Work With a Trusted Medical Billing Vendor So You Can Focus on Your Patients

This post was originally published on March 2, 2017 and updated on September 6, 2019.

Why should you consider a comprehensive medical billing approach?

Comprehensive medical billing includes managing claims, payments and revenue generation, from first patient contact to paid account balances and everything in between.

Handling your clinic’s revenue cycle starts before the patient visit and ends when there is a zero balance that is owed to you, encompassing the many processes that impact your revenue. Even though patient care is your top priority, there is no denying the importance of maintaining a healthy bottom line.

As simple as this sounds on paper, you know from experience the complications and added stress the collections process can have on your time and resources. Medical billing and collections can tie up computers and phone lines, slow down office operations, and create additional and often frustrating work for your staff. Unfortunately, spending an inordinate amount of time managing your revenue cycle also translates to spending less time, energy and focus on patient care.

Also, when you’re managing billing and collections in house, it’s not uncommon for mistakes to occur. Common errors include incorrect information being obtained when appointments are scheduled, failing to verify payment methods or not updating insurance information with each new appointment made. Many errors are the result of data entry mistakes.

Whatever the cause, there are really only two workable solutions. The first involves investing more time, energy and resources into training current employees; the second is investing in professional support.

Even if you enlist help from a medical billing service, most vendors merely provide a basic set of administrative services to process claims—not enough to address the entire cycle. That’s why our three-pronged approach of people, processes and technology can help you achieve better results than you would be able to with administrative services alone.

By combining our Business Operations Services and Practice Management software, our modmed® BOOST solution provides comprehensive medical billing management and gives you visibility and control of the process.

Which medical billing performance metrics are most important to track?

Many practices miss the mark on financial performance because they aren’t analyzing the most important metrics that impact revenue. To properly evaluate your medical billing performance and increase efficiency, consider the following metrics:

• Total Clinical Collections — How much do you generate in total clinical collections?
• Net Collection Ratio — What percentage of money do you collect against the amount you are owed?
• Adjustments/Write-Offs — What are your current insurance adjustments? Are all of your write-offs justified?
• Days Sales Outstanding — How long from the date of service is it taking you to collect money?
• Aged A/R Analysis — What are your current A/R balances? What percent is collected within 60 days?

Also, you should consider taking a closer look at your:

• Rejection and denial rates
• Days to process a payment
• Days to process a claim
• Total accounts receivable balance
• Provider charges
• Patient encounters
• Payment details
• Unpaid claims
• Patient balance reports
• Payer performance reports
• Aging by payer class

Once you have analyzed these metrics, additional time and energy must be spent in leveraging findings to rethink and refine key processes. This is when experienced, professional support can really help streamline your medical billing and collections process.

Monitoring your overall financial performance requires precise data analysis and reconciling month-end reports with collection performance. Many front office employees do not possess or have not yet been trained with the skills needed. An understanding of available reports is valuable in revealing any alarming trends or potential problems.

However, analyzing reports requires the right type of experience, and most practices do not understand how to utilize the data properly. This is why enlisting the help of medical billing and collections services makes sense for any practice that is looking to improve its revenue cycle and bring the focus back to patient care.

When you sign up for modmed BOOST, we focus on analyzing all of the medical billing key performance indicators discussed above to help optimize your revenue cycle.

Your client manager will send you financial health reports with various key practice metrics. They’ll also have regular online meetings with you to discuss the contents of these reports, answer financial questions, identify trends, go over metrics and analyze overall practice health. In addition, you can also track most of these revenue cycle KPIs in real time using our Practice Management system.

What are some of the benefits your clinic can see if you opt for a third-party comprehensive billing service?

There are quite a few, including:

• Eliminate large delayed accounts receivable
• Lower claim denials
• Improve revenue cycle
• Grow your business
• Boost collections; get paid what you deserve

Utilizing a comprehensive medical billing and business operations service can make it easier for you to manage your practice. But, is medical billing support readily available? Does it have proven results?

In a word, yes. Skilled, specific support is just one part of the comprehensive services we offer. Client managers will personally work with you to identify inefficiencies in your current billing processes, set up an efficient process that works for your practice, and work with you every step of the way to keep it up to date. The service is one that is specific to your practice’s needs.

