info@ppmatl.com
"With Precision, I’m confident
that the business side of my
practice is taken care of."
Dr. William Stoll, Atlanta Foot Care Center
Billing and Collections Services
The majority of our clients contract with us for billing and collections services. All of these practices use what we call Core Services, which includes everything from claims submission to sending patients to your collections agency. Additionally we offer other services on an a la carte basis.
Core Services:
This is our most common group of services. The practice enters patient demographics, code the charts and enter charges. We handle everything else up to the decision to send patients to collections. The major tasks include the following:
Technology. We will license, implement, train and support our web-based practice management system. The system is full featured, robust and requires minimal onsite infrastructure, a Windows PC and high speed internet. Included in the service is the fully integrated Gateway EDI clearinghouse service as well.
Claims Submission. Electronic or paper if necessary.
Copay and Payment Posting. Payment documents are either received by ERA or scanned and securely transmitted to us. During this process we post denial information to the claim for additional follow up.
Filing Secondary Claims. Generally one or two secondary claims are filed per claim and then drop it to the patient.
A/R Follow Up. It’s our single largest commitment because it pays off in reimbursement. We assign claims to roles in our organization based on the complexity of the denial information posted during payment posting. We also report back denial statistics to our clients on a monthly basis. The goal is to work together to eliminate systemic denials, reduce errors and speed collections.
Outbound Calls to Payers. Claims that are not resolved within a certain number of days are called by a dedicated call staff to check status. They collect relevant information that is passed on to the A/R Follow Up team.
Patient Statements. We use a bulk printer for all statements. The actual out of pocket cost of $.60 each is passed along to the client. Frankly, life is too short to stuff envelopes. Statements are printed every night on an automated basis which overall will reduce the days in A/R for patient liability by 15 days over sending statements once a month.
Incoming Patient Calls. We print our toll free number on the statements so the patients call us not you. I’ve never had anyone turn this down. You can even integrate our phone number with your phone system (push “2” for billing questions) to save you more time.
Collections Services. We will manage the work flow to get your accounts to your collections agency. All you have to do is pick the ones to send.
Monthly Client Report. We will prepare a comprehensive monthly report that covers all aspects of our work. We review it to spot problems and then will offer a call or meeting to go over them with you and your team. It allows us to easily identify and discuss problems that we’ve discovered and how we’ll resolve them.
This group of services varies based on specialty and practice size. The cost is a percentage of total collections.
Additional Billing Services:
In addition to the services above, consider any or all of the following:
Demographic Entry. You scan us the patient face sheet or similar document and we’ll enter the patient information into the system.
Patient Insurance Plan. Entering and maintaining the patient insurance information.
New Insurance Plans. We will enter any new insurance plans and map them to the clearinghouses electronic submitter ids, if possible.
Charge Coding. Scan us the chart and our certified coders will code the CPT and Diagnosis codes. This service is not available for all specialties so an evaluation is necessary.
Charge Entry. If we do your coding this will be done as a part of that service, if you code the chart, scan the superbill or similar document and we’ll enter the charges for you.
These services are priced on an a la carte basis generally as a percentage of collections.
Advanced Billing Features:
As a result of our focus on technology and workflow efficiency, we have several advanced billing features that are optional as well.
Integrated Banking. We have developed a close relationship with a business bank to be able to integrate and streamline many business functions. A large portion of Affinity Bank’s, formerly Atlanta Business Bank, customers is physician practices and other healthcare concerns. Affinity offers many services that are attractive to this community at a significantly lower cost. For example, they offer practices a check scanner at no cost for in office deposits therefor avoiding any trips to the local branch.
Eligibility Checks. On demand eligibility checks are available with automated batch eligibility checks coming soon. The practice either clicks an icon on the patient information screen for a check within a few seconds or batched checks will display icon notification on the web-based schedule to follow up.
Insurance Card Scanning. Using an inexpensive ($80) card scanner the practice can scan each patient’s driver’s license and insurance card, front and back, into the billing software.
Patient Portal. Patient communications is likely the second most expensive function a practice has after A/R follow up. We believe we can streamline and reduce this labor intensive responsibility by providing a secure web portal for patients to request appointments, ask questions, receive statements, etc.
Payment Portal. With the trend towards increased patient liability, every practice should increase its availability to receive payments. A recent study showed that about 40% of the time the decision to pay a bill is made outside business hours. Undoubtedly, if a practice cannot receive a payment at that time the opportunity may be lost. The cost of manually receiving, recording and posting a patient credit card payment is significant, about $1 to $1.50 which offers an opportunity to reduce costs or redeploy labor.
Charge Capture. Undoubtedly, every practice at one point or another will neglect to bill for a service rendered. Either by missing additional billable services or down coding or, at worst, not submitting a claim at all, practices lose material revenue. Whether through training, improved workflow or technology, we can develop a customized solution to the needs of each practice to minimize or eliminate the problem.
Other Services:
We have developed several non-billing services that have helped physician practices in the past overcome issues or to improve their existing businesses. While closely related to the billing and collections function they are generally beyond the scope of our work.
For many of these services we offer a partial rebate against billing services over a two year period.
Practice Assessment. This service involves an onsite visit to evaluate the practice operations as well as collecting and analyzing practice financial data. A verbal, summary or full written report will be delivered upon completion. Generally the report will include comments on safety, practice operations and financial issues that require attention.
The cost of this service varies based on the size of the practice and the reporting requirements.
Credentialing and Contracting. These tasks are often overlooked with a new provider in a practice and we are observing many existing providers with unresolved credentialing issues. Credentialing can be provided on an individual application basis or annually for all applications including support. Contracting can be provided for new providers or practices. Comprehensive contracting needs can be evaluated as well.
The cost for credentialing is approximately $300 per application and annual support is $1500 per provider per year. Contracting services can be provided on an hourly basis.
Practice Startup. The project would include establishing workflows, policies and procedures, staffing, technology implementation, patient flow, etc. The work will require extensive onsite work including the day or days when the practice opens for business.
The cost of this service varies based on the size and complexity of the practice.
Ongoing Oversight. Most new practices do not require a high level practice manager but would benefit greatly from a resource to call on with questions or assistance. Typically a monthly visit for a status meeting is all that is required along with as needed phone support. Many aspects of practice operations can be managed and monitored remotely as well.
The cost of this service varies based on the size and complexity of the practice.
Coding Support. The coding requirements of the average practice are often the most underserved function of the business. Having access to a resource for regular chart review, training and as-needed support can be invaluable.
Coding services are available on an hourly basis as needed.
Practice Bookkeeping. Many practices struggle with managing the day to day accounting for their business. Nearly all accounting professionals are unfamiliar with the unique needs of even the smallest practice and struggle getting their needs met.
Bookkeeping services are available on an hourly basis as needed.
Rural Health Clinic Development. Rural Health Clinics are a high profile business opportunity for some providers. Our team can assist providers from the initial filing to facility development to policies and procedures to successful site inspection. We also provide billing services to a number of existing RHCs in the state of Georgia.
RHC Development is provided on a project basis. The cost is determined by the scope of work and the number of sites.
Technology Implementation. We can evaluate the existing clinical and billing technology of the practice and recommend adjustments or replacements. Practices have generally done a poor job making technology purchases. Our bias is toward inexpensive and functional web-based technology that requires minimal onsite technical requirements and maximum flexibility.
PPM offers a comprehensive basket of services that are greatly needed by the physician practice community. Whether it’s with new or existing practices, we focus on concrete issues that drive compliance, increased reimbursement and improved efficiency. These areas are mission critical issues in nearly all practices.