Medical Billing Management, INC. 460 Boston St. • Topsfield, MA 01983
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Medical Billing Management
Case Studies
MBM Clients: How We Helped
Medical Health Care Specialties
The Situation
This family medicine group has a busy and bustling practice. And they are blessed with a first-rate administrative staff that is also quite comfortable with eClinicalWorks. But when they called us, they were very frustrated with their billing company. Claims were not getting filed, denied claims were not getting pursued, and the unpaid claims amounted to several hundred thousand dollars. But what troubled them the most was that they could not get a straight answer from their billing service. The practice no longer trusted their billers to give them honest, transparent communications.
What We Did
We took several steps immediately. We took a hard look at their old receivables and gave them an honest (if unpleasant) assessment of how much they could collect and how much they’d never see. Then we worked closely with the front desk staff to make sure that we were all following harmonious procedures in recording and processing their claims. We began uploading comprehensive reports into a HIPPA-compliant encrypted portal that we could share.
The Results
The first results were as much emotional as financial: they immediately felt better that they were being told the truth, even if some of the truths were hard to hear. The reports we provided them helped them make a clear-eyed assessment of the financial status of their practice. Finally, we always answered the phone and gave them straight answers when they called. Then things got better yet, because the cash began coming in: we collected old receivables for an immediate boost in their bank account, and we streamlined the billing procedures to eliminate delays and lost claims. This progress freed them up to hire additional physicians and expand their service to their community. This is now a much happier medical practice.
Tang and Associates Dermatology Practice
The Situation
Dr. Stephen Tang set up his practice 20 years ago to provide expert dermatological services to residents and visitors to Wellesley, MA and the surrounding towns in Middlesex County. Dr. Tang had first asked MBM to utilize the DOS-based PCN electronic medical records system from Sage to manage his practice. When the nearby Newton Wellesley Hospital and its associated Mass. General Brigham & Women’s hospitals chose to utilize the Centricity/AthenaPractice electronic medical records system, Dr. Tang asked MBM to convert his PCN system to Centricity/AthenaPractice. It was important to Tang and Associates to be able to work well within the Mass. General Brigham hospital system by utilizing the same Centricity system as the hospitals.
What We Did
MBM ported all of Tang & Associates’ data into the Centricity system and created a secure electronic connection between the Tang and Associates’ medical offices in Wellesley with the MBM offices in Topsfield, MA. MBM hosted the Centricity system for Dr. Tang’s practice. All patient appointments were captured in the scheduling module of the Centricity system, and all patient encounters were also captured in the system. Patient encounters were therefore able to be billed to all insurance companies through the Centricity billing system, which was an important part of the Centricity electronic medical records system. Since each patient visit was captured in the scheduling module, and the actual patient visits were captured in the Centricity patient records module, all billing could be accomplished within hours of the actual patient visit. Now, the Tang and Associates practice was utilizing the same Centricity system as the Mass General Brigham hospital system for scheduling, patient records, visit notes and billing.
The Results
Just as planned, these sophisticated steps that we took paid off handsomely. Dr. Tang’s practice remained in the dominant hospital system network. And the Tang and Associates financial results were optimized by utilizing one system, Centricity, for scheduling, patient records and billing.
Neurology Center of New England
The Situation
The Neurology Center of New England was swiftly growing in the region surrounding Foxborough, Massachusetts (home of our New England Patriots!). The practice grew quickly from one provider to many providers offering medical treatment, physical therapy and occupational therapy services to hundreds of patients. All patient encounters were recorded in the eClinicalWorks system. The part-time, on-staff biller became overwhelmed by the sheer volume of claims, and that staffer was replaced by a local billing company. However, the billing company did not utilize the eClinicalWorks billing system, but used, instead, an entirely separate billing system. Consequently, the practice would send their eCW files to the billing company, and the billing company’s staff would manually enter the data into the billing company’s system. Results: delays in reimbursements, and some lost patient encounters that were inadvertently not entered into the billing system.
What We Did
The MBM Team immediately instituted billing directly through the practice’s eClinicalWorks system. With this process improvement, the delay in billing shrank from as much as weeks to as little as one day. And absolutely all patient encounters recorded in the eCW medical records system were certain to be billed and then collected from the insurance companies. Prior to this change, paper checks had been received in some cases at the practice, and in other cases at the billing company’s offices. This produced further delays in the practice’s cash flow. The MBM Team also set up electronic payments directly into the practice checking account, which dramatically accelerated cash collection.
The Results
The practice’s cash flow flourished as all claims were promptly converted from patient encounters into electronic billing to the insurance payers via the eCW system. And all possible payments from the insurances were received directly in the practice checking account. The dramatic increase in cash flow allowed the practice to continue to expand. Our MBM Team was proud to assist this very important regional provider of neurological therapies in New England.
Bermuda Medical Specialties Group
The Situation
Bermuda Medical Specialties Group is an independent, fast-growing internal medicine practice in Hamilton, Bermuda. The Founder and Chief Medical Officer Dr. Arlene Basden and her medical team launched their practice 6 years ago to provide immediate appointments and great patient care for the citizens of Bermuda and the tens of thousands of visitors to the beautiful island of Bermuda. The rapid growth of the practice and the two new versions of the eClinicalWorks system combined to overwhelm the on staff billing team. Charges to the 5 major insurances in Bermuda were delayed by weeks, or months in some cases. Cash flow was severely constrained.
What We Did
MBM’s deeply experienced team immediately logged into the Bermuda Medical Specialties Group eClinicalWorks system and diagnosed the problems that were causing the charges to the insurance companies to not go out to the insurers. Some insurance payers required electronic submission of claims, and other insurance payers required the submission of claims on paper. And the remittance advice documents and actual payments from each payer arrived electronically in some cases and on paper in other cases. Once this setup puzzle was solved, all claims were swiftly submitted to the proper payers.
The Results
Cash flow to the practice was restored. The hard-earned reimbursements arrived; the backlog of unfiled claims was cleared. The practice could once again count on timely payments from all insurance companies. The MBM Team was proud to assist this very important multi-specialty practice in Bermuda.