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Presentation on theme: " Billing Depot New Generation in Healthcare Claims Processing and Outsourcing Solutions “Billing Depot helps the physician spend more."— Presentation transcript:

1 Billing Depot New Generation in Healthcare Claims Processing and Outsourcing Solutions “Billing Depot helps the physician spend more time with patients, reduce management overhead, and grow profitability.” - Dr. Zelik Frischer, Clinical Professor at the Department of Urology at Stony Brook University and three-times named in New York Magazine survey of best doctors in the Metropolitan Area

2 2 www.BillingDepot.comCopyright © Billing Depot, Inc. Billing Depot Concept It is becoming harder to earn a living by practicing medicine because: Increasing regulatory scrutiny and compliance requirements Growing insurance costs Uncooperative payers In-house billing dilutes focus on health care: – Hire your own staff and manage hiring, training, payroll taxes, HR benefits, vacations, sick days, and turnover – Buy your own software and manage systems setup, downtime, backups, and replacement – Perform complex claim follow-ups yourself In-house billing is ineffective and inefficient: – Chronically delayed and incomplete payments – Persistently low efficiencies and high processing cost In-house billing result: – Physicians work longer hours – Collections shrink and slow down – Physicians spent more time on administrative problems Why outsource billing? – Faster, more precise, and fully compliant payments More and better trained personnel with single focus Better management, e.g., separation of labor, individual tracking State of the art technology Business continuity planning (backups, redundancy) Regulatory compliance – Lower costs due to economies of scale – Continued improvement because of growing economies of scale – More time spent on health care and less - for administration Why outsource to Billing Depot? – Guaranteed productivity – HIPAA compliance – Transparency – full control including ability to observe every claim and intervene throughout the entire process 24 x 7 – Competitive cost structure – ZERO upfront investment

3 3 www.BillingDepot.comCopyright © Billing Depot, Inc. Days in AR Billing Depot performance metric is comprehensive: It measures total payment time from service delivery to the last payment Days in AR Service Delivery Claim Created/received at Biller’s Office Primary Payer Paid Secondary Payer Paid Patient Paid Billing Stages Industry Average Days in AR: 73 Billing Depot Average Days in AR: 31 Billing Depot reduces actual days in AR with: Workflow Management Upfront Knowledge-Based Claim Validation Specialized Workbenches Comprehensive Follow-up Rejection Aged AR Systematic error analysis Online 24x7 access to complete process history

4 4 www.BillingDepot.comCopyright © Billing Depot, Inc. Why Traditional Billing takes longer and costs more? Provider Billing Office Payer Notification Submission Correction Single-threaded: Allows only one billing activity at a time Passive: Waits for the Payer to trigger every billing activity Relies on Payer to find and communicate errors Shields Provider from observing the process Creates opportunities for holding claims indefinitely Ignores individual accountability Depends on manual reconciliations Wastes time on multiple notifications and reconciliations

5 5 www.BillingDepot.comCopyright © Billing Depot, Inc. Straight Through Billing Provider Payer Upfront Quality Control Validation / Eligibility Pricing Follow Up Scrubbing/Rejection AR Follow Up Vericle® Workflow Charge Entry Patient Invoicing Collection Payment Entry Provides 100% transparency for the entire process Multi-threaded - Multiplies channels for systematic corrections Identifies majority of errors upfront Leverages specialized workbenches Provides 24x7 on-line comprehensive quality reports Enables individual accountability Tracks all claims and prevents losing claims in aged AR Automatically assigns and tracks follow up action items Proactive - Eliminates delays Manual reconciliations Notification

6 6 www.BillingDepot.comCopyright © Billing Depot, Inc. Services Doctor credentialing Enrollments Billing Patient account and charge entry Paper On-line Scrubbing follow-up Rejection follow-up Patient invoicing A/R follow-up Collection Payment/EOB entry Recurring error analysis

7 7 www.BillingDepot.comCopyright © Billing Depot, Inc. Reports and Interaction Forms Transparency is a key differentiating aspect of Vericle. Reports are - available 24x7 via Internet browser - interactive - drillable to lowest claim detail and action made Custom reports are available upon request, usually within 48 hours. Billing Process Management  Cash Flow  Status  Workbench  Billing Period Close  Referral Tracking  Productivity AR Reports by  visit  payer  CPT  financial class Forms  Patient Entry  Charge Entry  On-Line Claim Editing  EOB Posting

8 8 www.BillingDepot.comCopyright © Billing Depot, Inc. Cashflow Cashflow report shows anticipated cash from past claim submissions Total Outstanding Amount Collected Weighted Average AR Failed Claims # Active Claims Instant big picture % Paid in 45 Days

9 9 www.BillingDepot.comCopyright © Billing Depot, Inc. Status Real-time Status report show summarize the overall state of the billing process Interactive reporting drills into specific claim detail for instant error correction

10 10 www.BillingDepot.comCopyright © Billing Depot, Inc. Workbench Workbench shows a queue of personally assigned claims for follow up. The assignment is performed automatically based on specific kinds of errors and attributes of payer, provider, or patient.

11 11 www.BillingDepot.comCopyright © Billing Depot, Inc. Billing Period Close

12 12 www.BillingDepot.comCopyright © Billing Depot, Inc. Referral Tracking

13 13 www.BillingDepot.comCopyright © Billing Depot, Inc. Productivity Heatmaps show relative under- and over- performance by color shading Productivity report measures billing effectiveness

14 14 www.BillingDepot.comCopyright © Billing Depot, Inc. AR by Visit Reports support instant sorting and filtering

15 15 www.BillingDepot.comCopyright © Billing Depot, Inc. AR by CPT - Payer Reports support export to Excel

16 16 www.BillingDepot.comCopyright © Billing Depot, Inc. AR by Financial Class

17 17 www.BillingDepot.comCopyright © Billing Depot, Inc. Patient Entry

18 18 www.BillingDepot.comCopyright © Billing Depot, Inc. Charge Entry

19 19 www.BillingDepot.comCopyright © Billing Depot, Inc. Online Claim Editing

20 20 www.BillingDepot.comCopyright © Billing Depot, Inc. EOB Posting

21 21 www.BillingDepot.comCopyright © Billing Depot, Inc. Billing Depot Benefits Better Results More Accurate Remittance Powerful database for robust audit, drill down, and troubleshooting Comprehensive Claim Scrubbing New Jersey LMRP rules updated monthly CCI rules updated quarterly Payer-specific data validation Eligibility testing prior to claim submission Faster Reimbursement Automatic 835 EOB posting for larger payers Prompt follow-up for rejections, denials, partial-payments Systematic error analysis to continually optimize the billing process Less Risk 100% Transparency and Accountability Real-time feedback to physician’s office 24x7 Full HIPAA-Compliance Industrial-strength technology and state-of-the-art data center Large pool of certified coders and billers Lower Costs 0 upfront investment Competitive fees Contact 732 845 3433 today for a FREE profitability review

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