Medical Consulting and Medical Billing Services

Our Services

PRACTICE MANAGEMENT
Knowledge is power. We like to educate our physicians and their clue staff members in such a way that they understand the reason for any proposed changes and fully implement them in a short period of time. Our services include but are not limited to:

Practice Analysis and Complete initial setup:
Before taking over billing and collections we proceed with a complete analysis of the practice in question and provide them with suggestions for the documentation necessary to collect the maximum allowed payment for services rendered. In order to achieve optimal results, we carefully evaluate the office flow as well as the forms you are using now. If necessary, we will re-design and produce a customized set of patient information forms and office notes consequently simplifying the paperwork and making it more efficient without increasing the physician’s workload.
Appropriate documentation:
We will train you and all your medical personnel in such a way that you will be able to understand and fully implement the rules and regulations regarding the documentation necessary to collect the maximum allowed payment for services rendered.
Maximizing your billing:
By understanding the carrier’s requirements for each level of visit, you will be able to accurately maximize the level of visit for each of your patients, optimizing the reimbursement for the time you spend with your patient.
Understanding the concept of “peer review”:
We will train you in the most efficient way to read, understand and respond each peer review received, in such a way that denial of payment for this reason will be minimized.
Re-licensing:
We make sure that the appropriate licensing is up to date and that everybody in your office is completely covered at all times.
Managed Care Contract:
Due to our broad knowledge of the system, we are able to negotiate in behalf of the physician, in order to obtain a fair contract with the least limitations and the least economical penalties that sometimes come with it.

BILLING
We are fully equipped to do electronic and paper billing for Medicare, Medicaid, Group Insurance (HMO, PPO, POS Indemnity), Workers' Compensation, Personal Injury and Cash payments.

We excel in accurately coding and billing for office visits, consultations, professional fees for surgical procedures, technical components, professional and facility fees for hospitals and ambulatory surgical centers, anesthesiology, hospital visits and in-office minor and major procedures. We will analyze and advise you of the advantages of facility vs. non-facility interventional procedures when it comes to reimbursement as well as optimal patient care. We keep current with insurance specifications and regulations and ensure the fees are kept at the maximum allowable reimbursement. We also focus on procedure codes so claims are not suspended or rejected.

Each EOB is carefully analyzed and appropriate credits entered for the proper claim. If necessary, immediate steps are taken in order to process unpaid or reduced claims and make sure that you receive every penny you are entitled to.

We process Secondary Carrier claims upon receipt of the primary carrier EOB making sure that you receive the maximum amount covered by the Insurance Companies and minimizing out of pocket expenses for your patients.

COLLECTIONS
Our services include collection of unpaid accounts, response to peer reviews, request for re-consideration of denied payments, Medical Dispute Resolution and in the last instance SOAH. We follow-up on all claims that have gone unpaid beyond 30 days and process the required appeals if necessary. We also process and mail all patients statements and focus on “soft collections” consisting of letters and telephone calls.

PHYSICIAN ASSISTANT TRAINING
We offer the services of our experienced personnel to train the physician and his assistants regarding maximizing the type and number of services accessible to the patients. We make sure that everybody in contact with the patient is capable of fully documenting the services rendered in such a way that every minute spent is accounted and properly billed for. We will help your personnel to understand the type of practice you have and maximize the available treatments for your patients.

CUSTOMIZED REPORTS
We provide reports detailing billing transactions on a bi-weekly schedule. Our reports are easy to read and easy to understand and will give you an accurate idea of the state of your practice. We also have the technology to provide you full access to your account from virtually any place in the world.

OUR CLIENTS
We help physicians all over the country to set up new practices and/or improve their existing ones. Our client profile varies from physicians that have a large established office but are eager to learn and improve. The physician that had a bad experience with his previous billing service and does not trust anybody when it comes to his finances. The new kid on the block just starting on their own and wanting to do it right from the beginning. After all he went to medical school, not business school and doesn’t know how to get started. Physicians moving to a different place, opening a second location or just separating from a large group and starting on their own that also want to have a fresh beginning. The physician frustrated due to his low reimbursement despite the hard work performed and the long hours spent away from his family. Our goal is to help you get started or to help you improve your existing practice. Remember: if you don’t get paid, we don’t get paid. It is in our mutual benefit to collect the full reimbursement for services rendered.