Challenge:
Managed Outsource Solutions helped in the case of a Board Certified Internal Medicine MD. Our client renders critical care services at Lutheran Medical Center in Brooklyn NY. Critical care is medical care provided for a gravely ill or unstable patient. In addition to critical care services, the physician also provides gastric intubation, cardiac output interpretation, ventilator management, and vascular access procedures.
Juggling Medical Billing and Patient Care Was a Struggle for Him
The physician faced a real dilemma. He had the required knowledge to handle medical billing and collections – in fact, the entire revenue cycle was managed by him. However, he found it to be very time consuming to do both at the same time. What’s more, he was worried that his practice management software was not correctly capturing his payments and he was powerless to handle the outstanding claims efficiently. He needed outside help and approached MOS.
Solution:
What We Did for Him
Our medical billing team provided him with a complete cycle medical billing solution that included charge entry, eligibility checking, payment posting and claim follow up.
MOS implemented the following processes:
- Analyzed his current software and discovered cases of improper billing. We found that certain claims were being denied because they were being billed without suitable modifiers. This hurt his bottom line.
- Encouraged him to change over to our recommended software which could prevent such instances in the future due to its claim scrubber feature. It also has comprehensive reporting and real time claim tracking features that help to prevent time/improper claim problems and enable faster resolution for all billed claims. While switching to the new software, we ensured that there was no break in his billing and collections procedures.
We meticulously reviewed the super bills the client regularly uploaded to our secure FTP and add all related modifiers for suitable reimbursement. The bills are then reviewed and fed into the software within one day. The claim is then followed until final adjudication is complete.
Result:
The client has been using our medical billing services for the past year. He is very happy with our medical billing and coding. He trusts us with his medical billing and his work is in good hands. All his questions and concerns are handled quickly.
- Our client now has more time to focus on patient care while also appreciably increasing patient volume.
- Claim denials have come down substantially
- Collections soared by 40 percent in just two months.
