Medical billing consulting that helps practices stay profitable.
Our medical billing consulting services examine clinic operations and conduct root cause analysis to resolve issues. Examples include looking at complexities related to insurance billing, payor mix analysis, CPT code review and more.
But here’s what makes our medical billing consulting different…
We share the data you need and explain why it’s valuable. We find patterns and trends that you should act on.
Example: Medicare claims
First Coast Billing Group looks at your different providers that send out Medicare claims. Out of 20, 18 providers might look good, they’re collecting on 92% of procedures. But you have two providers collecting at 60%. You might know this is a problem but you don’t know the true impact to your practice. Maybe the providers collecting only 60% aren’t credentialed or certified. This represents $125,000 worth of lost revenue.
When we do analysis like this across all claims, the impact on revenue and operations is significant.
Full or Partial Medical Billing Consulting Options
Whether you have an in-house medical billing team or you are looking for help with a specific billing area of your practice, we are here to help. Beyond the basic EKG billing and AR wind down services, we offer comprehensive consulting services including:
- Full charge reconciliation
- Credentialing and Contracting
- Coding and Chart Auditing
- Collections and Billing Process Improvement
- Internal Controls Assessment and Improvement
- Fee Schedule Analysis
- Benchmarking
Actionable, usable data
You need a report that shows you what needs to be done and a progress report on how well your billing company worked on those reports. This is where we come in.
We’re not talking about your run of the mill progress reports where “Blue Cross Blue Shield represents 20% of your total charges and generates 35% of your total revenue.” If our team suspects that BCBS should represent more revenue, we pull a random sample month of service for payments and give you very specific information including:
- Total of procedures performed
- % of procedures that were BCBS
- Total BCBS charges in $
- % revenue in BCBS charges
- Total charges we believe were underpaid
- Total procedures underpaid
- Total procedures with no response
- Total procedures that required additional information
- Total procedures that were underpaid for other reasons
- Annual $ impact to your practice
- Suggestions for improvement (ie) front end process, system enhancements, etc.
- Proof of procedures to bring back to BCBS
We’re known for solving old AR but we also help you navigate medical billing vendor selection. Ask about our relationships with national billing companies. Or if you’re not ready for a consult but want an assist with due diligence, download this sample RFP.
