Denials Management are a thorn in the flesh for most medical practices. But there are some specialties that have an exceptionally high denial rate. Obgyn is, unfortunately, one of them. Denial rates in this specialty are the highest at a whopping 22.42%. Denials are an everyday occurrence for most obgyn centers. But that doesn’t mean you need to live with them. Most denials are “soft” and with some effort be easily overturned. The cost of handling a denied claim is on an average $25. It considerably adds up to the administrative and financial burden of a practice.
Recently BiIlingParadiseworked with an ob-gyn practice that was facing a financial slump. Upon analysis, we found that their previous biller had no experience in billing for antepartum codes and also repeatedly missed adding Modifier QW for screening services. This led to a high number of denials and a steep downturn in revenue for the ob-gyn practice. The appealing process was extremely tough given that most claims were also way beyond the timely filing limit.
Here is the Video of One of our OBGYN Manager Reveals how Billingparadise helped her Practice Increase Revenue by 60% within a few months. This story does have a happy ending.
Here is an interview with one of our clients who recounts how much money her center lost due to inefficient billing processes and how BillingParadise helped her bounce back from the financial setbacks her ob-gyn practice faced.
The medical billing Service Company they previously worked with was not proficient with their EHR. Their reluctance to work with eClinicalWorks was hindering the operational and revenue performance of the center. The previous biller was also not familiar with the nuances of obgyn billing. After working with BillingParadise the ob-gyn center saw phenomenal revenue growth. In a freewheeling chat with us, the client reveals how
BillingParadise quickened her cash flow and why she’d recommend BillingParadise’s services.
In this video, Teresa the office manager of an ob-gyn practice shares her wonderful experience of working with BillingParadise explains about the strategies followed to improve her Bottom line and why she feels BillingParadise is a paradise for billing.
The video includes the concept of
Do you think BillingParadise understands ob-gyn specific billing guidelines?
Oh, very well. They understand the coding and the procedures that the doctors perform at the hospital and office, very familiar with the terminology.
How much has your ob-gyn center’s revenue increased after working with us?
We’ve definitely seen an increase and money coming in sooner than it would have in previous, with our last company that we were using. So money coming in quicker, everything happening fast, everything is smooth. So Billing Paradise has definitely made my job a lot easier to do. And I commend them on the job that they have done, I am very happy.
BillingParadise is paradise for billing, definitely.
How proficient are we in working with the eClinicalWorks EHR?
So there is a big difference because the way we were doing it before was outside of the eClinicalWorks which is our electronic charting system. So now that we are billing in the charting system it’s just so much easier even to get paid. So payment is quicker, more thorough, there is just no – there are no hiccups. And if there was before it would just take more time to figure out where with the way that Billing Paradise works with us and our eClinical system
How would you rate Billing Paradise amongst other billing companies in Northern California?
I would rate them, I mean off the chart they are phenomenal billing company to work with. The company we were using before it’s like night and day, compare the two. I love the advanced technology and any interaction that I’ve had with Billing Paradise has always been positive and outcomes have always been positive.
What do you think about teambillingbridge – The revenue reporting and workflow management app?
I think they are definitely ahead of the curve. I like that they are advanced, they are definitely with the times. The Team Billing Bridge is going to be a nice way to communicate through their app, so we’re just kind of softly getting introduced to this new technology and its phenomenal like I am so excited about it.
How responsive is billing paradise’s team? Can you recount an incident, If possible?
They are very responsive, easy to get in touch with, any questions that I have had I can relate, I have to go to representative William that I work a lot with. And Maria also – our nurse practitioner and our certified midwife here, she works with him as well. Any coding or diagnosis or any – they are just – they are very easy to work with, there has not been that one issue that I can even think of.
Would you recommend Billing Paradise to your peers?
Absolutely, and I already have, I think that Billing Paradise is the way to go as far as, you know – if, especially with paper – paperless charting that we do, it’s just easier to communicate with companies that know what they are doing and that are up with the times. So yes if you want advanced technology with Billing, Billing Paradise is your go to.
In this lively video, Theresa the office manager of an ob-gyn practice in California shares her wonderful experience of working with BillingParadise, explains about the strategies followed to improve her bottom line and why she feels BillingParadise is a paradise for billing.
How to improve your OBGYN Practice’s Revenue by 60% in 3 months – https://bit.ly/2AwGLcR
BillingParadise is a revenue cycle management provider with a huge client base of ob-gyn centers. The ob-gyn specialty has a high denial rate of close to 22%. It is a huge challenge for ob-gyn providers to stay in business in an environment of cost-prohibitive programs, capitated payment plans, and ever-changing payer-provider dynamics. With our deep experience and unwavering commitment to providing the best possible revenue solutions to our clients, we’ve helped to turn around the profit of several ob-gyn practices.
Know How BillingParadise increased 60% revenue for an OB/GYN Center – Case Study – https://bit.ly/2OG1Kx4
For more information, contact:
BillingParadise
2009 N. Lynn
Taylor,
TX 76574,
The United States.
