The charge cycle begins with accurate entry of patient demographic information. Submission of a clean claim to the appropriate insurance depends on receipt and entry of valid data from the originating source. All information received is scanned into our billing system allowing easy access and retrieval. Reducing the time spent compiling and filing individual documents allows IBA staff to accurately attach chart and billing information together into each patient's electronic record. Patient and insurer inquiries can be handled quickly and accurately with immediate access to scanned images of relevant documents.
Diagnosis and procedural coding of the patient's surgical, pain management, or diagnostic service is a vital step in the claim submission process. Capturing the patient contact using the "Charge Master" form allows accurate information to be passed from the provider to the payer.
Advanced electronic technology allows cost-efficient electronic claims submission and processing. Using the most up to date payer lists, IBA is able to electronically transfer claims directly to payers, audit transmission and immediately reconcile problem claims. Benefits of electronic claims submission include faster reimbursement from payers, efficient management of claim rejections and errors, HIPAA compliant, and effective for both large and small volume submitters.
All payments are reviewed and posted as necessary on a daily basis. Specific edits are in place to review the contract allowed amount versus actual amount paid. Underpaid claims and payment errors are tagged at this point to initiate the appeals process. Patient payments are evaluated and steps are taken to receive payment in full as quickly as possible. Daily deposits must pass three separate auditing individuals before finalized. A banking relationship with a local financial institution allows electronic deposits into your designated account. Arrangements for money transfer or internet access and transfer keep you in control.
Follow up of reimbursement is completed by our experienced staff and accounts are worked according to guidelines set out by the provider. IBA respects your special instructions and adheres to the guidelines established by your practice. The billing system is configured to automatically push accounts into follow up according to preset guidelines, at which time our staff calls on all accounts regardless of balance. Insurance balance due accounts are corrected and/or resubmitted as necessary. Patient due accounts are pursued for payment arrangements.
In the ongoing effort to collect reimbursement for your services, statements are sent, as well as, collection letters and personal phone calls to patients. Our toll free telephone number is provided on every statement and letter. If payment is not received within a reasonable time frame the account is again pursued with either the carrier or the patient. Employee in-service training is periodically held to insure consistency and compliance to the Fair Debt Collection Act. 75% of our time is dedicated to assuring that payments are received in a timely manner.
All accounts undergo an internal audit on a regular basis. Audits are performed by objective staff members who are familiar with but do not regularly work that account. Providers are notified of problem areas in their account and suggestions for a remedy are made.
Software built in reports and graphs analyze the status, performance and productivity of the staff and practice. Statistics based on any parameter (Practice, Provider, Location, User, Plan, Plan Type, Procedures, Financials, etc.) are available for management to constantly monitor, review and analyze. Reports can be output to the printer or to a file in any one of many industry standard formats (txt, Excel, HTML, Dbase, etc).
Some built in reports include: