A Complete Solution for your Medical Practice
Medical Billing Services
Business Process Optimization
Increase Patient Revenue
Decreasing denials is the easiest way to increase revenue, and Doc-Bill has several mechanisms in place to do just that! We review your practice’s denials and write practice and payer-specific rules. These rules reduce coding and demographic errors ensuring a clean claim that is paid the first time.
Automatic eligibility checking: Doc-Bill will check patient eligibility for 100% of claims before the claim is submitted. This practice significantly reduces denials and improves the quality of A/R.
How the Doc-Bill Rules Engine Increases Your Revenue
eClinicalWorks software includes a rules engine, customized by Doc-Bill to meet predefined payer-specific rules for your payers. These rules identify errors in recorded charges to ensure accuracy and coding compliance. Click the next tab to see examples of these payer-specific rules.
This solution has produced a significant increase in customer revenue by reducing first-time denials. In conjunction with the reduction in denied claims, the software and rules engine also identifies procedures codes that are not submitted at the time of service, but which should be submitted for claims reimbursement by the physician. For example, many physicians only submit a claim for the actual vaccine administered during an immunization. However, the physician is eligible for reimbursement for his services in the administration of the immunization. By identifying missed opportunities for reimbursement, our system is able to capture additional revenue for the practice. Doc-Bill also builds new client-specific rules based on the client’s denial trends and payer mix so the system can “learn over time”, which also contributes additional revenue for the practice.
Payer-Specific Rules Include:
- Missing or invalid CPT Code
- Invalid modifier w/CPT
- Invalid modifier w/ other modifier
- Modifier -25/26 required
- Rebundle to appropriate procedure code
- Unbundled Procedure
- Unbundled E/M services
- Established vs. New patient
- Patient age not valid for procedure
- Global editing 30, 60, 90 all payers
- Conflicting E&M / Procedure
- PT Gender missing or incorrect
- ICD code invalid or missing
- LCD Local Carrier Policies
- Diagnostic test in hospital setting
- Post-op unrelated service
- Place of service not typical
- Missing or invalid place of service
- Medicare Unrelated surgery
- Referring Physician
- Referral Authorization Number
- Missing Demographic Information
First-Class Personal Service
Doc-Bill is a client-centric organization and we strive to demonstrate this right from the start. Co-Founder John Swen will be your primary contact during the on-boarding process. He will handle your implementation and personally make himself available to you 7 days a week to handle any questions or issues you may have, even outside of normal business hours.
We are personally committed to the success of each client. Our goal is to be the best, not the biggest.
The Doc-Bill Service Guarantee
We created Doc-Bill to provide the best revenue cycle management service, not the biggest. Our objective is to grow the company only to a limited number of clients so that we can personally supervise the quality of our service to each and every client. We believe our academic and work experience is unique for a billing service organization. More importantly, we are personally committed to your success. To demonstrate this commitment, each client has one of our personal cell phone numbers, and is welcome to call at any time between 8AM and 10 PM, seven days per week.
You Are in Control
You have complete control and 100% transparency of your billing process at all times. eClinicalWorks provides an extraordinary array of ready-to-run reports that provide an easy, automatic approach to all key practice data.
Reports can be run at any time. In addition to the ready-to-run reports, eClinicalWorks has a powerful report writer included! If there is a specific report that you need, Doc-Bill will use the custom report writer to design and save that report for you so it can be run easily anytime in the future.
Easy to Generate Reports
Doc-Bill offers a variety of ways for you to obtain timely information on the operational and financial performance of your business. First, we will provide a standard report package for month end reporting through eClinicalWorks web-based software. These reports can be run automatically at predefined times (daily, weekly, monthly). They can be run by physician, department, or location and can be exported into an Excel spreadsheet.
- Insurance payment lag report; How long payers take to pay claims
- Provider Lag report; How long doctors take to submit claims
- Monthly begin, end A/R, charges, adjustments, collections.
- Total AR, AR trend, Days AR trend
- Insurance Claim Aging; Insurance claim aging by carrier
- Patient Balance Aging Detail; Patient AR detail
Technology Designed for You
Web-based software from eClinicalWorks means all of the maintenance and support is our responsibility, not yours. No paying an IT guy hundreds of dollars to install security patches or costly upgrades to your medical software to stay compliant. Updates to the system happen automatically, at no cost.
Plus, eClinicalWorks mobile means you can access the system anytime on the go, whether your preferred device is an iPhone, iPad, or any other mobile phone or tablet.
eClinicalWorks: A World-Class Software Solution
We chose eClinicalWorks as our software vendor because we believe it gives us a major advantage over other billing service companies. eClinicalWorks offers an extraordinary suite of powerful software solutions including Electronic Medical Records (EMR), Practice Management, Patient Portal, and Mobile-readiness. eClinicalWorks is the EMR market leader for small to medium-sized practices and the recipient of numerous awards, including KLAS recognition as the #1 Ambulatory Care EMR, the #1 Practice Management software suite, and ranks 38th on the Healthcare Informatics top 100. eClinicalWorks is featured in a Harvard Business School case, written by Professor Robert Higgins (available on line).
eClinicalWorks software solutions allow us to focus on customer service and tailoring the product to your needs rather than on software development and support.
Day 1 to 30
- Coding Review
- Fee Schedule Consult
- Patient Payment Process
- Financial Review and Targets
- Process Mapping
Day 15 to 75
- Demographic and Insurance Data Migration
- System Configuration
- Credentialing Review
Day 60 to 90
- Coordinator Training
- Reports Training
- Physician Training (as needed)
Day 90 and on
- Monthly Meetings
- Quarterly Meetings