Phone: +1 214-783-6295
BillingParadise has developed a dedicated software for workflow management. A web application that addresses the revenue cycle challenges of single physician practice owner to Hospital CFOs. From tracking denials to Cross-team collaboration to monitor denial workflow and generating reports with just a few clicks.
We have given a simple demo of denial management process optimization and workflow management module here.
This demo will walk you through, how decision makers like you can zero-down on denied claims. Thus increase revenue by improving productivity and cut costs.
Welcome To BillingParadise, In this video, we are going to see “ How Billing paradise Increased 60% revenue for an ob-gyn center.”
An OB-GYN Center Based in California experienced the billing paradise difference.
#1. Challenge
• A large ob-gyn group in California needed to improve its operating margin, streamline processes and lower its cost base.
• The medical billing company they worked with was not proficient with their EHR.
• This led to fragmented billing data and the additional expense of paying for two systems.
#2. Discovery
• A critical first step was to conduct an audit to discover hidden deficiencies.
• The fact that numerous patients were unhappy with the practice and were switching to other providers was also a spot of bother for the ob-gyn practice.
• BillingParadise analyzed the current workflow, billing cycle and payment information of the group practice to identify its performance challenges.
#3. Medical coding audit
• BillingParadise proposed a business intelligence system to correct the below-average coding quality and yield strong lasting results.
• Since we’ve been in the industry for more than a decade and handling many ob-gyn practices’ revenue, we knew that for ob-gyn patients claims should be submitted to after giving birth.
#4. Know your Payers’ Timely filing limits
• At BillingParadise, we always we maintain a chart for timely filing deadlines.
• For Medicare – 365 days from the date of service
• For BlueCross blue shield – 365 days from the date of service
• For Cigna 90 days from the date of service
• For Medic aid 95 days from the date of service
• For united healthcare 90 days from the date of service
• For secure horizons 90 days from the date of service
• For health net 120 days from the date of service
#5. Modernizing the billing cycle
• A concerted effort was made to consolidate and standardize our client’s revenue cycle.
• After making changes across the billing cycle the ob-gyn center was able to see a visible change in top-line revenue growth and workflow efficiency. We could improve the monthly revenue by 50% within a few months.
#6. ERAs and EFT enrollments
• BillingParadise’s OB-GYN billing team completed ERA and EFT enrollment and improved payment TAT.
• It has helped to zero down denials systematically by directing denials to our Denial Manager software.
• In fact, we have not only increased 50% monthly revenue but reduced 3% of their expenditures.
#7. Improving patient experiences
• Our team coordinated with the client to implement a pilot program to strengthen patient relationships.
• As a first step, the patient department of BillingParadise contacted patients and resolved queries and complaints regarding their bills.
• An e-statement pathway was created to send patient statements and real-time views of patient payments were made available to staff to resolve queries. In addition to financial counseling for patients, they were also educated on online payment methods.
#8. Antepartum care billing
• Our deep experience in offering billing support to ob-gyn practices for 15 years we understand that antepartum care is one of the major revenue spinners for ob-gyn practices.
• Patients who’d moved to other states or practices were not issued billing statements for antepartum care by BillingParadise. The patient billing department got in touch with them to recover money for unbilled care.
#9. NST services
• Our deep experience in ob-gyn billing and the intricacies of the specialty helped us to guide the doctors on global billing and to bill claims on Global billing package.
• We also educated them on signing charts for outpatient visits and inpatient services.
#10. AR and Denial Management Solutions
• Standardization of AR workflows and processes through our AR management platform led to reduced AR days and improved revenue capture.
• By implementing our denial management software we were able to discover and resolve critical issues, accelerate the denial recovery process, eradicate controllable write-offs and protect the practice from future denials.
How billing paradise is Unique :
1. We excel at medical coding,
2. Expert in antepartum care billing
3. Using Updated Billing Cycle tools
Our tailored billing approach:
Code Auditing
Revenue Cycle Audits
ERA Enrollment
Patient AR Recovery
Denial Management
E-Payment Pathway For Patients
We’ve been for more than a decade in the medical billing industry. On paper, we know all that it takes to improve the revenue of healthcare organizations. But in reality, every day throws a whole new set of problems and possibilities. Working with ob-gyn centers for several years we’ve learned that the performance challenges vary and usually it is not just poor collections. There are a lot of fault lines that can lead to operational and financial bumps. But no matter the size, location or patient population of the ob-gyn practice, a few reasons for revenue leakage and operational inefficiency remain surprisingly constant.
Here are top 6 factors that stop ob-gyn practices from realizing their full revenue potential.
Inconsistent revenue audits
Coding issues that go unnoticed
Inadequate knowledge of timely filing limits
Improper billing for antepartum care and NST services
Patient billing mistakes
Small things matter
Nancy Lopez, Multi-Certified Revenue Cycle Manager of BillingParadise shares her views and guidance on how healthcare practice administrators and managers can handle value-based care challenges.
