Outsourcing Improves Accuracy and Cash Flow for Physical Therapy Clinic
In keeping with its ongoing objective to provide unparalleled service to patients and increase profitability, a large Physical Therapy Clinic decided to outsource its medical billing and account receivable process.
With Medica as the vendor of choice, the company is experiencing a new level of costeffectiveness, efficiency, accuracy and overall patient satisfaction.
Medica Billing Solution's knowledgeable delivery team handles the complete medical billing process, including:
- Secure scanning, digital imaging and indexing of all Demographic, Fee Slips or Superbills, reimbursement checks and Explanation of Benefits (EOB)
- Separate auditing systems in place to insure accuracy in charge entry and payment posting
- Submitting claims to primary, secondary, tertiary insurance companies and patients
- Following up on each claim until payment is made
- Managing patient queries with the highest level of professionalism and customer service. Because after all your patients are our patients.
- Producing effective monthly reports focusing on industry specific Key Indicators* allowing our clients to manage their practice with up to date and accurate information
The digital imaging system is web based, which enables instant viewing of the critical documents for each account from any location in the world with internet access. This process is HIPAA compliant with file encryption and redundant offsite remote backups.
Medica separates the billing, posting and deposit functions. All charge entry is reconciled daily by units and dollar amounts. All posting activity is reconciled with deposits and tape on a daily basis. We prepare a daily reports consisting of activities performed and any new events that occurred. In essence (Charges - (payments + adjustments)) should equal the daily change in A/R.
Medica has instituted effective quality assurance measures in its medical billing process services. Standard procedure calls for data entry personnel to check all data immediately after posting, followed by an audit. In addition, we create a customized quality process that focuses on the specific types of errors identified during the normal quality/audit process
60% of all unpaid claims are due to errors involving paper claims. These errors are contributed mostly to scanning errors, illegibility, human error, or lost claims. By sending all claims possible electronically, not only does Medica eliminate 60% of unpaid claims, we increase your turn around time. Some carriers pay in as short as 15 days.
Billing and accounts receivable in the health care industry is as much an art form as it is a science. Like most rewarding skills, it takes thought and repetition to get it right. Just as professional athletes dedicate themselves and practice to achieve unbelievable results, so should you're A/R management staff. Our A/R management staff is awarded bonuses equal to a 20% pay increase of their salary based on collecting the Hard Dollars**.
There are two main components to create patient satisfaction. One is quality of care and the other is account management. The core instrument of the clinic is, as it should be, Quality of Care. On the other hand Medica's core instrument is account management. When you are able to blend two core components patient satisfaction is enhanced. Patient relationships are key to our industry. Being focused exclusively in rehabilitation clinics, Medica understands the power of the referral.
What good is a pilot without a map? How effective is an engineer without schematics? How can a Clinic operate, plan, and grow without effective reports? The answer to all is that they can't. Simply put without the correct information on a ongoing basis, you could be leading your company away from profitability.
The health care industry in unique in that primary source of payment for services rendered comes from third party payers. This leads to the complexity associated with proper billing and collections.
Picture this: assuming all things equal between two identical clinics, the only variance is an exponentially higher profit margin. The difference is that one has a well-focused and successful A/R management process. The other one just gets by.
* Key Indicators- (payer mix, average reimbursement per visit, average dollars billed per visit by therapist, visit counts, referral tracking, charges, payments, adjustments and percentage of arrivals.) These are some of the reports that are supplied to our clinics. We have the ability to generate over 1500 different reports or can have them custom made to suit your needs.
** Hard Dollars- (these are the monies that are past due and outstanding)
