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ORI’s MedBizCloud Revenue Cycle Management Workflow Tools

MedBizCloud is ORI’s proprietary suite of RCM tools that enable an efficient roll out, training and integration to get services up to speed. MedBizTools tools are offered as part of a comprehensive package of services when contracting with ORI.

The MedBizCloud suite are built on secure and robust technology platforms that are customized and integrated with every practice to ensure maximum efficiency.

ORI implements MedBizCloud tools on site and provides all training and ongoing support. Each of the tools is web based offering secure access.

Open Practice Solutions is ORI’s chosen Practice Management system platform. Built on an open concept, OpenPM is fully customizable to your practice requirements. ORI provides setup, EDI, interfacing, training and ongoing support at no extra cost to your practice.

ORI’s digital imaging system is an integrated financial management and reporting system for all receipts and correspondence for your practice. Automated workflows for processing of clearinghouse payment data ensures timely and accurate deposits management as well as payment posting workflow. Your financial data is available on-demand every day of the month.

MedBizCloud ticket and case management is built on the Salesforce CRM platform and handles the volumes of details associated with medical billing. Our client portal allows up-to-date management of changes and requests. Internally the system maintains patient customer service and insurance exceptions management. The system is integrated with our account auditing software and daily reporting suite to ensure we maintain our timeliness guarantees.

Secure file transfer, notification and storage is offered through our Citrix based Client Transfer Hub. Scanned documents are easily  transferred to and from the clinic and all file movements can be tied to individual or group notifications and  recorded.

Challenges tracking credit card, cash and check payments?

MedBiz Bill Pay offers an efficient credit card portal for patient customer service payments. ORI will integrate with your website and statements for online patient payments. Credit card processing fees are volume discounted for your practice.

All of the proprietary MedBizCloud revenue cycle management tools are offered at no extra cost to your clinic. Give us a call to learn more.

 

 

 

 

 

Create a Clinic Culture for Outsourcing

When practices are experiencing time-consuming regulatory hurdles, increasing technical operating costs, insurance denials and declining reimbursement what can an administrator do? Administrators need to stay focused on performance of the overall practice and consider shifting the strain on your practice’s revenue cycle management operations to an outsourcing solution.

When you review your options consider outsourcing your business office. A question administrators need to ask is whether their clinic has the culture to outsource the business office. There is always resistance to change in every clinic, whether it is a new doctor or manager or a new EHR or practice management system. Some clinic staff will deal with change effectively and others will resist.

An administrator needs to review staffing issues and address the culture issues before taking on big initiatives. Financial viability depends on administrator leadership and the health of the practice must override the wishes of individual employees or providers. Meeting one-on-one with informal leaders or practice “Champions” to get their buy in is a wise use of time. Cultural resistance to change is a serious detriment to a successful business. Resistant staff must be given an ultimatum or removed when they consistently drag down change initiatives, no matter how valuable they are (or it appears they are).

ORI works with practices to influence a comprehensive culture change towards a business oriented model. This begins with an assessment which provides projections on cost savings and change initiatives that focus on quality front end data entry, increased productivity, and efficient billing workflows. The goal is to increase reimbursement, decrease aging and increase recovery rates with more robust technology and fewer staff. While administrators see the bottom line improving with outsourcing, staff may feel threatened by the change. Administrators can strategically shift billing operations to outsourcing while reduce internal staff and then re-purpose office space and equipment to drive production and quality.

The Medical Group Management Association (MGMA) provides accepted bench marking for staffing ratios. Outsourcing will reduce the support staff and technology  costs significantly. ORI assesses these savings with practices and provides projected savings reports prior to establishing contractual relationship (MGMA Executive Summary Report).

Communicating with patients and health insurance companies is a big area of savings with medical billing outsourcing. Outsource Receivables operates as a first party service so patients and insurance companies experience a seamless transition and a clear separation of responsibilities with the outsourcing company and clinic staff is required for success. For example, if a front desk staff person questions a patients bill or calls for a review of insurance coverage it can create conflict with patients and the clinic. The billing office staff will follow the explanation of benefits and work any denials directly with the insurance company. Once the insurance has paid, the billing office will hold the patient accountable for their balances and establish qualified payment plans when necessary. Ensuring that there is clear and consistent communication and a culture of patient responsibility may be a big change for some clinic staff. ORI assists with the transition by providing front desk staff training on consistent patient policy and trains staff on new technology. Once staff understand that the outsourced billing office is a valuable resource they stop trying to research balance inquiries and rely on their billing partner’s expertise.