She explained how practice administrators must be prepared to help hospitals and
medical practices thrive in the current value-based reimbursement climate while answering a
the question of a practice manager during BillingParadise’ client conference held at Texas.
For More Details, Contact Through
BillingParadise
2009 N. Lynn
Taylor,
TX 76574,
The United States.
The biggest struggle medical practices face today is hiring trained staff to handle MACRA. CMS’s final rule for MACRA alone has 2200+ pages. How do busy practices cope with this onslaught of information? Hiring additional staff to implement MACRA will place a financial strain on medical practices but is it the only way out? This infographic based on a recent study conducted by Physicians Practice sheds light on this ongoing MACRA challenges faced by medical practices.
Even if the defendant fails to admit some of the other sub-parts, you will know when you receive the defendant’s answers exactly what issues will be disputed at trial.
• Consider filing a motion for partial summary judgment regarding the reasonableness of the medical expenses and include the argument that allowing the issue of the reasonableness of charges to go to the jury would invite speculation on collateral sources and cause the jury to substitute its own judgment for the reasonableness of the providers’ charges.
• Be prepared early on to have to lay the foundation for your records, which can be done a few ways. First, a treating doctor or retained medical expert can testify that the charges were reasonable and the care was necessary. Second, a billing and Coding specialist from the facility can testify the charges are reasonable for these services, because the specialist knows what other facilities charge. (You will want to keep in mind my cautionary note above regarding multiple witnesses for numerous providers in catastrophic injury cases). Lastly, depending on the size of your case, you may wish to consider hiring a medical billing specialist with special background, training, experience and knowledge in the areas of medical coding, medical billing and reimbursement, and medical services and administration to offer opinions regarding the fair and reasonable cost/value of the medical bills incurred by the plaintiff for accident-related care and treatment and that the accident-related medical expenses incurred by the plaintiff are usual customary and reasonable charges for their geographical area.
• Know and understand the law regarding what damages an injured party is entitled to submit to the jury and the collateral source rule in the jurisdiction in which you are trying your case. Pennsylvania has adopted the “collateral source” rule, which prohibits the introduction of evidence that an injured party has received compensation on account of the same injury from a source other than the defendant, such as social security disability benefits or other insurance payments, as in Denardo v. Carneval , 297 Pa. Super. 484, 444 A.2d 135, 140 (Pa. Super. 1982), (and cases cited therein) (an injured party is entitled to the damages caused by the tortfeasor’s negligence [or product defect] regardless of compensation the injured party receives from other sources.) Simply stated, the law in Pennsylvania is that insurance proceeds may not be used to set off a subsequent damage award and is therefore inadmissible. In addition, with one limited exception, evidence that an injured party was compensated by a collateral source for all or a portion of the damages caused by a defendant’s wrongful act is generally inadmissible, see, Gallagher v. Pennsylvania Liquor Control Board , 584 Pa. 362, 375, 883 A.2d 550,558 (2005); 88 C.J.S. TRIALSECTION138 (2004), (“The fact that the plaintiff is insured or otherwise indemnified may be shown where it is a material issue in the case, or where it is brought out as an incident to the proof of some other fact properly involved, as, for example, employment.”
Despite long-standing controlling authority, defendants, relying upon, Moorhead v. Crozer Chester Medical Center, 765 A 2d 786 (Pa. 2001), now seek to limit an injured plaintiff’s medical expenses and/or damages to sums “actually paid” and exclude proof of the medical charges that were billed (either written-off or paid by insurance). In Moorhead, the Pennsylvania Supreme Court held that only the amount actually accepted by the defendant-health care provider from the plaintiff’s health plans (the plaintiff had both Medicare and a private insurance) as payment in full for services rendered was recoverable economic loss in a personal injury action. The amount traditionally recoverable was “the reasonable value of medical Billing services.” The court held the collateral source rule was not implicated because payments were not being reduced. The plaintiff could still recover that amount actually paid.
This holding undermines the very intent of the collateral source rule: the wrongdoer should be held fully accountable for his actions or defective product rather than having that accountability reduced because of the plaintiff’s foresight in procuring insurance. Moreover, subrogation and lien rights must be accounted for as any amount recovered by the plaintiff may have to be repaid to lien holders thereby preventing a plaintiff from realizing a recovery. Therefore, the plaintiff should be allowed to put before the jury all evidence of accident-related medical expenses (amount billed). The full amount of medical expenses awarded by the jury should only be reduced (if at all) in a post-verdict proceeding at which time the plaintiff should present evidence of the amount paid by or on behalf of the plaintiff to secure the collateral source benefit (i.e., insurance premiums the plaintiff paid for the health plan coverage) as well subrogation and reimbursement lien claims asserted against any third party recovery.
Anticipating, and being prepared to respond to, these challenges will help streamline the trial and maximize the injured plaintiff’s recovery.
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