Increasing Cash Flow While Streamlining Your Business in Manageable Steps              

           By Kathleen Lloyd

            Tri-City Physician Services

 

The software solutions offered to clients will always reflect on the quality of the provider. Without first-rate product, all are left with empty words and shallow optimism, rather than practical, real solutions that can make a big difference to  clients.

 

Tri-City Physician provides the answer

 

These issues are of particular importance to Tri-City Physician, because every client we work with gets our commitment:

 

ﺭ  Tri-City Physician is an organization built on strong partnerships. Our approach

    frees physicians to concentrate on what they do best – practice high quality

    medicine. 

 

ﺭ  We exist to make money. To do that we must ensure that YOU make money.

 

It is because of this that we have designed our services as we have: developing systems to ensure no charge goes unbilled; no billed charge goes uncollected.

 

As an active practitioner, the world of medical coding and reimbursement is difficult at best to keep current with. If you’ve ever wondered where to get information about specific characteristics of CPT codes, such as whether the procedure is unilateral or bilateral, what the specific global period is, or just how much revenue you may be missing out on by not having your fees set at their current market value, your search has ended. Don’t lose out on the financial reward of your expertise by giving your services away for less than what they are worth or miss hidden revenue because you didn’t know all of the facts regarding a specific CPT code.

 

This is a business model most have never heard of before. We work with client’s problems, expand services as needed, and streamline business management processes.

 

Beware a service that offers guarantees up front !

 

Many billing companies “guarantee a 30% increase in revenues!” before they even look at your financial information. How can they be certain of that? They can’t. If only 20% of your charges are being neglected, they can only improve your revenue up to that 20%. We will examine your current reports and tell you where we can make improvements. If your current service is performing well, we’ll tell you that, too. Once we tell you what we can do, we’ll guarantee our assertions.

 

Beware the service that says they can save you money !

 

Sure, you’ll save money on employee benefits and office space, equipment, software and supplies. You will save on payroll and unemployment taxes, training and absentee expenses. 

 

We will only assert to your cash flow being insulated from personnel-related issues until a further analysis of your current expenses and needs are done.

 

The advantages of outsourcing your reimbursement functions don’t necessarily have anything to do with saving money.  It has to do with likely increasing your revenue, ensuring better compliance, and generally relieving

you and your staff of the headache that is medical reimbursement, so the business of medicine can proceed. Furthermore, we are here every day – you  never have to worry about illness, snow days, vacations or resignations. There will never be a gap

in the reimbursement process.  You will never again have to worry that only one employee knows how to bill and collect your charges.

 

We have more than twenty years experience for all provider types – inpatient, outpatient, ancillary, acute, chronic, in the professional facility and home setting.

We have dealt with all types of government and private payers. It has been our

experience, proven over and over again, that 90% of the claims issues come to provider error, either in the original billing and coding, or in neglecting to follow

up on rejections, receipts and correspondence and inquiries from the payers.

We have seen this in small, sole practitioner physician offices,  and we have seen

it in a branch of the largest for-profit hospital chain in the U.S.

 

We provide practice management or component services to any client.

We are also a reseller of the same software, PMX3, which we use. 

 

About the author

 

Kathleen Lloyd is an Accountant and successful developer of Tri-City Physician Services  providing consulting and billing services to the medical and ancillary community. Services include but are not limited to practice management, revenue recovery, billing, workflow processes review, conversion assistance and credentialing. Kathleen has extensive direct work experience including development and management of two Durable Medical Equipment company Billing Departments prior to forming her business.  She understands full revenue cycle processing, procedures, analysis, reconciliation and reporting.

 

Selected Accomplishments

 

●  Developed Billing Department after MSO services terminated. ● Developed Billing Department for expansion facility.  ● Credentialed expansion facility. ●  Increased average monthly collections from $500,000 to $800,000 per month for existing facility  ●  Managed billing software and clearinghouse implementation  ●  Co-ordinated payor contract negotiations to achieve higher reimbursement and better terms  ●  Liaison between physicians & DME company ensuring patient  qualification  for equipment and timely completion of Certificates of Medical Necessity 

 

Billing  - formatted billing system to comply with payor and HIPAA standards in both an electronic and paper environment.  Supervised charge entry / insurance verification personnel, maintained billing system parameters and data, assigned billing system security levels, maintained charge master including ICD-9 codes, CPT  & HCPCs codes, managed eligibility systems and processes including Medicare Secondary Payor Questionnaire compliance due to heavy ESRD entitlement.

 

Collections – appealed denied and short-paid claims, ensuring payment in line with contracted allowables; followed up claims with no EOB or rejection before timely filing deadline set by state law and/or payor contract, negotiated non-network payor ad-hoc contracts and payment negotiations, patient invoicing and financial advisement with emphasis on ERISA procedures and cost report bad debt procedures, heavy coordination with Social Workers regarding patient financial condition.

 

Assumed additional responsibility for $2,000,000 three year old pharmacy receivable. Within ten months effected collection of 85% deemed uncollectible.

 

Audit & Internal Controls – developed and performed daily and monthly crosscheck and reconciliation practices to ensure no payments, charges or claims were missed.

 

Period Close - developed and performed daily, monthly and year-end close of billing system.

 

Cost Report – provided cost report figures, developed and implemented CMS and OIG compliant bad debt and hardship waiver program in conjunction with facility

Social Worker.

 

Banking – reviewed daily walk-in cash and check deposits, maintained and reconciled paperwork forwarded by lockbox service.

 

Software –  ● Medical Manager ● Medisoft  ● Lytec ● Kareo ● PMX3

 

Professional Associations & Designations

American Health Information Management Association

American Medical Billing Association

Medical Association of Billers

Richmond Health Science & Technology College Board

Crater District Health Advisory Board

Colonial Heights Food Pantry Board

 

Education

University of NH @ Keene – Accounting

Strayer University @ Richmond – Certified Managerial Accountant