With the challenges of bringing about change it can be easy to put decisions off. Some clinics wait until they are far behind and have a huge backlog of aging. ORI recommends that you take the first step and get a free outsourcing assessment of your practice. We will provide a review of processes, technology and financials to give you a clear picture of how much can be saved by outsourcing. Typically, the savings are significant when you consider that your entire billing office will be offsite with the most advanced technology. The savings are even greater when ORI helps clients on-board a new practice management and EMR/EHR system. With advanced systems in place, clinics can automate many of the duties handled by staff, and implement new processes and workflows that drive down costs.

The end result is that you will maximize revenue collected from both patients and payers, increase cash flow by reducing days in A/R, improve patient satisfaction and staff productivity and improve your decision making with access to specialized expertise and reporting.

To get your Practice Assessment and learn more about the benefits of outsourcing with ORI, contact Dan Smits today.

Taking the Plunge: EMR/EHR Upgrades for Mid-Sized Independent Practices

For many mid-sized independent practices the idea of implementing a new Electronic Medical Records (EMR) system that meets the standards of meaningful use for Electronic Health Records (EHR) – and meets the standards of their staff, physicians and patients – can give one an overwhelming feeling. The solution for many practices is to wait on the side and watch as others take the plunge. But that strategy is only effective for so long and with more and more industry changes on the horizon, serious planning and budgeting for a new practice EMR/EHR is no longer optional.Diver

Once a practice accepts that a new EMR/EHR is the right choice there are several important considerations from ORI as a billing service provider. One is cash flow during implementation. In choosing an EMR the system must be easy to transition and utilize with your current charting and workflow. Having staff and providers befuddled for weeks or months can create a cash flow disaster.

Practices need to ask questions about the level of technical service support for setup and testing, as well as interfaces with other systems. EMRs should use the standard HL7 interface with practice management systems as well as other records and billing related software. Avoid “one stop solutions” or proprietary systems that don’t play nice with others. They will limit your options. Some vendors may prioritize selling you their systems over what’s best for your practice. These often have a significant up front cost as well.

In regards to the clinic side, doctors are doctors because they are focused on patient care, not a computer screen. You don’t want to have to become a technology guru to use the EMR. That’s why a system that is user friendly and easy to learn is of the utmost importance. The initial and ongoing training that is offered for a new EMR is a very important consideration. Some positions, such as the front desk, may have a higher turnover rate so easy training and transition is a must. EMRs should include setup and training as part of the initial purchase. Always ask for references and inquire about the quality of the customer support team and service. For most small and mid-sized practices the costs of having on-site training can be unrealistic. As a billing service provider, Outsource Receivables will need to be at the table during training and implementation and can be an advocate for your internal processes and practice overall.

What are some of the benefits? From the perspective of a billing company, EMRs can reduce errors and rejected claims and increase accountability which will add to a clinics bottom line and cash flow. Other positive impacts of a robust EMR include the ability to chart more efficiently with higher quality. If you are reducing paperwork, there is potential for staff reductions and less office time for practitioner charting.

But with all the proven benefits of EMRs the implementation across mid-size independent medical practices is still limited. Those that have taken on the challenge often don’t fully utilize system capability. The argument that physicians don’t have the time or the interest in using an EMR is a big reason why systems have not been adopted in many clinics. However, there are many tasks that an EMR can facilitate to make patient data more accessible and follow-up and processing of appointments faster and easier. A real benefit of adopting a robust EMR is that it contributes to improved care through the quantity and quality of information available. It is difficult to deny that having patient records and results at your fingertips can create an environment for better informed decision making.

Implementing a new EMR is a first step in the right direction to improving practice efficiency, quality and profitability. It can also be a great time to transition to a billing outsource provider. If you are just taking the first steps or if your clinic is nearing the implementation phase, ORI can be of assistance. It is a great opportunity to review how your EMR will impact your medical billing and what your options are going forward.

Independent Practices Provide a Strong Base in Health Care Provision

Outsource Receivables focuses on mid-sized independent practices as it’s core outsourcing business. Independent practices need to stay competitive in today’s changing market with corporate mergers and large clinic systems dominating the market in some geographic areas. It is ORI’s goal to bring a full team of experts to clinics in the area of technology, customer service, reimbursement, and strategic leadership to manage independent practice medical billing. Additionally, we want to provide this expertise in a cost effective, seamless manner with an “in-it-to-win-it” approach for mid-sized practices. ORI can do this all within a competitive pricing structure by bringing together multiple clinics into a single business office. The advantage for practices is the ability to focus on providing medical care and leave the business office to ORI while saving significantly on overhead expenses.

Independent practices must keep up with an ever expanding complexity to stay viable. To this end, ORI is continually focused on keeping clients competitive through process development, workflow improvement and providing supporting technology and expertise. Whether in the areas of technology and training or best practices for a front desk, insurance verification or collections, ORI is continually working towards the highest quality and productivity revenue management cycle possible.

Other organizations support the marketing arm of independent practices. MIPA, or the Midwest Independent Practice Association, is comprised of independent primary care and specialty physicians throughout Minnesota and Wisconsin. MIPA supports patients in choosing the right independent practice for their health care needs. MIPA advocates for independent groups in part because “independence allows doctors the freedom to… refer you to any doctor or hospital, or question any health plan directive for the sole benefit of you, the patient.”

ORI understands the desire to be independent from years of working with administrators that need to be responsive to the requirements of their board and physicians. If you would like to learn more about our approach call Dan Smits, Founder and CEO of Outsource Receivables. ORI can work with you to develop an assessment of your private practice’s billing functions.

 

 

 

 

 

 

Managing Practice Expenses in Healthcare

Outsource Receivables provides revenue cycle management expertise to a variety of surgical, family practice, specialty clinics, therapy offices, and mental health clinics throughout the Upper Midwest. Through our years of experience, ORI knows that managing practice expenses is a key task for administrators. Reducing costs and raising compensation for physicians and employees are drivers for a successful practice. Most clinics will spend half of their revenue on support staff so it is a common place to look for savings. However, you need to optimize processes and technology before deciding to reduce staff or it may cost you more than expected in your revenue cycle management processes.

According to MGMA, primary care focused  physician-owned multi-specialty groups have the following average costs:

  • 31% salary and benefits
  • 29% operations
  • 7% compensation and benefits for non-physician providers
  • 30-35% for physicians/owners

MGMA DataDive™ Cost and Revenue: 2015

  

With so many industry changes on the horizon its time to get a clear picture of the health of your practice. Outsource Receivables’ can provide the second opinion you need. You will receive a customized performance improvement assessment for your clinic and an initial evaluation of existing revenue cycle management operations, current performance benchmarking, and identification of opportunities for financial and overall practice readiness. Our knowledgeable professionals conduct the evaluation with minimal impact to your organization through a three step process that includes: survey assessment, data gathering and analysis, an on-site presentation of the findings.

After completing the assessment ORI provides you with recommendation and a cost comparison for outsourcing your business office and revenue cycle management needs. Outsource Receivables provides revenue cycle management expertise to a variety of surgical, family practice, specialty clinics, therapy offices, and mental health clinics throughout the Upper Midwest. The assessment can give you the tools to make an informed decision on outsourcing.

Medical Billing Strategies for Patient Responsibility

The first quarter is typically the largest ‘self-pay’ quarter of the entire year because most patient deductibles are re-setting.  In reality however, more and more of a medical clinic’s total billing is going under the self-pay column.  Insurance is covering less and deductibles are set higher.  Learning how to efficiently ask for and accept more self-pay in your office is a must for your medical billing strategies.

Outsource Receivables provides online payment tools to efficiently collect and record cash, check and credit card payments. iPayX hosts the technology for an efficient payment and reporting portal called MedBizBillPay.com. The employee facing portal can be setup to manage multiple clinic sites, online website payments, electronic payments from patient statements and payments through your offsite billing office.  The web payment portal is driven by patient statements which provide a clinic code and patient IDs for posting. There is also the option for employer payments for occupational health services. The suite of payment portal tools are managed by ORI, not your clinic, which helps medical offices focus on collecting patient self-pay at the time of the visit.

iPayX is a web-based credit card payment portal that can be accessed by your employees on any networked computer in the office.  The low processing fee and the online nature of this portal make it very easy for your office to implement and use.

Some of the benefits for your office include:

  • Eliminate the costs and hassle associated with a dedicated point-of-sale service
  • Improved collection rate by providing patients with flexible payment options
  • Increased efficiency of your staff to search for payments made by a patient and generate copies of receipts
  • The ability to e-mail patient receipts instead of printing
  • Offering patients the option to pay online
  • Payments are pulled the next day and posted to accounts so outgoing statements are kept current

iPayX is also used for collecting and processing payments that are mailed in, called in and also payments that are made online, including insurance virtual credit cards.

Having as many medical billing strategies for your patient payments on the front desk and in the billing office after services have been rendered are key to keeping your accounts receivables in good health and your patients happy! Outsource Receivables Inc. (ORI) works with a variety of independent mid-size medical practices across the Midwest in Minnesota, Iowa, and Wisconsin to implement best practices that save time and boost cash flow. Give us a call or fill out the contact form to find out about the options available for your practice.

