Iowa Provider Services
Medical Billing Services
We provide complete medical billing solutions for your practice including practice management consulting. Since each provider and/or practice is unique, we customize our Medical Billing Services to meet your individual needs.
We have the ability to remotely access you current database, working in real time with your office staff, and we do offer a practice management system for you practice, if needed …
This also includes all or some of the following services, depending on you individual needs:
- Data entry – we obtain information from the provider and/or practice and enter this information into the practice management system.
- File claims – The vast majority of claims are transmitted electronically, however there are a few that must go on paper. We file all of your claims without adding a clearinghouse and/or postage expense back to you.
- Statements – Statements are mailed out from our office on behalf of your practice or facility. The protocols of statements and collection are done specifically to your specifications. The provider and/or practice will continue to control this function of the billing without having to spend the time to prepare the statements or the business expense of the postage. All statements will have the practice and/or providers name and address on the statement and Outsource Management Groups 1-800 number.
- Payments – Payments from insurance companies and patients will continue to go to your office! As we receive payments and explanations of benefits from your office, we post these into the practice management system. More and more insurance carriers are going to EFT and electronic remits. If your office has not set up those functions, we can take care of those as well for you. This does decrease the paperwork and help main stream the office procedures. Each EOB/ERA will be audited for correct payment and/or benefits.
- Appeals – Incorrect payments and/or denials are appealed or challenged with the insurance companies to ensure the correct reimbursement for your practice.
- Aged accounts receivable – The accounts receivable is always a concern for providers and/or practices. At Outsource Management Group, we work the AR aggressively every 30 days. We have been very successful in recovering monies that most providers thought were a lost cause. The filing time limits that some of the insurance companies have instilled on the providers make working the AR a top priority.
- Reports – Practice management reports are typically issued every month, however, we do customize the reporting to your specifications along with the types of reports that are advantageous to your practice and/or accountant.
Medical Coding Services
At Outsource Management Group, we not only provide medical coding services, we also offer your practice medical coding solutions that include claims analysis, coding audits, and consulting.
Medical coding is a serious business that impacts the financial health of your practice. Without the expertise and focus of medical coding and reimbursement methodologies, providers and practices are putting themselves at high risk for audits and decreased reimbursement …
We Can Show You How To:
- Optimize your revenue without sacrificing your compliance.
- Increase you cash flow by decreasing the delay time frame of getting the claims submitted.
- Reduce administrative burden and provider frustrations
Our medical coding services can be included in our billing services without any additional costs to your practice or we can do your coding while you keep the billing in-house. Regardless of your needs, we are confident that our comprehensive specialty coding staff, which is comprised of AAPC and AHIMA certified coders, will exceed your expectations!
What You Will Receive:
- Expert, certified coders that is specific and dedicated to your needs and practice.
- A process that is tailored to each client’s policies and protocols
- A process to identify documentation issues and how to avoid them
Whether you need to address a backlog, temporary staffing issues, or a long term contract, Outsource Management Group is here to help you!
Provider Credentialing Services
Provider, or physician credentialing is the process of becoming affiliated with insurance companies so that the medical provider can accept third party reimbursement. The importance of being credentialed with insurance companies has become extremely important to the success of a clinical practice.
Patients are faced with higher premiums to the insurance companies in order to have health insurance, which forces them to seek providers that are in-network with their health plan. All of which can be extremely important depending on the geographical location of you practice …
Outsource Management Group provides complete credentialing solutions for all new and relocated providers in any specialty nationwide. We can credential you with the insurance carriers and networks of your choice.
These carriers include:
- Medicare
- Medicaid
- Blue Cross Blue Shield
- Commercial carriers
- HMO carriers
- DMERC carriers
- Workman’s Compensation carriers
- and more.
We will make sure that you have all of the key elements to ensure a successful practice.
Our provider credentialing experts have developed and maintained strong relationships with third party payers to allow for quick resolution. Out persistent tenacity ensures that you application is processed within a reasonable amount of time. We take the paperwork hassle out of your hands!
Most importantly, do not assume that all of these carriers and/or networks are going “back date” your participation. Most DO NOT! Call Outsource Management Group and we will assist you with your planning. We have discount price packaging available.
Medical Claims Audits
Correctly coding and processing medical claims is vital to any provider getting reimbursed for the services rendered to patients. It is equally important to avoiding external audits by Medicare and other third party payers as a result of inappropriate charges and/or overcharges
The only way to verify whether a claim’s coding is appropriate to the services, is to audit the claim by comparing it to the clinical documentation or dictation that was recorded in the chart. A claim audit can reveal whether any variation from average reimbursement is due to inappropriate coding, incorrect submission or processing, as well as failure to followup with denials …
Our claims audit can help you make necessary corrections to your medical claims before payers challenge any inappropriate coding, thus expediting your reimbursement process.
