Medical Billing Services Tailored for Your Practice and Systems

No two medical practices are run completely the same and it’s likely the practice’s billing is addressed differently as well.

With this in mind, Consolidated MD’s medical billing services offers solutions based on your practices processes.

We work with you to achieve maximum reimbursements and our expert billing staff works in multiple practice management systems to reduce the costs of transition, stress and loss of revenue when transferring. If you like your practice management system, but need medical billing services, we can start almost immediately with just a few easy steps!

Types of Medical Billing Services

Temporary Billing Services

With all the changes to medical billing and coding in the past few years, some staff had needed assistance to stay caught up with the daily billing. We offer temporary billing in these times when your staff needs assistance but you still want to keep your medical billing in-house.

full-service-medical-billing-revenue-cycle-management
Our full service medical billing are performed to ensure all your claims get submitted correctly the first time. This leads to a lower denial rate and keeps your revenue consistently flowing in your practice. Full service medical billing includes all the following services.

  • Dedicated expert medical billing specialist
  • Government and Commercial Insurance Billing
  • Review of Daily Charges for Proper Coding
  • Initial Electronic Scrubbing of Claims
  • Electronic and Paper Submission of Claims
  • Secondary Clearinghouse Scrubbing
  • Timely A/R Follow Up
  • A/R Recovery
  • Patient Statements
  • Patient Billing Calls
  • Unpaid Claims and Patient Balance Follow Up
  • Payments and Adjustments Posting
  • Adjudication
  • Appeals

We do not write off any money that a provider is entitled too contractually.  We FIGHT for every dime!

 

Full Service Coding and Billing

ICD-10 code set requires specificity and granularity to ensure a claims is paid at its highest level. Our AAPC certified coders assess your notes and code your claims in the correct sequencing to keep your claims getting processed correctly the first time. Full service medical coding and billing includes the following services.

  • Dedicated, certified expert coder/billing specialist
  • Government and Commercial Insurance Billing
  • Review of Daily Charges for Proper Coding
  • Initial Electronic Scrubbing of Claims
  • Electronic and Paper Submission of Claims
  • Secondary Clearinghouse Scrubbing
  • Timely A/R Follow Up
  • A/R Recovery
  • Patient Statements
  • Patient Billing Calls
  • Unpaid Claims and Patient Balance Follow Up
  • Payments and Adjustments Posting
  • Adjudication
  • Appeals

An external billing audit can help ensure appropriate payment and compliance with applicable laws.
Auditing physician charges and billing practices is burdensome, but it will typically provide improved claims management processes, cash flow and compliance with applicable laws and regulations.  An annual audit allows providers and practice staff to identify specific coding and other issues that may recur in similar claims submissions.  Careful pre-submission monitoring and review of these similar claims may safeguard against errors that could result in claim denial.  An external audit allows the physician and practice staff to identify incorrect billing patterns before claims are denied or outside (payer) auditors access penalties.

A prospective or retrospective billing audit is commonly performed to ensure the physician is submitting appropriately coded claims as the physician is ultimately responsible for claims submission, even if a billing service or clearinghouse is used for claims submission to payers.

Physician’s offices are busy places, and often it takes everything you and your staff has just to get through the day seeing patients. Keeping track of records for errors and omissions may be a burdensome task and sometimes even impossible. While errors and omissions are not uncommon they may be costing your office more than you realize.

Auditing medical charts is the first step and a critical part of any successful medical office operation. Although chart auditing may seem intimidating for many physicians, there are many positive aspects of chart auditing including increased revenue, treatment efficacy research, and peace of mind in the event of third party audits. New attention from the OIG, RACs, and other third-party auditors makes this built-in practice self-check more important than ever.

Consolidated MD offers concurrent and retrospective audits for a charge based payer population. These audits can be performed remotely from our office. We can prepare an off-site audit of approximately 10-15 patient charts to ensure compliance with Medicare (CMS) guidelines and to establish proper billing and documentation procedures to protect you and your practice from a Medicare audit. It is important to make sure all of your records are in order in the event of an audit.

We can also assess your reimbursement and account receivable balances and current medical billing service practices, whether it’s currently being done in house or with another billing company. Our goal is to keep you within compliance, while providing you with the maximum amount of fee income. Improved coding and auditing guidelines can also improve the relationship between physicians, their patients, and third party payers.

An essential key to long-term practice success is adapting a Total Quality Improvement system used by professional auditors. Below are 10 easy steps for a successful practice:

  • Have a proactive and knowledgeable stance when it comes to your office records.
  • Communicate confidently with physicians and staff about proper chart documentation.
  • Find under or over documentation in your charts that can create improper code selection.
  • Implement controls to help prevent coding errors.
  • Ensure that appropriate levels of service are identified and billed.
  • Learn how to audit based on coding facts and potentially uncover missed revenue.
  • Learn the proper steps for choosing appropriate levels of history, exam, and medical decision-making.
  • Get the chart audit forms to implement your internal audit program.
  • Receive a thorough E/M documentation guidelines review.
  • Make chart auditing an essential component of your practice compliance plan.

Although these tips are very helpful to get you started in maintaining and verifying your medical charts, we encourage you to allow Consolidated MD provide your practice with more extensive training in chart auditing that will prove invaluable to your office operations. Our professionals will not only give you the tools that you need to complete thorough chart audits to address your specific Total Quality Improvement goals, but will also walk you through the process so that the staff understands the various and sometimes complex aspects of medical coding.

Overwhelmed?

Your first consultation is always free, so you have nothing to lose.  Please call us today to schedule a phone or in-person meeting today!