Billing Environment Assessment & Recommendations for Medical Practices
When you’re considering changes into your radiology or imaging center billing department, there are a multitude of concerns you have to think about. You may not be ready to fully outsource your billing operations just yet, but still understand the benefits of doing so. Having to both manage the technology and the people can be taxing on your practice or tie up resources that might be better allocated to other areas of the business. Canopy Partners has developed a unique solution that takes the best of both the in house and outsourced billing models and combines them. The Canopy Partners team offers a healthcare revenue cycle audit as a consulting engagement. During the audit engagement Canopy Partners provides the following services:
- Technical Billing Assessment
- Workflow Assessment
- Findings and Recommendations
Examples of Scope of Services Includes:
Coding Check - We will check CPT & ICD-10 coding accuracy and exploring missed opportunities. A mix of Hospital and Imaging Center procedures can be included in the sample. All Modalities including MSK, Neuro, and Breast will be included. PQRS check is optional. We will also compare exam report to what was actually coded and provide feedback on dictation.
Charge Capture - We will ask you to provide logs from sites and Imaging Centers. We will go back randomly choose 10 reports on several different days on different doctors and modalities.
Contract Variance - A check on contract variance showing whether you were getting paid according to contract.
Denial Management - Canopy will take an in depth look at certain denials and providing feedback on missed opportunities and will give a best practices scenario on how to best handle this crucial area of Revenue Cycle Management.
Bad Debt Analysis - Analyze a 12 month summary of your collection agency analysis on their performance of bad debt turnover from your practice.
Analysis of Billing Metrics - A full analysis on the major billing metrics will be examined and comparison made on where most practices fall. We take a close look at collections per procedure along with procedures per FTE. This will show if the operation is efficient.
Policies and Procedures/HIPAA Overview - The scope of an audit can be as light or heavy as you would like. Example would include: Are you sending out secure e-mails with PHI in it? If we were to walk through the billing area after hours, is everything secure? Are there EOB’s on the desk? Are you using Secure FTP sites, are servers secure? also, Disaster Policies.
Best Practices, Feedback, and Action Plan - At the conclusion of the audit you will receive a complete report.