Medical Billing FAQ's
Why outsource your billing?
It's a Matter of Economics!
Over the last decade or so, medical providers have become buried in paper while it has become more and more difficult to get paid for their services. Today every provider faces the potential of getting paid less for more work. Gone are the days of "submit a bill and get paid." Insurers have deployed "armies" of people, using high-end computers, with sophisticated software in order to find ways to deny providers payment. We call this Revenue Leakage.
At risk is the loss of tens of thousands of dollars in revenue to your practice. Cape Medical Billing can help to substantially lower your costs; increase revenue collected and reverse your Revenue Leakage (lost revenue from denials and poor follow-up).
Billing systems and human resources are often difficult to maintain and very expensive. Many billing personnel in a private practice lack experience, training, time and resources to properly manage your billing cycle. Hiring, managing and successfully maintaining in-house billing staff is a challenge in many practices, and can negatively impact your bottom line. Training billing staff to become proficient requires time, money, and resources. Staff vacations, illnesses, medical and family leave, etc. can be disruptive. Attrition and turnover - after you pay for all of the training - can be catastrophic.
In addition, there are computer software and hardware expenditures. Service, training, support, maintenance, and upgrade fees also must be considered. And the cost of not upgrading can be even more expensive resulting in high claim rejections. Then you also have the cost to mail patient statements - envelopes, postage, phone calls coming into the practice, and on it goes!
With Cape Medical Billing managing your revenue cycle you can reduce your billing cost, helping you improve your bottom line.
Increase Revenue Collected
Cape Medical Billing has a proven track record of reversing Revenue Leakage and maximizing the revenue for our clients. Our services and systems are designed to get you paid faster, prevent rejections, track claims efficiently, and follow-up on unpaid claims and patient balances.
Over 95% of charges submitted by Cape Medical Billing are paid on first submission. Our clients experience half the national average of Days in AR. We can improve your cash flow significantly by getting you paid faster and collecting the maximum amount of money possible.
What makes CMB different?
We are the solution that healthcare providers turn to for plugging the revenue leakage problem that plagues their practices. As healthcare providers face ever increasing cost and revenue pressures, the last thing they can afford is to "leave money on the floor" - but that happens all too often in many practices as revenue leakage is significant and widespread across the medical practice landscape.
Nobody reverses revenue leakage faster or better than we do - our innovative software and specialized services solutions quickly drive significantly improved results. We can deliver substantial cost savings as well as significant improvements in revenue and cash flow.
Our powerful combination of technology, expertise, and people quickly delivers unmatched results.
I just bought a new Electronic Health Records (EHR) program and need a new billing service that can interface with it. Can you do that?
If your EHR vendor can export an HL7 or other data file, then yes, we can work with them. Cape Medical Billing (CMB) offers a comprehensive medical billing option that can interface with Electronic Medical Records (EMRs).
CMB can integrate your patient demographic, insurance and charge data with our medical billing software to save you money by reducing your operational cost and often will increase revenue by vastly improving the efficiency of your billing cycle.
Do you assist your clients with Medicare Provider Revalidation and Medicare Audits?
Yes, we can help process client Provider Medicare Revalidation applications. And we offer to our clients a free a review of their documentation when responding to a Medicare or any Insurer's Audit requests.
How do I send my patient data to CMB?
CMB utilizes state-of-the-art scanning technology and can accept billing data on paper or electronically via sFTP, efax, fax, USPS, UPS, or FedEx. CMB is a paperless office.
What does CMB do with all the paper it receives?
Over 96% of our clients now send data electronically. However, any paper documents sent to CMB are scanned into digital files within 24 hours for processing. All paper is then either returned to the client or shredded.
How does CMB handle data backup?
- a continual replication system on two separate servers,
- data iis backed up to separate off-site storage devices, and
- have an advanced automated backup electrical generator to insure systems continue to function during a loss of electric.
Will CMB perform a strategic analysis of our billing process?
Yes, CMB will provide a detailed analysis of charge practices to determine your deficiencies. We then recommend changes to your billing process (Charge forms, etc.) to ensure prompt payment.
Does CMB handle all the steps of the billing process for us?
Yes. CMB receives the required data from your office, and handles the rest: From billing insurance and patients, answering patient questions, to final resolution of each account.
Will CMB educate my staff to ensure I get paid properly?
CMB will work with you and your staff to make sure the necessary documentation is collected and sent to CMB for billing.
It seems like there are frequent changes in medical billing laws and regulations, can you help us keep up?
Yes, CMB sends a monthly newsletter to clients highlighting important billing changes. When necessary we will email, fax or call with time-sensitive issues. We stay on top so you can focus on your patients!
When insurers deny valid claims, will CMB handle appeals?
Absolutely! CMB experienced staff will automatically review and resubmit as needed. If additional documentation is needed by an insurer, we will work with your staff to obtain and send it.
What is "Days in Accounts Receivable"?
It's your Money! You want to be paid by insurers and your patients as soon as possible. The industry standard to measure the speed of medical payments is "Days in Accounts Receivable." In this case the lower the number, the better!
Simply, it is how fast (or slow) in "days" it takes on average for your money to be collected from insurance companies and patients. Too many Days in AR results in lost revenue.
If your days in Accounts Receivable are over 20 days your billing system could be costing you tens of thousands of dollars in lost revenue while remaining virtually undetected.
For many medical specialties, CMB averages less than 20 days-which is considered excellent in the industry.
What is your Days-in-Accounts Receivable? Not sure? Provide your monthly charges for the last three months and the month-ending accounts receivable for the third month and we'll calculate it for you. You may be very disappointed to learn you have a sluggish payment cycle!
Does CMB have a Compliance Plan?
CMB has a fully operational Compliance Plan and has been involved in Compliance since 1998.
Does CMB have a Disaster Plan?
Yes. Our actively tested Disaster Plan will protect your practice's lifeline of revenue. It was activated successfully for both Hurricanes Irene and Sandy. Our state-of-the-art automated backup electrical generator even insures we are operational for less extensive power outages.
Your financial data is secure. Our Disaster Plan ensures that your financial data will survive a natural disaster and will help you avoid a catastrophic loss of cash flow caused by Mother Nature.