“We are in a rural community and local coders are hard to find and retain. Turnover and leaves of absence require overtime. We usually get behind when these occur and morale is impacted. When new services are introduced, we are challenged to find coders qualified to code the new services. Billing gets behind, cash flow suffers and physicians are irritated by late query requests. Overtime is not approved here so performance suffers”, complained Edel Johnson.

Edel is the coding integrity head of a ob gyn medical group based in South Florida. She approached BillingParadise for medical coding support early last year. An coding audit conducted by BillingParadise revealed that the coding accuracy of coders ranged from 70-91%.

Though the DNFB standard of the medical group was no more than 3 days due to technical issues, turnovers and absences it was usually in the 7 day range. BillingParadise proposed a business intelligence system to correct the below-average coding quality and yield strong lasting results. An initial run of the system brought to the surface that numerous claims were denied because they missed a critical modifier. Modifier QW that is used for denoting screening services, was missing on most claims. The modifier was added to the claims and resubmitted. The billing company of the client routinely assigned the wrong codes for bundled payments. Bundles based on sequential procedures were inappropriately unbundled and coded as separate procedures. Fragmenting a single service and separately billing for each component is not only erroneous but also fraudulent.

After making course corrections the ob gyn group was able to see:

• 40% reduction in coding cycle times
• Coding errors were reduced by 97%
• Coding accuracy rate improved by 99%

RCM Transitioning from the tried and tested fee for services model to the riskier (though more rewarding) value based payment environment can be tough on group practices. Bundled payments provide a middle path that makes the journey less stressful. The risk and rewards are arguably, the highest for anesthesiology practices. But bundled payments add more complexity to the billing and collections process and this is one reason why healthcare organizations are wary to adopt this model. You need a trusted partner to make the leap. And we are one for several anesthesiology group practices based in California, Texas and New Jersey.

A powerful tool to help you thrive in a bundled payment arrangement

The Physician Productivity Metrics Tracker tool will enable anesthesiology group practices to view the individual productivity scorecard, work RVUs, productivity metrics, charges, collections, productivity ratio and more, of physicians. Track and analyse a detailed scorecard of individual physicians in under 2 clicks. We put the power of accurate data in your hands so taking decisions and apportioning payments is no longer an irksome task.

The backbone of all healthcare data is claims data. Tracking key revenue cycle performance metrics is essential to make process improvements and identify revenue leaks. A recent survey reveals that the top challenge faced by healthcare CFOS is tracking RCM metrics. Here’s finally a tool that gets it right.

theBillingBridge is a free revenue cycle reporting tool that will enable your anesthesiology group practice to track revenue cycle metrics, view detailed collection reports, understand your claims cycle better and offer you full visibility of your RCM processes. It is built to work in the Smartphone environment and is available on both Android and iOS platforms.

It is integrated with several major PMS, EMRs and EHRs like Kareo. Data that is captured in your PMS is instantly available on theBillingBridge because it is seamlessly integrated with the system you use.

With theBillingBridge you can:

• View your claims journey in realtime
• Track insurer and patient payment reports separately
• Schedule appointments quickly
• Know the productivity scorecard of providers
• Categorize and manage denials
• Know your top paying CPTs and insurance companies
• Communicate with your billing team within theBillingBridge

And a host of other secure, HIPAA compliant, customizable features! Sounds good? Please ask for a free demo of theBillingBridge to know why you should download it.