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    The heart of revenue cycle management is an effective and compliant billing and collection process, which is essential to your nephrology practice being paid every dollar appropriately due. Billing claims in an accurate and timely manner provides the cash flow your practice needs meet its financial goals. An efficient medical billing process and committed collection team can make the difference between a practice that is just getting by and one where the physician partners/owners receive a fair return on their investment in the nephrology practice.

    We do this via the following offerings:

    • NPI registration
    • Medicare and Medicaid enrollment and reassignment
    • Health plan initial credentialing
    • Hospital privilege initial appointment application completion
    • Dialysis center application for privileges
    • IPA credentialing application completion

    Highlights of our billing & collections services include the following:

    • Claims Billing
      Each claim processed is pre-scrubbed to verify a comprehensive set of criteria has been met prior to claims submission. If any criteria are not met, the claim will be returned for correction. We can also manually create provider-specific rules to hold claims when required information is not present to ensure clean submissions every time.
    • Denial Management
      We analyze denials to identify trends and create processes in place to eliminate further issue. Our continued diligence of this process helps ensure first submission clean claims. Additionally, we handle appeal submissions.

    MGMA found the average denied claim to cost a practice $25 in administrative time to rework the claim for submission? They also found that 50-60% was never reworked.

    How much of your hard earned money are you willing to leave behind?

    • Accounts Receivable Management
      As part of our services for your practice, we will collect the money due to you. Our professional team helps you to improve your revenue realization rate (RRR)—the percentage of dollars collected compared to net charges. A higher RRR equals better cash flow for your practice.

      We also offer assistance with the following:

      • Bad debt and write-offs
      • Patient balances
      • Unapplied credits

    The average number of DAR
    is 45. NPS averages 22.

    Less time = faster payments

    • Self-Pay Management
      Our team works directly with self-pay patients to follow-up on outstanding patient balances and billing questions. We will work with your practice to establish collection and bad-debt write-off policies with the intent to improve your AR balance and reduce write-offs and uncollectible balances.
    • Reporting Key Metrics & Dashboards
      It is important to stay abreast of your nephrology practice’s performance. Each month you will receive a dashboard report showing the key metrics for your practice, how your practice compares to industry standards and information on our performance as your service provider. We believe you should get what you pay for, so we hold ourselves accountable. This snapshot allows us to quickly assess how the medical billing and collection process is working, identify opportunities for improvement and develop action plans to revamp processes and collections. The key metrics we report each month are:

      • Payment Receipts to Target — Based on the volume and mix of current and prior month charges, a collection target is calculated and compared to actuals for your practice each month. This metric provides an early warning of any problems in the billing and collection process.
      • Revenue Realization Rate — This metric is calculated by comparing actual collections to the contractual amount due in a six-month period.
      • Days in Accounts Receivable — This metric measures the average number of days it takes your practice to receive payments for a claim.
      • Accounts Receivable Greater than 90 Days — This metric shows the percentage of accounts receivable that have aged more than 90 days.
      • Bad Debt Write-Off — Measures the percentage amount of claims written off during the month.
      • Denial Rate — Measures the percentage of claims that are denied during the month.
      • Days on Hold — Measures the average number of days that it takes to work a Secondary Hold claim and submit it for payment.

    Optional Technology Services

    A variety of software programs, such as pMDsoft, allow for real-time hospital and dialysis charge entry that NPS can work with. These program may have an additional fee for licensure and entry of charges by NPS; however, we have found these systems to be very helpful in ensuring patient encounters are properly accounted for and changes aren’t missed.

    • View real-time patient data on a handheld device
    • Have NPS complete the charge entry of hospital and dialysis claims
    • Monitor missing hospital charges
    • Track and report on dialysis patient visits