No Delay Sending And Processing Claims
ADVOCATE Manages Growth
2013 was a big year for Sunshine Radiology (SUN), as they were expanding to three hospitals. As a result, Roberta chose to partner with ADVOCATE Radiology Billing & Reimbursement specialists, a national billing company that specializes solely in Radiology. “We knew 2013 was going to be an important year for us with the addition of five new hospitals and eight new radiologists to our practice and we needed a billing company that could handle the growth we were anticipating. This is why we partnered with ADVOCATE to handle our outsourced billing.”
In addition to finding a billing company that could handle their growth, SUN also wanted a company with state of the art technology to capture every penny, and offer detailed and customized reporting. Roberta said, “We are a large radiology practice that must have instant and reliable reporting. Being located at so many facilities, we are constantly looking to evaluate items such as staffing, physician productivity, and revenue trends. ADVOCATE has been able to provide detailed and accurate reporting.”
Highlights
- Improved revenue by 4%
- Provided accurate, timely, concise data to run the practice
- Reduced AR over 120% by 65%
- Reduced days in AR by 25%
- Reduced denials by 10%
Implementation
The billing transition and implementation can cause a lot of anxiety for any radiology group because they don’t want a decrease in collections. “We underwent a large expansion this year and we had concerns about establishing a process to receive dictated reports and patient information from the new facilities, and we wondered if credentialing of the physicians would be ready on time. ADVOCATE met our expectations during the implementation, and they had all the data connections set up at the start of billing for each new facility. There was no delay in getting claims sent out and processed”, said Roberta.
The credentialing staff at ADVOCATE had the knowledge and expertise with Florida governmental payers to ensure applications were approved timely. ADVOCATE was able to avoid errors in the credentialing process which could have delayed the effective date with insurance payers, thus putting downward pressure on reimbursement.
ADVOCATE emphasized the importance of quality dictation in the radiology reports and provided immediate personalized feedback on a weekly basis to the radiologists in order to identify and quantify any dictation issues. Communication between ADVOCATE and SUN radiologists further reduced denials and improved charge capture.
ADVOCATE implemented processes that ensured the capture of all charges and receipt of payment from insurance companies. ADVOCATE’s IT experts established connectivity before the implementation to receive reports and patient information from all facilities. In addition, procedure count verification was set up to audit the capture of billing data to ensure no charges were missed. ADVOCATE also verified that there were no underpayments from insurance companies. The managed care payer fee schedules were loaded into the ADVOCATE billing system to confirm insurance payers were paying their contractual obligation.
“We outsourced our billing because we wanted a superior service that we didn’t have to manage ourselves. ADVOCATE delivered and we are pleased we chose to partner with them. We look forward to working with ADVOCATE for many years.”
Specialty
ADVOCATE’s account management team has oversight of the complete billing system for SUN and offers support beyond billing. They help with budgeting for revenue and showing the impact of the Medicare fee schedule changes on each locality. The account manager also provides regular updates on Medicare regulation and how it will impact SUN. Medicare is a significant payer in Florida due to the large retirement population. Beyond budgeting and regulation updates, the account manager is available to assist in items such as physician productivity benchmarking and meeting with hospital personnel.
Immediate Reporting
The ability to instantly run reports from ADVOCATE’s billing software was a requirement
for Roberta. ADVOCATE Information Management System (AIMS) is the end-to-end business intelligence solution that delivers business information value to radiology practices.
Roberta has found AIMS to be beneficial to SUN. “I spend a couple hours on AIMS several days per week to evaluate the productivity and collection trends for each radiologist. Many of our hospitals are located in areas with volume variability, due to the large transient retirement population. AIMS allows us to see these trends promptly, which helps us with scheduling. I can log on anytime of the day and see my month-to-date collections and procedures that have been billed. AIMS makes everything completely transparent.”
There are additional realtime features on AIMS that help manage the workflow of the physician practice. “AIMS has given us a clear picture of the entire billing process. With AIMS, I am able to know immediately if a certain hospital location is delayed in transferring patient information that is required to bill. We can also see if there are physician claims on hold for credentialing, or check for denial trends by facility, insurance company, or physician.” AIMS provides transparency in the complete billing process and reports are updated daily. SUN is able to drill down each report by location and in some instances by insurance payer and physician. The reporting allows SUN to view how many charges have been billed by each location, charges on hold for missing demographics or credentialing, accounts receivable follow-up broken down by denial or delinquent response from insurance companies, live one page accounts receivable balance, denial management, and an analysis on customer service phone calls.
The Future
Now knowing that her billing is under control, Roberta can focus more time on improving her Radiology practice and less time on micromanaging the billing process.