Transitioning Your Billing In-House

Zarina Nagrani President Professional Revenue Recovery Solutions Zarina@PRRSInc.com https://www.linkedin.com/in/zarinanagrani/

Choosing the Challenge of Revenue Cycle Management Verifying Benefits Utilization Management Billing and Coding Collections Managing Your Payments Properly Managing Your AR Payer Relationships

5 Critical Things to Know When Deciding to Take Your Billing In-House Staffing and Training Choosing a Software Separating from Your Current Billing Vendor Understanding Payer Policies and Procedures Transition Support Teams

Staffing and Training

Staffing and Training Building a highly skilled team requires a significant investment in time, training, cost and more. Hiring experienced, motivated staff and providing them with the necessary training on every aspect of revenue cycle management should be your primary focus PRIOR to billing your first claim

Staffing and Training Hire Staff with Industry Knowledge, Experience and Credentials Train, Train, Train Monitor and Audit Establish a Quality Assurance Team and Policies Retrain Regularly

Software Solutions

Choosing a software solution can be challenging. Knowing which software can address your specific revenue cycle management needs is important. Research and testing take time but are necessary if, you want to avoid costly time consuming changes in the future

Software Primary Purpose and Design Who Owns the Data Training and Support Customization and Collaboration Integration with Current Systems

Transition from an Outsourced Vendor

Your current vendor may: Your current billing vendor may make transitioning to an in-house model seem impossible Your current vendor may: Obscure vital information Revoke Access to Your Billing and Payer Portals Threaten to Report Shortfalls to the Payers Stop Work on Your AR Withhold Valuable Reporting Data and Threaten Legal Action if You Terminate Services.

Understanding policies and procedure for each payer

Understanding policies and procedure for each payer can seem like an exhausting task Private health insurance companies change their policies on billing and medical necessity so frequently it may prove difficult for a new team to keep up. Understanding and assimilating these changes into your own policies and procedures are essential to optimized reimbursement.

Understanding policies and procedure for each payer can seem like an exhausting task Medical Necessity Criteria Diagnosis Coding Changes Billing Practices by Payer Collection Laws Appeals Processes and Rights Payer Policies and Procedures for Verification, UR, Billing etc.

Transition Support Team

Transition Support Team Hiring a Transition Support Team can help mitigate all these challenges. - A strong support team, like PRRS, can provide training and staffing support, software recommendations, protection against unfair retaliation and clear and concise support on payer and internal policy and procedures.

Transition Support Team Staffing and Training Software Assessment and Recommendations Account Review and Support Policy and Procedure Development Ongoing Training and Monitoring AR Review and Recommendations

For More Information Professional Revenue Recovery Solutions www.PRRSInc.com 1-888-405-3118 Info@PRRSInc.com https://www.linkedin.com/company/prrsinc https://twitter.com/prrsinc

Professional Revenue Recovery Solutions Thank You Zarina Nagrani President Professional Revenue Recovery Solutions Zarina@PRRSInc.com https://www.linkedin.com/in/zarinanagrani