Sequel Systems EPM software offers many reports that can be sent in Excel or PDF formats. In addition, MDS presents each client with a detailed spreadsheet of productivity on a monthly basis. This data includes Gross Collection Percentages, Average Days in Accounts Receivable, MTD and YTD charges, payments and adjustments, 13 month trending data, Monthly payer mix information, amounts turned over to collections, adjusted collection percentages and more.
Electronic Data Interchange (EDI)
If a payer allows submission of claims electronically, this is how you want your claims sent. Claims pay 2-4 weeks faster than paper claims processing. We send electronic claims to every payer that accepts them in this format. We also track EDI acceptance/rejection reports daily to monitor each batch and catch any errors in processing early. This keeps interruptions in cash flow minimal.
Internal Collections Department
We have five FDCPA; Fair Debt Collection Practices Act certified collectors: Our internal collectors have been trained to make certain all laws of patient collections are being followed. This applies to patient balances after insurance or denied claims that are now patient responsibility. They use all resources available to determine the patient’s true ability to pay. They are trained at overcoming objections and obtaining payment resolution as quickly as possible.
Managed Care Contracting
We have an integrated software system that tracks expiration and renewal dates to keep the denials at bay. The staff also pursues new contracts, links new physician groups, applies for provider numbers, NPI numbers, etc. as needed for any new or existing practice that we serve.
ERA Posting & Direct Deposit
EFT or Direct Deposit capability allows the payer to deposit their patient payments directly into the client’s account rather than sending a paper check for posting. Our clients have money in their accounts quicker and the remittance advice is retrieved electronically for posting.
MDS has practice management software that has interface capabilities to most other software programs. We can pull the data from the clients system in many formats including HL7 and integrate it into ours with a paperless trail. This allows for claims to be billed quicker and for our clients to receive faster reimbursement from payers.
MDS is proud to announce that they have both RCC and AAPC certified coders. They are up to date with the most current CPT, ICD-10, and HCPCs codes as well as modifiers, LCD’s, and CCI Edits. They have decades of combined experience in multi specialties and are here to answer any coding questions from our clients. We also have several experienced coders and billers who are equipped with training on the coding guidelines in 5 states that we currently service (Louisiana, Mississippi, Alabama, Oregon, and California). Many have received coding and billing certifications from LSUE in Eunice, LA. We refer to the guidelines of the following entities: RBMA, ACR, AMA, and CMS.
The auto dialer is a process in which a voice response system calls the patient and leaves a message in the evening after business hours. The message sent is a generic HIPPA complaint message that requests that the patient call the billing office regarding a medical matter. With this process we are able to contact more patients in a timely manner and more efficiently so that we can get them on the phone to make a payment in full or set up a payment plan. These messages go out to patients who have not responded to statements and letters informing them of their balance. The auto dialer has proven effective through the results of the call campaigns that are emailed back showing the calls that were successful and unsuccessful.
Denial & Claims Management
MDS is efficient in resolving claims due to the robust “Follow Up” claims management system imbedded in our Sequel PM software. The accounts are separated into plan and patient buckets for proper handling. The accounts can be worked by groups, actions, or reasons and sorted by locations, plans, age, etc. These indicators allow us to sort claims by their status such as; refunds, recodes, attorney resolution, insurance denials, etc. Our staff is trained on allowable reimbursement per plan for multiple regions so that underpayments are addressed in a timely manner. In addition, we work closely with our managed care department for specific payer requirements and guidelines including workers compensation guidelines.
Corporate & HIPAA Compliance
HIPAA is a national standard for privacy. This is in verbal or written communications. The standards must be followed with authorization to speak to a patient or an outside party. This is specific to treatment, payment and operations. MDS takes every precaution to protect your patient’s privacy. We use tools to limit any exposure including secure email, de-identified file formats, and password protected transfer of data. We also have a documented Corporate Compliance Plan that addresses issues such as: Upcoding/Undercoding, Unbundling, Professional Courtesy, Inappropriate Balanced Billing, Voluntary Refunds, Hardship Protocols, Medical Records Storage and Retention, Disaster Recovery etc.