NextServices : Physician Billing, Practice Management and EHR Services


FAQs

Where do checks arrive? There are 2 options: Practice receives it, staff deposits them and sends them over to us along with the EOBs. Practice uses its bank’s lockbox facility (e.g. we use www.republiclockbox.com for one of our clients) where checks are automatically deposited the day they arrive, EOBs and checks are scanned and associated and batched, summary reports and search is provided. This is the preferred, cleaner option. How do we send super-bills and EOBs to you? Again, there are two options: Non-EMR and no-lockbox option: Super-bills have to be scanned/ faxed/ mailed to us. Scanning is the quickest and most secure option. EMR + lockbox option: We will ‘pull’ the super-bills from the EMR on a daily basis. All EOBs are already scanned by the bank and we will ‘pull’ it from the lockbox’s website. The only thing that would need to be scanned are any insurance correspondence that comes by mail (this is important). How often are patient statements sent out? Once a month or as preferred by the practice. Who answers patient billing calls? We do. We also communicate with patients in Spanish whenever required. What is the lag time between date of service and claim submission? 24-48 hours from date of service. How often do you use electronic remittances? We use e-remits 100% of the time whenever insurances allow them. Do your clients get reimbursed for facility component? If our physicians perform the procedure at an ASC, we ensure that we maximize reimbursements for the facility component. Do you do patient collections? We send out three patient statements, update the practice on balances owed during patient visits but do not perform activities of a collection agency. What is your refunds process? Refunds are processed and brought up to date every month after consultation with the practice. If a new physician joins the group, how would you help set him/her up? We take the responsibility of credentialing the physician with insurance carriers and setting up EDI agreements. How do you manage denials from insurance companies? An entire team focused purely on managing denials and AR; denials are addressed on the same day that they are received. We constantly bring to the attention of the practice, the reasons for denials and areas that require attention. AR activity reports are available anytime. Similarly, EDI exclusions are handled everyday. Appeals whenever required are done within 1 month from date of process. Do you help with insurance negotiations? We actively negotiate with insurances for a variety of reasons: a) non-par insurances where a ‘contracted amount’ is not established b) facility fees/ global issues such as continued denial of a particular procedure c) when contracts are up for renewal. If we move to your software system, what happens our patient data? Before the beginning of the operations, the data gets imported into our software system. How will NextServices access records and demographics from the hospital system? Practice will have to setup access privileges with the hospital’s system. Which clearinghouse do you use? We use McKesson - the second largest clearinghouse in the country. How do you ensure that the coding is up to date? Not only do we implement updated codes within the week of change, we also educate the practice about these changes. We have certified coders on staff to do the same. Periodically, we monitor coding practices of the physicians and extend analysis reports of the same. How do you ensure that physicians maximize their reimbursements via coding? Here’s a recent example. When HIP insurance in NY offered an incentive for physicians when they counseled ESRD patients, we made sure that our physicians became eligible for this incentive. Similarly, we implemented Physician Quality Reporting Initiative (PQRI) for our gastroenterology clients to cover four GERD measures and get a 1.5% bonus from Medicare. How do you ensure claims are clean as per Correct Coding Initiative (CCI)? Our software system actively uses a claims scrubber to review claims against LCD/ LMRP guidelines, which cover CCI.		Operations Where do checks arrive? Where do checks arrive? How do we send super-bills and EOBs to you? How do we send super-bills and EOBs to you? How often are patient statements sent out? How often are patient statements sent out? Who answers patient billing calls? Who answers patient billing calls? What is the lag time between date of service and claim submission? What is the lag time between date of service and claim submission? How often do you use electronic remittances? How often do you use electronic remittances? Do your clients get reimbursed for facility component? Do your clients get reimbursed for facility component? Do you do patient collections? Do you do patient collections? Insurances What is your refunds process? What is your refunds process? If a new physician joins the group, how would you help set him/her up? If a new physician joins the group, how would you help set him/her up? How do you manage denials from insurance companies? How do you manage denials from insurance companies? Do you help with insurance negotiations? Do you help with insurance negotiations? Software If we move to your software system, what happens our patient data? If we move to your software system, what happens our patient data? How will NextServices access records and demographics from the hospital system? How will NextServices access records and demographics from the hospital system? Which clearinghouse do you use? Which clearinghouse do you use? Coding How do you ensure that the coding is up to date? How do you ensure that the coding is up to date? How do you ensure that physicians maximize their reimbursements via coding? How do you ensure that physicians maximize their reimbursements via coding? How do you ensure claims are clean as per Correct Coding Initiative (CCI)? How do you ensure claims are clean as per Correct Coding Initiative (CCI)?
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