Billing Services
With today’s billing requirements, each specialty has unique demands, complex payer requirements and relatively low reimbursement per procedure when compared to years past. Additionally, payers have made it difficult to appeal denied claims, shortened timely filing requirements and created inconsistent authorization requirements that lead to unpaid claims, increased bad debt and accounts receivable days and decreased collection ratios for most practices.
TMM addresses these issues in the following ways:
- TMM utilizes state of the art practice management software and technology, including document imaging software and automated coding technology.
- Primarily all billing information is received via electronic interface directly from the hospital or clinic, resulting in fewer lost claims and greater accuracy.
- Private pay and Medicare payments are posted electronically for speed and accuracy.
- TMM has developed a formal compliance plan for the HIPAA Privacy Rule as well as Fraud and Abuse. A recent audit found “no evidence of compliance problems.”
Review of Current Status
- TMM will analyze current reports, processes and coding to ensure optimal performance and establish accurate expectations.
- TMM will work towards creating paperless billing options wherever possible; eliminating long lag times between treatment and billing processes.
- TMM will give written recommendations related to current processes, highlighting billing and process improvement opportunities.
Setup
- TMM will create a separate billing database to ensure separation of data and appropriate security levels.
- TMM will provide onsite training to ensure that coding and data entry are done timely and accurately.
- TMM will establish remote connectivity between the billing office and the client’s site to ensure secured access to billing and patient data as needed.
Performance Indicators and Reporting
- Billing/collection performance will be assessed on a daily, weekly and monthly basis.
- A/R days, Collection ratio and bad debt are reviewed and analyzed monthly. A formal report is submitted for your review monthly
- Front end editing is done prior to claims transmission, eliminating unnecessary denials and providing timely feedback to our clients related to data entry, authorization and coding errors.
- Clearing house denial rates are monitored and error rates are analyzed daily.
- Special, custom reporting is done based on your needs