Throughout our 20+ years of business, our hospital-based physician clients (Emergency Medicine, Pathology, Radiology, Surgery, etc.) have sought advice regarding their frustration of not knowing if their billing company was doing an effective job of billing & collecting for services rendered. Many times, we were asked to recommend a new billing company. Historically, we have been reluctant to recommend third-party billing companies due primarily to the fact that there were only a handful of billing companies that could be relied upon in our service area to fully meet the needs of our clients.
During a strategic planning session in 1988, a new division of MDMANAGEMENT was created to service the needs of hospital-based physician groups. Our focus is to identify and correct inefficiencies that arise in the performance of fundamental billing and reimbursement activities by your third-party billing company. Acting independent of your billing company and on a direct reporting basis to our physician clients, we schedule monthly site visits to your billing company to audit the previous month’s billing & collection activities. We investigate not only suspected problems, but also common operational areas that are often overlooked or not thought to be an issue. We ensure that your business practices are effective and financially strong.
MDMANAGEMENT’s basic services include identifying the list of specialty-focused billable procedures, determining appropriate fees for services, calculating the realistic revenue potential of the physician group, establishing billing policies, analyzing billing systems, and working with physicians to assure that record documentation and billing accurately reflect the services rendered. MDMANAGEMENT audits patient charts with sign-in logs; maintains an audit trail of accountability for services outsourced to third-party billing services; makes sure that all procedures and services are properly coded and transmitted to the billing agent or hospital; sets fees for billable procedures; tracks billing through payment, and interacts with third-party payers if payment problems develop. Periodic audits assure that all established management policies are being followed.
MDMANAGEMENT knows through our experience that payers save billions of dollars annually by systematically under paying, arbitrarily denying, and alleging not to receive physician claims. Our focus is on making sure that your billing company is appealing underpaid claims and fighting for your reimbursement dollars.
MDMANAGEMENT assists hospital-based physician groups to realize significantly greater revenues through improved coding, reimbursement, and management system development. As a result of this process, accurate information about the group practice is generated to assist in the development of management strategies.
