inbound and Outbound Electronic Data Interchange
● Electronic Remittance Advice (ERA) with underpayment analysis
● Contact and Denial Management
● Custom management reporting
● Payer Reimbursement Tracking through Lag Reporting
● Capitation
● Risk Management
● Billing system data reconciliation
● Document Image Retrieval
Strategies for Success
Physician Billing Specialists’ strategy for success is focused on technological tools and functions for its outsourced revenue cycle management solutions. We have implemented a multitude of solutions for an overall total impact to the bottom line profitability.
Examples of transfer methods used are:
● System to System file transfer
● Shared Drives
● Hard Copy
● Directly to Client
Client fee schedules and payer negotiated fees are maintained by our system allowing our staff to know immediately when a claim has been paid incorrectly.
Accounts Receivable & Collections (payer specific)
Our Accounts Receivable staff is assigned by the payer and patient responsibility. Those assigned are experts in their specific payer policies and are cross-trained to others. Routine follow-up on unpaid claims begins with payers at 31 days. We aggressively follow-up on every claim paid incorrectly. Payer aging of accounts is reviewed monthly by management and the patient aging of accounts is also rigorously monitored and collections are pursued according to a policy established with the client at the time of contracting.
The Bottom Line
Physician Billing Specialists use of healthcare practice management software, along with our highly professional staff, allows us to offer many services to our clients all with the focus of improving their bottom line. Physician Billing Specialists’ internal resources allow us to tailor our business model to that of our clients’ to enhance the workflow and reduce their downtime. With our systems in place, we can offer built-in reports as well as our customized reports in order to really drill down into the revenue cycle and to find the best places to focus on to increase revenue. Some of the financial benefits of our system are:
● Improve day-to-day collections and cash flow
● Manage and reduce outstanding AR
● Reduce billing errors delaying cash flow
● Increase collections at time of visit
● Access information to improve efficiency and increase revenue
● Provides valuable insight into the practice