When I spoke with Marie Miller, she shared her experience that since they’ve been using modmed BOOST, their patient collections have been the best they’ve ever been and their accounts receivables have decreased significantly. Net collections for the practice saw an increase of 20 percent in less than three months.

The truth is, if left unattended, your unpaid patient debts will keep piling up. Even if it is not something you are worried about today, uncollected debts inevitably become an unavoidable problem. When you are worried about unpaid debts, it shifts a great deal of energy away from your practice and patients and replaces it with stress and anxiety. Why not eliminate this potential problem before it even becomes an issue?

How is your modmed BOOST solution different from other medical billing services?

Rather than just providing basic medical claims processing, our modmed BOOST solution combines people, processes and technology to address your revenue cycle from beginning to end. Our approach includes:

• Patient call handling – As part of our collection process, we provide automated outbound collection calls. We also have customer service representatives who handle inbound patient calls to answer questions and help patients understand why they have a balance. To help address your required hours of operation, we have multiple operational centers with flexible employee shifts.
• Industry-leading technology – Our modmed BOOST solution includes our #1-ranked EHR, EMA, and integrated Practice Management (PM) system. With automated suggestions for medical billing codes as well as claim scrubbing tools, these medical billing software solutions help you capture the right data for billing right from the start—not to mention providing you with a seamless all-in-one solution and easy-to-use interface.
• Appointment reminders and insurance verification – Help reduce no-shows and address insurance eligibility issues before the visit. As part of our medical billing service, we can verify eligibility and send appointment reminders for you. You have the option to do these tasks yourself in our PM system, but by letting us handle them instead, you can free up your staff to focus on what matters most—your patients.

I’m afraid I’ll lose control of my finances if I outsource medical billing services. What does your team do to keep my practice in control?

When done right, working with a comprehensive medical billing and business operations service can actually give you greater control of your billing through improved transparency and personal relationships with specialists. Our modmed BOOST team acts as an extension of your business office, helping manage the day-to-day operations of the revenue cycle. This, in turn, can give you the opportunity to focus on the metrics, not the management.

To make sure you know what’s going on during the billing cycle, we document our activities associated with each medical claim and provide monthly performance reports. This can give you a level of financial and operational visibility that you may not be able to achieve on your own.

What is the importance of a practice management system?

A practice management system can streamline scheduling, billing, financial reporting and document management. In addition to providing tools for managing claims, payments and patient recalls, it can help improve office flow from pre-visit to post-visit and provide visibility into where each patient is within the practice. This can improve overall practice operations while helping reduce check-in and checkout times for patients.

As part of modmed BOOST, our PM system even allows you to create custom claim scrubbing rules by payer, provider, location, CPT code, ICD-10 code and modifier. This allows for claims to be fixed even before submission to the clearinghouse, helping reduce rejections and denials and shorten the revenue cycle process.

Can I use your medical billing service without your practice management system?

To help provide a topnotch experience, we require that our modmed BOOST clients use Modernizing Medicine’s Practice Management (PM) system, which works together with our EHR, EMA, to give you a seamless all-in-one solution. With PM’s easy-to-use Cloud-based interface, powerful financial dashboards, automated Appointment Finder tool and more, you can be better equipped to bring the front and back offices together.

What do clients have to say about your billing and collections services?

“The modmed BOOST solution has exceeded my expectations and has been seamless from the start. The average turnaround time for my payments is 13.5 days, and our denial rate is only 2 percent, which is impressive and a huge weight off my shoulders. It’s really rewarding to be able to watch our cash flow grow.” – Kelly Tepedino, MD

“Since we’ve used modmed BOOST, our patient collections have been the best they’ve ever been, and our outstanding accounts receivable have decreased significantly. Modernizing Medicine manages the entire dermatology billing process, from the time the patient comes in until the time we are paid.” – Marie Miller, Office Manager

“Our dedicated ophthalmology Client Manager is tremendously helpful, and we have full visibility into our financial data, so there are no surprises. The Modernizing Medicine team’s responsiveness and the ease of the process confirm that we made the right decision.” – Maria Ruttig, Practice Administrator

About Veronica A. Diaz, MD

MEDICAL DIRECTOR OF ORTHOPEDICS AT MODMED