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Revenue Cycle Outsourcing September 7, 2015September 7, 2015September 7, 2015 www.nationalASCbilling.com
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2 CONFIDENTIAL www. nationalASCbilling.com We Measure Our Success By Your Results Revenue Cycle Management. It’s all we do. It’s all we think about. And it shows.
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3 Our Mission CONFIDENTIAL www. nationalASCbilling.com “We are singularly focused on delivering the best results, providing exceptional customer service and building relationships with ambulatory surgery centers and associated physician practices based on trust, performance and integrity.”
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4 Overview Who We Are Who We Are What We Do What We Do Why We Deliver the Best Results Why We Deliver the Best Results What Our Clients Say What Our Clients Say Summary Summary CONFIDENTIAL www. nationalASCbilling.com
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Premier revenue cycle management company focused on the ASC market and their respective professional practices Premier revenue cycle management company focused on the ASC market and their respective professional practices Named one of the world’s best outsourcing service providers in Fortune Magazine 2012 and 2013 Named one of the world’s best outsourcing service providers in Fortune Magazine 2012 and 2013 We code and bill for surgery centers and practices in 40+ states We code and bill for surgery centers and practices in 40+ states Management team is highly seasoned with deep billing expertise Management team is highly seasoned with deep billing expertise Cutting edge processes and technologies Cutting edge processes and technologies We significantly increase cash per case in compliant fashion We significantly increase cash per case in compliant fashion Highest customer satisfaction rates in the industry Highest customer satisfaction rates in the industry 5 Who We Are CONFIDENTIAL www. nationalASCbilling.com We Are the Revenue Cycle Experts … Just Ask Our Clients
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6 What We Do CONFIDENTIAL www. nationalASCbilling.com We provide the following services for our clients: We provide the following services for our clients: Complete revenue cycle outsourcing Complete revenue cycle outsourcing Coding services Coding services Comprehensive coding and billing audits Comprehensive coding and billing audits Managed care contract consulting Managed care contract consulting
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7 Our Coding Expertise CONFIDENTIAL www. nationalASCbilling.com Certified coders with extensive experience in multi-specialty surgery coding Certified coders with extensive experience in multi-specialty surgery coding State of the art coding software State of the art coding software CCI edits CCI edits Checks ASC approved codes Checks ASC approved codes Local Medicare review polices Local Medicare review polices State and carrier specific requirements State and carrier specific requirements Experts in identifying opportunities for missed revenue and trained to handle complexities such as: Experts in identifying opportunities for missed revenue and trained to handle complexities such as: Inappropriate bundling Inappropriate bundling Medical record documentation requirements Medical record documentation requirements Capturing all procedures in complex cases Capturing all procedures in complex cases
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8 Our Billing Process CONFIDENTIAL www. nationalASCbilling.com Reconciliation between OR schedule and EDI reports daily Reconciliation between OR schedule and EDI reports daily All claims (except those requiring attachments) are billed electronically within 48 hours from receipt of all source documentation All claims (except those requiring attachments) are billed electronically within 48 hours from receipt of all source documentation EDI provider is ASC experienced and compliant with HIPAA transactions and 5010 code set requirements EDI provider is ASC experienced and compliant with HIPAA transactions and 5010 code set requirements Contract review takes place at time of billing and payment posting Contract review takes place at time of billing and payment posting Daily reconciliation of deposits received to bank transactions and system postings Daily reconciliation of deposits received to bank transactions and system postings
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9 Our A/R Process CONFIDENTIAL www. nationalASCbilling.com Established relationships with carriers Established relationships with carriers Experienced in handling out-of- network claims Experienced in handling out-of- network claims Superior reporting capabilities Superior reporting capabilities Spot trends Spot trends Monitor cash flow Monitor cash flow Aging reports analyzed at least once a week Aging reports analyzed at least once a week Aggressive and successful appeals process Aggressive and successful appeals process Medical necessity Medical necessity Usual and customary reimbursement Usual and customary reimbursement Medicare Medicare Coordination of Benefits (COB) Coordination of Benefits (COB)
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10 Our Customer Service CONFIDENTIAL www. nationalASCbilling.com Dedicated account representatives to take patient calls and answer questions Dedicated account representatives to take patient calls and answer questions Patient statements sent weekly Patient statements sent weekly Outbound calls made daily on delinquent balances Outbound calls made daily on delinquent balances Recommend high tech, web based patient portals to allow online payment ability and access to account review Recommend high tech, web based patient portals to allow online payment ability and access to account review
