CODING AND Billing
- Although each practice provides the primary coding, MPMS staff is readily available to review any difficult cases inclusive within the monthly billing fee. MPMS reviews all coding that is sent, insuring its accuracy based upon the limited patient encounter information we have at the time of review.
- When necessary, we will request documentation to ensure the correct coding.
- To further ensure correct coding and available research materials, MPMS maintains a library of coding material, access to third party web sites and maintains affiliations with various healthcare associations and government websites.
Posting Methodology Goals
- MPMS posts all clean charges/claims within 24 hours of receiving complete information for posting.
- MPMS notifies clients of non-clean charges /claims within 48 hours of them coming to attention.
- All charges are reviewed for accuracy before billing to payers or patients.
- All payments are posted within 24 hours of the complete information being available for posting.
- Insurance claims are submitted daily.
- Statements are sent on a mutually agreed upon schedule.
- MPMS works directly with clients to establish what accounts receivable reports are necessary each month from each clients practice management system. (See section on View Success Stories for a sample of reports we can provide).
- The goal of MPMS staff is to close month end within 3 business days of having all the necessary information from clients.
- Month end reports will be prepared within 15 business days of the end of the month.
- MPMS generates and publishes monthly accounts receivable report graphs including gross/net collections, days to collect charges and accounts that exceed 120 days past due.
- Monthly aging reports are prepared by insurance groupings to show where issues are.
- Collection ratios are analyzed and compared to standards such as MGMA surveys.
- At the end of the month, MPMS can generate graphs of monthly visits, charge and payment per encounter, aged analysis by category and credit balances. Customized reports can be created upon client request, such as charges and payments by location and provider, etc.
- MPMS staff members will become experts on each practices management systems, and can assist with the development of reports needed by management for areas other than accounts receivable.
Review of Encounters
- By request, MPMS annually reviews E&M coding of encounters for providers. Additional reviews during the year are available at a very competitive fee.
- For an additional fee, every documented encounter can be reviewed for coding accuracy and to ensure that all services have been coded out.
- MPMS also has available staff to review encounters for completeness and quality of visit documentation, for an additional fee.
- If necessary for compliance, i.e. a RAC audit, an additional review shall be provided free of charge.
Other Management Analysis
MPMS can provide other management analysis of the providers billing practices and profiles. Depending on the extent of the work that is needed to be done, MPMS will determine if there will need to be a mutually agreed fee for said services. Consulting fees may apply when more extensive management work is requested.