What Happened to My Cash Flow? Medical Billing Strategies for Mid-size Independent Practices

When setting cash flow and medical billing strategies for your practice based on monthly receipts, it’s critical to review the number of days you have in a given month and where you have the opportunity to earn cash.  Some months simply have more days of earning potential than others.

A good way to explain this is to look at the first months of 2017, February and March. In February, your practice had the opportunity to make money on 20 days.  In March, your practice has the opportunity to make money on 23 business days.  If your practice is averaging $100,000 in receipts each day there will be a potential swing of around $300,000 from February receipts to March. You also have to take into consideration any holidays.  In addition, you need to factor in payor cycles. For example many government payers remit on specific days of the month. If you miss the charge submission deadline or the check day falls in the next month this can create a large variance in receipts from one month to the next. This can make monthly budgeting potentially challenging.

Business days 2017To base goals and cash flow on a flat amount each month is not sound planning.  In order to maintain a better handle on your practice’s month-to-month cash flow, we suggest instead setting goals based on per day and historic seasonal averages, then the number of days in a month. Incorporate provider vacation time and clinic downtime. Combining these factors will give a clearer picture of what you can expect for cash flow.  This process will allow you set and achieve more accurate results and set realistic monthly goals and expectations.

Outsource Receivables Inc. (ORI) provides monthly projections and helps independent medical practices everyday throughout the Midwest with strategies and services to effectively run their business office and manage their budget expectations for accounts receivables.

Checking eligibility is key to success: write off less, get paid more

Getting paid for your services is not always an easy process for medical professionals.  When a patient either knowingly or unknowingly presents incorrect insurance information at the time of their visit, your collections process becomes significantly more difficult. Having a team to supply your professional medical billing management can make all the difference.

In the following example, the patient presented an outdated insurance card at the time of service.  If they had used the correct card, the services would have been covered through insurance and both billing and collection on this account would have been a smooth process.  An incorrect address and phone number further complicated the issue making this claim very difficult to manage through the clinic billing office.

Our client in this case has a small staff at the clinic. Without ORI’s help, this account would have likely been written off and the revenue lost. Rejected insurance claims are common place in a medical billing office.  However, the claim noted in this study was being rejected initially on the basis that the coding for the service was incorrect.  This was confusing because it was clear this service was covered under the patient’s medical plan.  Through online eligibility, ORI was able to uncover that the patient had presented an old insurance card at the initial time of service.  The process had become further complicated by a move the patient made making their address and phone number incorrect. The incorrect address would have been caught either during the statement submission process which flags invalid addresses, or during ORI’s skip tracing process run on all return mail.

The outcome was the medical office was in full for both the insurance and patient self-pay portions of this claim.

The primary issue with timely payment in this instance was the outdated insurance card.  Spending the extra time upfront to check the card and run on-demand eligibility is well worth the effort in the end. In addition, if the clinic had requested the new insurance information at the time of scheduling, the daily scheduling eligibility report would have flagged the patients visit. The patient can then be contacted and asked to bring in their updated information or cash, check or credit card!

Outsource Receivables can help your office implement a process of upfront insurance verification.  These tools and tracking allow your office to look up insurance coverage, in real time to ensure the procedure in question is covered by a patient’s insurance.Outsource Receivables Inc. provides professional medical billing, process management and expertise to surgical, family practice, specialty clinics, therapy offices, and mental health clinics throughout the Upper Midwest. Contact us for more information and a free revenue cycle management assessment.

EMV Chip Cards and Payment Processing Options for Clinics

If your bank didn’t send you one already, your next credit card will be a chip based or ‘EMV’ card, different from your strip/swipe card. As part of ongoing credit card fraud and security issues, banks and credit-card issuers are moving to microchip-based cards. The change was mandated for last October but credit card processors are still implementing the updates.Credit Card / Gold & Platinum

EMV cards, or “Europay, MasterCard and Visa” was supposed to be issued and in use by the end of 2015. Canada and Europe have been using the new chip cards for years. For the U.S., the move to chip cards is not a federal requirement, however, clinics will want to be able to accept payments in as many forms as possible. There are other incentives, such as the changes in liability from credit-card issuers to the businesses that accept payment. For those businesses that choose not to upgrade they may be held liable for fraud by the card issuer and not protected from a charge back.

The scanners themselves look similar to the ones in place today but do have a higher price tag. The bigger challenge is ensuring your software is upgraded to handle the new technology.

Outsource Receivables has partnered with iPayX to deliver a cost effective and customized solution tailored for mid-size independent practices. The tool offers on-line patient payments, detailed customer service payment entry options, and automated daily reporting and posting among other features. And of course, the system supports the EMV readers and software upgrades. ORI began deploying the system and upgrades since 2015. If you would like more information on outsourcing technology and services to transition your clinic give us a call.