Not All Billing Services are Created Equal
Why do you choose a billing company?
- Limit Hardware /Software support fees.
- Reduce Claims Fees.
- Reduction in office supply costs ( forms, postage, printing)
- Reduced HR Costs - time, taxes and benefits
- Highest level of technology in claims processing
- Highly trained billing staff with continuous back up for office staff
- Reduced oversight time.
- Better Outcomes!
How do you choose a billing company?
- Experience
- References
- Outcomes
- Local Service
- Added Value to your Corporation
Introduction: What Makes MGA Unique?
- MGA Healthcare Claims, Inc. - founded in 2003
- MGA HealthCare Advisors (Sister Company) founded in 2000.
- Multi-Specialty Billing Services – billing for groups of all sizes.
- About our Ownership:
- Sole Ownership
- RN - Certified in Nephrology 1981
- MBA with 22 Years experience in Physician Practice Management.
- Board Certified by American College of Medical Practice Executives (ACMPE).
- Consulting experience includes Facility Start-ups, Practice Mergers, Documentation and Coding Lectures, Audits.
- Past President of MVMGMA, Active member in OMGMA, MGMA and Dayton Chamber of Commerce.
- Director of Operations and Daily Team Management.
- Active oversight of all client accounts.
- Personally analyze each client outcome monthly.
The MGA Approach:
- MGA staff is your local "back office".
- You have an assigned Account Manager who is your direct contact.
- The Account Manager is responsible for all aspects of the billing cycle.
- The Account Managers are specialty trained and receive ongoing education for the assigned specialty.
- The MGA Account Managers are motivated by goals, benchmarks and outcomes – their productivity bonus reflects their success.
- You have local access at all times to your billing team and patient reports.
MGA Guideposts:
- Charges keyed within 24 hours of receipt
- Payments keyed within 48 hours of receipt
- Daily Batch Summary reconciled to bank deposits
- Denials worked / corrected within 3 business days of receipt
- Utilization of Emdeon Office Subscription in verifying Eligibility.
- Claim appeals re-filed within 5 business days or as supporting documentation is received.
- Electronic Claims sent every 24 hours.
- Secondary or Paper Claims sent every day.
- Claims scrubbing and rejections corrected within 24 hours of processing
- Patient Statements sent monthly - or on demand
- Client Approval for all Formal Collections Activity
- Annual updates to CPT / ICD files
- Client Notification of fee variations from contractual agreements
- Ongoing analysis of Fee Schedule to Payment history.
- No direct handling of cash, checks or other forms of payment
- Ongoing monitoring of Denials / reasons with Client feedback monthly
- Utilization of Automated Collections Modules
- Work Aging Reports weekly.
- Initiate Payment Plans with Client Approved Terms
MGA Internal Monitoring:
- Intergy Software * option
- EHR option*
- Eligibility Feature - Emdeon Office
- Negotiated Managed Care Fee Schedules - loaded and monitored for accurate payments.
- A/R Benchmarked against local and national databases.
- Days in A/R - Goal: Insurance >90 days < 15%
- % of Patient Balances >120 days < 15%
- Move Patient Balances over 120 days to Formal Collections.
- Send no more than four (4) patient statements
- Create Coupons for Payment Plans
- Collection ratios monitored and benchmarked monthly.
- Charges / Fee Schedule update recommendations.
Standard Reports:
- Month-to-Date / Year-to-Date ( Corporation Year) Comparison
- Productivity by Finance Center or Payer
- Productivity by Service Code
- Productivity by Provider - Charges, Payments, Units
- Denial Tracking
- Lockbox Log - to reconcile with CPA or Book keeper
- Summary Aging Report
- *Any additional or custom reports as requested.