Choosing our team to conduct medical claim audits for your practice assures that your coding and processes are appropriate. It also assures you receive a full and complete reimbursement by all applicable payers.
Our claims auditing team will verify:
- Appropriate procedural codes were applied.
- Appropriate ICD-9 codes were applied.
- Appropriate usage of any modifiers.
- Appropriate linkage of diagnosis to procedure.
- and more based on information supplied by claims.
In addition to auditing claims for errors prior to submission, our claims specialists can provide an audit of your paid claims to verify full reimbursement. Our team will compare your explanation of benefits (EOB’s) against your paid claims to verify that you have been fully reimbursed for your services.
Each provider and/or practice is unique in their particular needs and expectations from a claims audit, and as such we have devised a system that allows us to tailor our extensive team’s knowledge and attention to detail, to fit the needs of any provider, large or small.
Contact us today to see how we can assist you in decreasing denials, and increasing revenue.
On-Site Management Consulting
It’s well known that provider billing and reimbursement is an ever changing environment, providers are constantly looking for assurance that they are being reimbursed the maximum for their services.
Our team is available to any provider or group practice in the United States. During our on-site consultation we will provide you with this assurance through an in-depth analysis of any or all facets of your practice revenue cycle. Our experience has identified a number of key metrics used to determine practice performance and therefore can suggest any areas of improvement.
Our team and revenue cycle solutions are an industry standard for revenue cycle improvement. Through our consulting services you have access to our proven solutions, which optimize performance and deliver a predictable revenue gain, while increasing other areas such as patient, provider and staff satisfaction.
No two healthcare providers or medical practices are the same, therefore we designed our on-site consulting services to be adaptive and ultimately unique to each provider. Some of the areas of expertise that our team specializes in are:
- Appropriateness of HCPCS, CPT and ICD-9 coding
- Bench-marking of third-party payers
- Charge capture – appeals, right-offs, etc.
- Fee schedule analysis – appropriateness
- Review of accounts receivables
- Review of available services
- Review of financial systems
- and more or less based on individual needs.
Online Practice Management Consulting
Our team provides online, distance-based consulting solutions to colleagues, providers, provider staff, insurance professionals, and other healthcare professionals as needed.
Whether you’re having an issue with a claim, a specific code, modifier, denials, compliance, HIPAA, credentialing, etc, we can assist you.
Online services can be utilized by anyone who is not local to our corporate offices, or who does not feel their issues warrant having our experts traveling to perform the consulting. If you have ever answered yes to any of the following questions then we can assist your office quickly, professionally and do it all online …
Has a medical billing claim got you stumped?
Are you having trouble with a claim form?
Are your claims being denied and you can’t figure out why?
Can’t find the correct modifier to use?
Are you having concerns with HIPAA compliance?
Can’t find the correct CPT, ICD9 or HCPCS code?
Would you like the assistance of an expert staff of professionally certified medical billing & coding analysts? Let our staff of billing & coding experts assist your office with the claims that are giving you trouble.
Our staff has the expertise needed to help resolve these issues in a timely fashion, saving your office valuable time and money. Our online “medical billing & coding question” consulting services are provided to medical billing & coding colleagues, provider’s in-house billing staff, and a host of other medical professionals as needed.
In-House Provider and Staff Training
Our team is always available to assist with industry training to any provider or group practice and their staff in the United States. During our on-site training sessions we provide you with the knowledge and techniques needed to successfully maximize your reimbursement.
We will analyze your current procedures to search for any metrics that we can suggest improvement, as well as answer any questions that arise regarding your current revenue cycle systems
Our professional solutions are the industry standard for increased revenue cycle improvement …
Through our in-house training you have direct, on-site access to experts with our proven solutions, which will assist in training your staff to optimize practice performance and deliver a predictable revenue gain, while increasing other areas such as patient, provider and staff satisfaction.
No two healthcare providers or medical practices are the same, therefore we designed our training services to be adaptive and ultimately unique to each provider and their staff needs.
Our team can assist you with:
- Correct Use of Modifiers
- Proper Use of the CMS 1500
- Denied Claims Appeal
- Individual Claims Assistance
- In-house Credentialing
- Interaction of Codes
- Appropriate ICD-9 Coding
- Appropriate HCPCS Coding
- Appropriate CPT Coding
- And more or less based on your individual or staff needs.
Contact us if you feel that your practice can improve with the guidance of revenue cycle specialists.
By utilizing any or all of our practice management services you are taking the first step to increasing your revenue. As your business partner, OMG becomes a seamless part of the daily function and overall financial health of your practice. We take great pride in continually striving to verify that you’re being reimbursed for everything that you deserve. Contact us today if you’re working long, hard hours and tired of needing more revenue. We will become your partner and guide you to a better bottom line!
