FLATIRONS PRACTICE MANAGEMENT
FLATIRONS PRACTICE MANAGEMENT
Medical Billing Services
We can help you whether you want to outsource the entire revenue cycle management process or you just need a little help. Our services can be customized to your specific needs.
Frequently Asked Questions
We can work with literally any EHR software. If we don’t already work with your software, we may be able to develop a custom interface. Alternatively, we can always extract the data and input it into our software. We might also opt to simply bill through your software. We assess each situation independently and work with our clients to agree on the best course of action.
That said, we currently work with:
- Amazing Charts
- Fusion Web Clinic
- NextGen Office
- Practice Fusion
- Raintree Systems
- WellSky Rehab
This does not include the systems we log into and export the data to then upload into our billing software.
Billing services are not a commodity and the services provided can vary widely from vendor to vendor. Furthermore, the difference in collection results between the best billing companies and the worst can be enormous. More often than not, you get what you pay for. There are billing companies that simply bill claims and provide no post-billing follow up whatsoever. They charge a highly discounted fee because they’re providing a fraction of the service we provide. In our experience, any amount you might save in billing fees by using a low-cost biller can easily be nullified by lost collections from the lack of follow up.
In fact, most of our clients came to us after having had a negative experience with a previous billing company. Submitting claims to insurance companies requires knowledge and attention to detail but it’s not especially difficult; the hard part of what we do is getting an insurance company to pay a claim they’re trying earnestly to avoid paying. One-half of our employees do basically nothing but follow up on unpaid claims and it’s a huge part of the service we provide. We utilize the same management techniques and quality assurance processes found at world class companies, such as GE Healthcare, and we produce better collection results than most billing service companies. We’re not the least expensive billing service in the business and we’re not the most expensive either. Rather, we strive to offer a good value to our clients by providing an excellent service at a fair price.
We provide a thorough monthly report to our clients that includes a monthly/YTD cumulative summary of key billing activity including charges, collections, adjustments, visits and aging, broken down into the classic aging buckets. The summary includes a number of useful collection statistics including charges per visit, collections per visit, collections as a percentage of charges, average days to collect, and more.
We also provide the detailed component reports that substantiate the monthly/YTD summary. The majority of our clients find our standard practice management report to be more than adequate but we have an ample menu of other available reports that we can include in your monthly report package if you have a specific request. We may also be able to create a custom report for you. If in doubt, please ask.
We send patients statements monthly when they have a balance due. If they ignore their statements we follow up with a series of up to three reminder phone calls over a three week period. In our experience, most calls go to voicemail and we leave carefully worded messages. The wording is structured quite deliberately to incite action on the part of a delinquent patient who failed to pay their bill while maintaining civility and professionalism. If they pay their balance due at any point after the first call, we stop calling them, otherwise they’ll get all three calls.
The key to this approach is that the language gets progressively more urgent and direct if they continue to ignore their balance due. By the time they receive the third call, they know they’re accountable for paying their bill. At the end of the call campaign, after a patient has taken 60 days and ignored two statements and three phone calls, it’s pretty obvious that they’re not planning on paying their bill. At this point, we’ll recommend assigning the account to a licensed debt collections agency. Of course you’ll always have the prerogative to offer payment plans or allow a patient more time to pay and we’ll gladly implement your wishes. We find our process to be highly effective in collecting your patient balances and are surprised that most billing companies don’t do this.
We first review the documentation to determine why it wasn’t paid, whether this was an error, and what the appropriate course of action is. Often times it’s simply the patient’s responsibility as they had an unmet deductible or the claim was processed as a non-covered service, etc. at which point we transfer the balance to the patient and send them a statement. In some cases, insurance companies deny claims in error or they deny them on ambiguous grounds such as “not medically necessary”.
In these cases, we compile the chart notes and physician referrals/prescriptions and draft appeals to substantiate medical necessity or to dispute whatever the erroneous denial happens to be. We will coordinate with you or your staff appropriately should a letter supporting medical necessity be needed. We’re responsible for following up on your unpaid claims and taking the appropriate actions to get them paid. We devote significant resources to this critical task as we recognize that our value to you hinges on our ability to produce superior collection results.
First, you’re responsible for maintaining your EHR software to include creating your patients’ charts and updating their demographic and insurance information at the point of intake and anytime it should change. This includes making sure that you’re providing us with accurate information such as whether to bill Medicare or a Medicare-replacement plan, for example. In conjunction with this, you should verify insurance eligibility and benefits for any new patients at least at the point of intake to include securing and managing any required authorizations. You should collect co-pays at the time of service and, to the best of your ability, we recommend collecting toward co-insurance and any unmet deductibles that might apply. You will need to report to us any collections you secure at least once per week so we can credit the patient’s ledger accordingly. We strongly recommend actively monitoring your queue to make sure that no visit goes unbilled because the provider failed to sign and finalize their notes.
Additionally, you will need to forward your EOBs and copies of checks to us for posting. We can electronically retrieve ERAs for any EFT payments you receive but we’re dependent on you to provide copies of your paper remits. We strongly recommend utilizing a lockbox service with your bank of choice. The money goes into your bank account promptly and we can secure scanned images of your EOBs and checks without you having to lift a finger. This approach is highly efficient and highly secure. Alternatively, you can scan them to our HIPAA-compliant web-based filing cabinet or you can have your mail come directly to us.
"Our practice has worked with FPM for several years and we are extremely satisfied with the work carried out so far. Flatirons Practice Management is organized, detail oriented, accurate, and trustworthy.
The claims are processed quickly and accurately and they understand which codes and modifier are needed for proper medical billing and maximum reimbursement. Their billing software is able to integrate into our EMR which has made our billing process more efficient and effective. The staff is very friendly and they are always willing to help when we have questions and/or concerns. They do a great job of answering patient questions and there is a specific person who is dedicated to answering patient calls.
I would highly recommend Flatirons Practice Management to any medical facility that is looking for a knowledgeable, accurate, dependable billing company. "
- Jessica F., Podiatry Office Manager