Page 27 - Delaware Medical Journal - April 2016
P. 27
BUSINESS OF MEDICINE
regulations and is responsible for conducting on-site quarterly reviews with the practice to discuss improvement in the monthly billing process. This includes relevant topics of concern to the practice such as Meaningful Use, electronic prescribing, CPT coding changes, PQRS, value added to keep current with medical billing and information technology issues from the federal government. The client manager should arrange for training needed to keep the practice staff current with any new billing procedures. The quarterly to work with your staff, not just be available on
the telephone.
Do they provide free software and/or hosting?
Practice management, electronic prescribing, and Electronic Health Record software are required to use RCM. The concept partner and each party has distinct responsibilities to maintain the revenue cycle. The RCM partner should offer a choice between a HIPAA compliant software hosting (ASP) or a client server model. Many practices feel better when the data is in
How do you disengage and get your data back in a useable form? What if it just doesn’t work out?
No one plans for the worst, but it could happen. You need to have your data and software returned to you so that you or another RCM partner can pick up right where the last company left off. Without the software your data may be useless.
Do they offer patient interaction?
It is important to understand who handles patient inquires and
know the patient best and many billing questions quickly turn into medical questions. But an RCM partner should have the or the staff to answer the calls.
Do they provide procedure fee review?
An RCM partner should review your current billing fees with recommendations on how you have these fees set based upon your geographic location, participating insurance carriers, and other standard fees from comparable practices.
to recommend coding for maximum reimbursement and assist with denial management. They also advise clients on how to with any issues that are taking place that could prompt an audit.
Do they provide one consistent account manager available by telephone?
It is essential to have one or two consistent account managers available by telephone, email, and internal messaging within the practice management software. Your account manager will grow should be available to address any concerns in a timely manner. RCM runs smoothly when one or two billing professionals are handling an account rather than a different person every week.
Do you have everything in writing and in the agreement?
It is important to document everything settled on within the agreement. Salespeople leave the company and even with the best intentions people can forget what was promised. If anything is in doubt be sure it is included as an addendum to the agreement.
With each passing month it seems running a successful practice becomes more complicated and challenging. But it doesn’t have to be this way if your practice partners with the right people with the best expertise.
CONTRIBUTING AUTHORS
■ ALI BENTLEY is the Mid Atlantic Regional Sales Manager for STI Computer Services, Inc., headquartered in Southeastern, PA.
■ LYNN ROBINSON is the Physician Relations Manager with the Medical Society of Delaware.
REFERENCES
1. Rousche LE. EHRs and audits mean new roles for doctors, staff. Med Econ. September 10, 2013.
2. Seidman BDO. HCFA continues to “re-engineer” Medicare. Healthcare Advisory Services newsletter. March 2000. 3. Dolan KP. Speed up payments with electronic transmissions. Med Econ. October 27, 1997.
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