New 2017 PCMH Recognition program

Recently, NCQA released their 2017 PCMH  Recognition program.

Unlike its 2011 and 2014 predecessors, 2017 version will rely more heavily on the EHR/EMR provider is using. It aligns it self with other (current) government incentive programs and reduces the amount of documentation provider needs to submit. It will utilize a new attestation system and not the old version of survey tool.

One major difference between the 2011, 2014 versions and the 2017 is that there will be a provider yealy check in; during which, NCQA representative will contact provider via Skype and go through the topics, review the needed proof. The check-in will last 2 hours, no interruptions and your (team) needs to be there too.

For a free Gap analysis of your prqctice please contact me and mention MEDEVAL code.

I offer EHR/EMR implementation training for either PCMH or other government incentive programs: MU2, MU3, Medicaid/Medicare EHR incentive program.

My training fee is $600* for 4 (3hour each) sessions.

If you would like more informatiom please feel free to contact me

914-338-8074 or email kredicalbilling@gmail.com

* flat fee for training only, does not include the actual PCMH recognition and NCQA (provider) registration.

Important: Check your Provider Information

Whether this is your first year or not, when attesting for any Incentive Programs (PQRS/Medicare EHR/Medicaid EHR), make sure the information for the Provider your are attesting for or the information for the qualified clinic/provider group is correct.

The last thing you need is to find out that CMS or Medicaid has the wrong NPI or Tax ID on file. This will hinder your attestation and will create nothing but delays that would draw a thin line between you receiving that incentive or getting a penalty letter.

If you have any more questions, please feel free to contact me for my consulting services.

Phone:914-338-8074

Email: kr2medicalbilling@gmai.com (fastest way to reach me, I reply within 24 hours after receiving your email)

Medical Billing Collections Companies: patient negative experience, poor customer service

As more and more providers find themselves in the hot water about not collecting the required patient financial responsibility: co-pay, coins, deductible, the more financial burden they are facing and turn to collection agencies.

Collection agencies work on percentage and are “aggressive” when it comes to uncollected money. However, there is a issue of a poor customer service. While most collection agencies and/or Medical Billing service companies promise you to return your lost revenue ie. deductible or OON payment from the patient( they do receive a percentage of that amount), they do it in not very friendly way.

Let me give you an example. When I worked in an Urgent Care-the A/R balance was ridiculously high and yes some of that revenue was actually a legitimate owed amount (some wasn’t), but either way through the course of a year there were 3 Medical Billing Companies/Collection agencies. It was all the same: promise we will get your money. Unfortunately, I worked in the Collections and since the actual A/R amount was small, the agencies just tended to stay on for 2 months and then leave.imagesCAL3COWL

But let’s get back to the customer service part. While my medical collections methods involve in actually researching whether  or not the patient actually owed us Urgent Care, the money, the collections agencies fail that part.  Mind you when I started with the UR I still was looking at 2014 accounts (of which only a small percentage was actually collectible. My UR was OON)

Anyway all three agencies worked on the old accounts, as per request of the owner, hoping for a nice payday (they charged as high as 25% of the collections). Anyway, the issue was that they just would go one by one and search with the account that had an open balance. Then without any research as to why this was the case they would contact the patient in regards to the account. Then of course they would put our company as the contact person, and I would  receive the angry phone calls regarding the letters or phone calls, that were sent to the patient, from so and so collections company. Stating that when the patient contacted the Agency or Medical Billing Company, their agents were not able to help the patient and just tell the patient to pay the outstanding amount, did not even have their current insurance information or all together were just rude, with horrible customer service skills.

Yes, this was double work for me, LOL. I would calm the patient down and do my own research. Sure enough the account would be in a good standing: patient was not liable for the outstanding amount, for various reasons: No OON benefits, no facility benefits, etc., take your pick. I would then calmly explain the patient what was going on, put my note in the patient record so everyone is on the same page.

 

These kind of patient experiences and my own are common. Sometimes the patients become so upset that they start to complain to the provider, making the already somewhat strained relationship between the patient and the provider worse (because of the increase in the patient financial responsibility: co-pay, deductible, coins).

 

To providers: to at least alleviate some of your practice’s collections, there are things that you can do. Like instituting a new patient financial policy, or collecting at least the co-pays the day of the appt. Train your staff to effectively communicate with the patients. Make sure to evaluate all your options before sending your outstanding accounts to the collections agencies. Try to come up with alternative ways to still not put the financial burden on your practice and offer your patients a more flexible way to pay their financial responsibilities. Because if not too careful, you will start to lose your long time in good-standing  patients for good.

Consulting Services and Fees

Consultation Services/Fees:

Compensation: I charge per hour – the total price depends on your practice needs. Please contact me for a quote today!

Some of the Topics that are covered:

  1. Prior authorization for Specialty Medications (multiple payers)
  2. Patient registration process (work flow)
  3. Billing
  4. Scheduling
  5. Common Denials (multiple payers
  6. Medical policies for certain proceedures (multiple payers)
  7. Medical Practice Policy paperwork
  8. Anything else (based on your practice needs)

If you have any other questions please feel free to contact me via email: kr2medicalbilling@gmail.com or by phone : 914-338-8074