mdbillables & practice management services: medical billing and services
TRANSCRIPT
PAGE 1 MDBillables
MDBillables & Practice ServicesMedical Billing Services
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.
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.
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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
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Medical Billing Process
Provider Enrollmen
t
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.
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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
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How we help to Increase Your Billing Revenue
1. Collect Payment Up-Front2. Automate Billing Procedures3. Maximize Payer Reimbursement4. Minimize Denials5. Monthly A/R Analysis6. Keep Ahead of the Curve (regulations, policies, etc.)7. Claim Bundling/Unbundling8. Global Periods
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
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MDBillables Services Portfolio
PS for Revenue Cycle
Consulting Services Business Intelligence
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•mdbillables.com
• (561) 409-0377
• (561) 320-0339
You manage your patients, we’ll help manage your practice