14 Signs That You’re Working With The WRONG Outsourced Billing Company
- Your outsourced biller collects the easy money, but it’s obvious they don’t work the hard stuff
Systems 4PT technology analyzes unpaid claims and assigns “which claim to work next” to the collections expert. This process begins before the claims are 30 days past due and ensures that all claims are worked, again and again, until paid.
- Your EMR misleads you stating that, “billing is integrated,” but your EMR is not integrated in the same, single database as your billing system. In fact, the EMR and billing software are separate entities. Because of this:
- You can’t see patient statements on your EMR
- Deductibles and coinsurance balances due are not visible at the front desk
- As a result, you lose about 3% of revenue
None of this is a problem with Systems 4PT. Scheduling, EMR, and billing are integrated into one database.
- Your incomplete registration/benefit data is billed out, causing rejected claims
Systems 4PT validates all required fields before allowing the registration to be signed. Incomplete data does not bill out. Instead, it is posted on a high-profile list: “TREATMENTS NOT BILLABLE.”
- Your staff isn’t aware of shifting payer rules, resulting in even more rejected claims
Systems 4PT ensures that payer rules are followed before each registration can be signed. Our technology constantly analyzes “Big Data” in your region. When we detect a new rejection trend, we add the corresponding rule to your software, resulting in the cleanest claims in outpatient rehab. Clean claims get paid 😉
- Your biller adds modifiers without alerting therapists (e.g., adding the 59 modifier for mutually exclusive codes). Without defensive documentation, an audit will result in takebacks
Systems 4PT automates touch-free CCI edit index modifiers (including the 59). And our validation warns the therapist (in real time) to defend the modifier in their note.
- When the secondary payer requires G-Codes, therapists can sign the primary without G-Codes (these secondary payers are not paying you).
Systems 4PT technology requires G-Codes on the primary claim in these circumstances. You deserve to be paid.
- Your therapists can’t sign notes for the Medicare 11th and 12th visits if G-Codes have not been submitted for the 10th visit (Medicare won’t pay these).
Systems 4PT technology integrates Medicare’s validation rules in our EMR. If a Medicare claim won’t be paid, we block the therapist from signing the note and list what needs to be corrected first. This technology exists for 9 other Medicare-specific scenarios besides the 10th visit rule. Remember, Medicare is judging you with a supercomputer. Practices using Systems 4PT collect more because their claims are submitted with their own supercomputer.
- You can’t see charges, collections, or write-offs per claim. And you know why. . . because the hard stuff isn’t worked
Systems 4PT provides visibility of charges, collections, and write-offs, by the claim, including the ERA detail.
- Your billing company is owned by a venture capital bank and to cut costs they outsource their work to India, or as they say, “transition responsibilities to a global revenue management firm.” (For obvious reasons, they try to hide this from you)
Systems 4PT is proud to utilize American talent and technology. Our collection experts are all Systems 4PT employees who all work in our U.S.-based technology center.
- Your outsourced biller has high employee turnover, you often feel like you are training their billing staff.
Systems 4PT has the lowest employee turnover in the industry (about 3%). And our “team approach” protects you from down time due to vacation or illness.
- Because all the other practices who work with your biller are having weekly billing meetings with that biller, you’re forced to have weekly billing meetings as well. If you don’t tell your biller what to focus on, they focus on other practices
We don’t have this problem. Systems 4PT’s technology focuses our Account Managers on which claims need to be called next. If problems are identified (by the collections expert or the practice) we communicate immediately. Why would you wait a week to discuss a problem?
- Your outsourced biller hasn’t said a word about MIPS. You have no idea if they’re prepared or if you’ll be safe.
Systems 4PT practices are aware of the substantial changes that MIPS will bring and they’re preparing now.
- Because of the above, you are collecting 9% less than you should be
Systems 4PT practices average 9% higher collections vs. their prior approach to billing. We measure collections before and after with each installation.
- And you’re paying 35% more than you should be
Systems 4PT delivers the highest technology at the lowest cost in outpatient rehab. No one else comes close.