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11 Our Detailed Reporting CONFIDENTIAL www. nationalASCbilling.com Our cutting edge business intelligence software and analytical tools allow us to provide you real time insights into the performance of your surgery center, thus enabling us to provide you with all of the key reports you will want Our cutting edge business intelligence software and analytical tools allow us to provide you real time insights into the performance of your surgery center, thus enabling us to provide you with all of the key reports you will want Missing information report sent at least once per week Missing information report sent at least once per week Unbilled report generated each month Unbilled report generated each month Cash sheets sent daily to reflect totals and projected collections in relation to monthly goal Cash sheets sent daily to reflect totals and projected collections in relation to monthly goal
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12 Managed Care Contract Consulting CONFIDENTIAL www. nationalASCbilling.com Evaluate and assess current and proposed managed care contracts Evaluate and assess current and proposed managed care contracts Identify contract nuances and educate billing team in order to maximize reimbursement Identify contract nuances and educate billing team in order to maximize reimbursement Work with network managers on carrier updates and communicate these updates with facility and billing team Work with network managers on carrier updates and communicate these updates with facility and billing team
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13 Implementation and Transition CONFIDENTIAL www. nationalASCbilling.com New Client On site kick off meeting Establish initial operating procedures, communication processes, and plan for transition. Go-Live Process 1-2 weeks Process stabilized. Ongoing tracking and monitoring. Transition 2-4 weeks Finalize detailed process design & migrate process. Continuous QC >4 months Continuous quality and process improvement. Optimize productivity - All resulting in increased revenue and compliance. Structured Account Management Process Management Rigor
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14 Client Services CONFIDENTIAL www. nationalASCbilling.com
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15 Why We Deliver the Best Results CONFIDENTIAL www. nationalASCbilling.com Surgery Specialization Surgery Specialization Deep Billing Expertise Deep Billing Expertise Seasoned Managed Care Contract Negotiators Seasoned Managed Care Contract Negotiators Specialized Certified Coders Specialized Certified Coders Skilled Accounts Receivable Experts Skilled Accounts Receivable Experts Seamless Transition Seamless Transition Strong Compliance Focus Strong Compliance Focus World Class Processes and Technology World Class Processes and Technology State of the Art Reporting State of the Art Reporting Unparalleled Customer Service Unparalleled Customer Service
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16 Ask Our Clients CONFIDENTIAL www. nationalASCbilling.com Revenue Cycle Expertise Led to 32 Percent Increase in Cash “NMBS’s dedication to and focus on maximizing revenue is evident in our cash performance. Their combination of exceptional customer service, highly knowledgeable staff and deep industry expertise has made NMBS our "go to" company for billing and coding. Most importantly, they increased our cash by 32 percent.” President, ASC Management Company Atlanta, Georgia
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17 Ask Our Clients cont. CONFIDENTIAL www. nationalASCbilling.com NMBS's Billing and Coding are Highly Superior to In-house Resources “We were handling our billing and coding in-house and thought that things were fine. NMBS offered to do an analysis of our business office at no cost to us, so we agreed. Upon reviewing the results, we were stunned to find out how much revenue we lost due to the fact that we were improperly billing and coding expensive implant charges. This process also taught us that it was virtually impossible for our business office to employ specialized billers, coders and AR experts in the way that NMBS does. NMBS is purely focused on billing and coding, and it shows. The results? NMBS increased our cash by 35%. We will never again bring the billing back in-house.” ASC Administrator Shreveport, Louisiana
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18 Ask Our Clients cont. CONFIDENTIAL www. nationalASCbilling.com NMBS’s Coding Expertise Identified and Captured Lost Revenue “NMBS’s coding audit identified that our previous billing partner was coding and billing our claims improperly. We were actually losing money on some cases because costly implant charges were not being coded and billed correctly. NMBS was able to go back and capture significant lost revenue. Their specialized, expert coders have maximized our revenue and compliance.” Medical Director Cleveland, Ohio
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19 Summary CONFIDENTIAL www. nationalASCbilling.com We are the premier revenue cycle company We are the premier revenue cycle company Deep billing expertise and experience Deep billing expertise and experience “Bend over backwards” customer service mindset “Bend over backwards” customer service mindset Exceptional results Exceptional results Trusted, high integrity partner Trusted, high integrity partner Loyal and happy clients – Please ask them! Loyal and happy clients – Please ask them!
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16759 Main Street, Suite 220 ° St. Louis, MO 63040 Office 636-273-6711 ° www.nationalASCbilling.com ° Fax 636-821-2517 Revenue Cycle Management. It’s All We Do. It’s All We Think About. And It Shows.
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