Optimize Your Revenue Cycle
Many providers believe their medical billing needs are being adequately served. However, when closely examined their key accounts receivable financial performance indicators are not within healthy parameters. United Medical Solutions (UMS) offers customized billing services tailored to satisfy the most stringent practice requirements. We focus on the whole practice, not just pieces of the billing process.
UMS provides full revenue-cycle management. All clients receive customized, comprehensive services designed to streamline billing processes to maximize profitability.
Medical Claim Creation
UMS has developed processes that ensure that claims are properly generated before they are filed, reducing denials and delays. This includes reconciliation with provider schedules, coding substantiation, and accurate registration of patient information to confirm all revenue is captured.
- Reconciling Daily Charges
- Coding
- Certified coders are on staff to ensure compliant billing and optimal reimbursement.
- Documentation Review
- Resolve and/or report discrepancies
- Assign or verify codes
- CPT, ICD-9, ICD-10, modifiers, PQRS and verification of authenticity
- Coding training and education for client staff
- Notify providers of document requirements and deficiency
- Integrate with leading software and medical coding systems
- Data Entry
- Proper data entry reduces accounts receivable days in collection. Patient insurance and demographic information is obtained from the practice and entered into a secure database.
Medical Claim Submission
Whenever possible, claims are filed electronically to further reduce time providers wait for reimbursement. We adhere to HIPAA Standard Transactions to deliver claims in real time, expediting payor responses and streamlining cash flow.
- Electronic and paper claim submission to Medicare, Medicaid and participating commercial carriers.
- Submission to patient secondary and tertiary insurance
- Coordination of liability claims with attorneys and third-party payors
- Accelerated claim adjudication
- Acknowledgment of successful claims submission for processing
- Confirmed compliant-clean claims for processing
Payment Processing
UMS utilizes direct electronic payments from Electronic Funds Transfers (EFT) and online patient portals including credit card and OCD payments. Reimbursement from third-party payors is monitored to identify problems with specific insurance companies identifying contractual reimbursement errors. Contracted allowables are maintained within state-of-the-art billing software enabling verification that correct payments are being received from insurance companies. Manual payments are sent directly to the client's practice or a post office box maintained by the client.
- Deposit Money
- Posting of monies received and balancing of daily work
- Recording of contractual adjustments
- Preparation of bank deposits and delivery to client's bank account
- Reporting of receipts to client
- Credit Balance Processing
- Researching and reconciliation of overpayments
- Verification letters sent to insurance companies
- Processing of credit checks for client
- Reconciliation of unclaimed property
Medical Claim Resolution
Our staff is well trained in customer service designed to complement our client's practice. The highest standard of care and the client's individual philosophy are part of the account resolution process. Performance indicators demonstrate our ability to get results.
- Insurance Claims Resolution
- Direct inquiry on denied or underpaid claims
- Investigation of denials and processing of errors
- Follow-up investigation on pending claims
- Follow-up correspondence with insurance company
- Follow-up communication on third party and legal accounts
- Resubmission of claims when required
- Monitoring of profiles of individual insurance companies
- Patient Account Resolution
- Handling of patient inquiries
- Patient statements with flexible billing cycles
- Administration of patient payment plans
- Assigning of uncollectible accounts to client's collection agency
Financial Reconciliation
Providers vary in their needs for critical month-end and year-to-date data and results. UMS can generate custom reports to aid the provider in measuring the success of their practice. In addition to these customized practice analysis reports, UMS will properly close the period, transfer bad-debt accounts to a collection agency, and issue credit balance checks to patients and insurance companies.
Value Added Services
Providing medical care is becoming more and more demanding. Using a medical billing company offers you the opportunity to focus on your patients instead of the administration of proper and accurate claim preparation, collection, and reporting. In addition, UMS provides comprehensive and cost-effective services that add value to every practice and institution.
