Medical Billing and Coding from Integra is different.
During our Billing Audits we almost always find that in-house billing clerks are “key it as you see it” coders. In other words, they simply record whatever code or procedure is offered.
We’re not like that.
All physician’s notes are read and considered against the medical code being submitted. The patient information is double checked and our entire Zero Denials approach is implemented.
If your practice is like others we’ve helped, your billing clerk(s) and coders might have more than 1 job. They may double as receptionist, office assistant, etc. Which makes sense in a busy office when you’re just trying to get your daily work accomplished.
But that’s not conducive to careful, methodical billing practices. Getting ½ way through even the most basic data entry tasks and having to answer the phone? That’s a recipe for Denials from the Payer.
At Integra Medical Billing and Practice Management we have a professional, in-house team of CPC Certified coders. That’s all they do! Every day, all day – code and bill. And that kind of focus is rewarded with accuracy.
These things all add up to higher collection rates. And outsourcing your medical coding and billing with us adds up to lower management costs for you as well.
That’s what we call the sum total of what we do on the Medical Coding and Billing side of Integra.
Via remote access, Integra’s billing team will perform the following billing duties daily:
Verify insurance eligibility and patient demographics.
Flag patient accounts alerting the front office to collect the co-pay, deductible, co-insurance or any outstanding balance. This will increase collections at the front office. All amounts to be collected will be noted on each account by the insurance Verifier.
Set up payment plans with patients when applicable.
Notify patients of their financial responsibility prior to appointment, (deductible, co-insurance, past due balance, etc.)
Telephone support for patients with billing issues/questions.
CPC coder will review CPT, ICD9, and modifiers prior to submitting claims to clearinghouse
Claims are submitted within a 48 hour time frame.
Review validation report from clearing house for errors/denials.
Correct claim(s) immediately and resubmit same day.
Post all insurance payments which includes electronic and paper payments, (primary and secondary insurance).
Compare insurance payments against fee schedule for all payers to ensure correct payment.
All denials will be researched and corrected upon notification of the payer.
The A/R staff member will correct/appeal the claim, send notes when applicable and resubmit within one week from date of denial.
The A/R staff member will work the 60-120+ days A/R on a daily basis, correct claims, appeals, send notes, etc. to avoid writing off balances due to timely filing, etc.
After the patient has received two statements and payment is not received within 60 days of the statements, two Pre-collections letters are sent to the patient. If there is no communication or payment from the patent, the patient is sent to a collection agency/attorney upon Drs. approval.
Patient statements are sent on a monthly basis, ideally, Integra's phone number and address will appear on the statement, therefore, all calls and payments will go directly to Integra.
Meet with staff on a regular or as needed basis.
Monthly financial meeting with either the Doctor or Administrator, or more often if needed or requested.
Another thing we find is that the busiest physicians often don’t have time to manage their offices effectively. And certainly, not enough time to chase Accounts Receivables and Aging AR.
But that IS part of the 3 Numbers Every Doctor Should Know. You can learn more about those there.
And because we want you to know how we’re doing for you. To know what your ongoing collections look like and what your income will look like in the coming months. We are almost aggressively transparent.
Transparency to Integra means you get Weekly Reports that look like this:
| Week Ending | Charges | Payments | A/R current | A/R 30 | A/R 60 | A/R 90 | A/R 120+ |
|---|---|---|---|---|---|---|---|
12/26/2020 | $64,789.50 | $73,443.57 | $302,873.17 | $43,742.22 | $21,074.94 | $8,077.08 | $13,109.03 |
AAID PAYMENTS $986.57 / OUTSTANDING BALANCE $6557.01 | |||||||
12/31/2021 | $40,719.00 | $79,880.56 | $223,854.67 | $51,651.66 | $16,493.90 | $13,023.03 | $12,170.01 |
1/8/2021 | $133,335.00 | $81,863.14 | $243,254.73 | $50,131.13 | $18,765.76 | $12,307.95 | $14,487.63 |
AAID PAYMENTS $1249.69 / OUTSTANDING BALANCE $4439.32 | |||||||
1/15/2021 | $152,124.50 | $73,888.98 | $294,644.37 | $38,788.60 | $16,974.17 | $14,709.91 | $14,189.69 |
AAID PAYMENTS $1610.03 / OUTSTANDING BALANCE $1713.20 | |||||||
1/22/2021 | $78,517.92 | $48,276.36 | $289,845.59 | $41,212.35 | $19,028.89 | $13,793.54 | $14,213.74 |
As well as monthly financial meetings to review the numbers. Weekly in the beginning. Along with regular meetings with staff on request.
