How? By performing retrospective claim audits to ensure accuracy in billing and payment.
Why? To avoid Medicare or other insurance audits and maximize reimbursement.
Where? In your office or remotely.
When? You get results within 3 - 5 days of receipt of information from your office.
Your first sample is free!
Let's get started right Away!
Here is what you need to provide!
- copy of paid claim (HIPAA compliant)
- EOB
- chart notes and/or dictated reports corresponding to paid claim
- rate page from contract for specific payor as on paid claim
- snapshot of what your billing system reflects as billed for the paid claim
Do the charges on your bill or statement seem high?
Here is what you need to provide!
- copy of your statement or bill from your insurance company
- copy of your statement or bill from your doctor and/or servicing provider
- copy of doctor notes and transcribed reports related to your statement or bill
- ask your doctor or servicing provider to provide you with an itemized statement including CPT codes and diagnosis codes billed to your insurance company
Additional patient services
Do you need help filling out your insurance forms?
Do you need help understanding your bill or statement?
Help is just a phone call away!
Call your Gainesville insurance expert at 352-373-3021.
| What Does A Medical Billing Advocate Do? | How Does Prime Services' Billing Advocate Process Work? |
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Medical billing advocates audit claims to make sure the procedure codes and charges are inline with the type of services rendered.
Hospital bills can be very complicated and unless you are a medical professional yourself you will undoubtedly be confused by some of the items and services listed. Private medical billing advocates are experienced industry professionals who know the business and can guide you through the process of making sure you are not being ripped off due to errant or improper charges. |
PROVIDE CLAIM: If you can provide the claim in question, we can provide the expertise on the details of the claim by telling you if it is right or not. We take claims via mail, walk-in,email,file upload,FTP,SSH GET PEACE OF MIND: Remove all doubt by having an expert examine the claim or bill and don't guess at something this important. |
FEEDBACK
One component at a time
Nearly every hospital is interested in improving its revenue cycle, but have yet to grasp the full scope of the pieces involved in the process.
Most organizations are struggling to Identify what pieces are directly or indirectly involved in the revenue cycle process. Very little is known about what affect those pieces have on the overall process. The result is there are a lot of gray areas in the life-cycle of an encounter that could be the cause of inefficiency at a time when every cent matters.
Hospitals are finding that one of their most critical workflows are suffering from a lack of integration and is operating in silos that lend themselves to a culture of legacy practices. The trend to embrace the ideas behind revenue cycle, though, late in coming is taking the industry by storm. I doesn't take much effort to make a business case for healthcare projects that promises greater efficiency.
The obvious question everybody is asking is where is the best place to start looking for inefficiency? Determining the best place to start will depend on what you have in place now and how well is it working. What is Healthcare Revenue Cycle? Simply stated,Revenue Cycle is the monitoring of an encounter from the moment the patient enters the facility at the registration point to payment from the insurance company. How well it is working is directly related to how well the system lends itself to metrics. Prime Services believes the healthcare revenue cycle can best be understood if it is viewed as a collection rather than a whole. Identifying the components of the revenue cycle and dissecting each of those components is the first step in evaluating the state of the system. Knowing what is missing, what is working and what is broken are questions that will have to be answered early in the evaluation process before any serious implementation can begin.
Prime Services offers tried and proven methods for establishing functional hospital revenue cycle frameworks. Since culture and environment are key governing factors that must be
addressed before establishing any revenue cycle parameters, we find solutions by highlighting the strengths and weaknesses of whatever is in place. In other words, we can tweak a broken system
if need be or we can instruct you on how to build a system from the ground up.Knowing the inner-workings of the components that comprise the revenue cycle will set the groundwork for establishing metrics and evaluating performance. Metrics are not relative to the facility. Revenue cycle performance is depends on a core set of standards that can be applied across the board.
Revenue Cycle best practices:
Monitoring your revenue cycle is crucial to revenue retention. This means ensuring that demographic information, insurance information, and charges generated at the department level are entered accurately and timely. Coding for services incurred absolutely must be coded timely, accurately, and to the highest specificity to maximize reimbursement for your facility.
Revenue Cycle components :
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Prime services provides onsite revenue cycle auditing services.
Prime services offers revenue cycle administration services designed to reduce waste, and increase revenue.
