MBS Services: Reimbursement Management

MBS scrutinizes all aspects of the revenue stream to determine areas of potential lost revenue. Whether it involves fine-tuning or a complete overhaul of current collection methods, MBS is committed to increasing our clients’ profitability.

Billing Oversight MBS pays close attention to all aspects of billing and collections ensuring proper and timely reimbursement.
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Whether your billing is done in-house, or through an outside billing service, MBS serves as an objective third party to oversee billing, significantly improving the revenues to medical practices.

Billers are involved in the day-to-day details of charges and payments. Our expertise lies in looking at the bigger picture, analyzing trends, identifying problem areas that may be negatively effecting financial performance and taking the necessary steps to ensure the billing process is reaching its potential.

We monitor biller performance through our unique tracking system that projects expected, upcoming collections based on actual information including the number of patients seen during a month, the distribution of CPT codes and your payor mix. This dynamic tool allows us to quickly identify and resolve any billing problems that may delay reimbursement.

MBS serves as a watchdog over the entire billing process. The importance of this in the healthcare industry cannot be overestimated. After all, would a billing service really tell their client they have failed to perform adequately?

Our experience shows that only in a rare occurrence would a billing service call attention to their inadequacies in collecting charges. As a separate, objective entity, MBS offers great value in assuring the billing mechanism is performing at its best.

With MBS involved, you will no longer live with increasing accounts receivable and decreasing reimbursements. MBS monitors all billing activities and ensures proper and timely collection of charges.

Link to Top-Performing Billing Companies
If your current billing mechanism is ineffective in billing and collecting for your services, MBS can introduce you to one of the many billing companies we trust to handle the specific needs of your practice. Our billing service affiliates have proven their ability to turn charges into revenues, producing remarkable collection results for each of our clients.

Documentation and Coding Analysis By auditing current usage of CPT and ICD-9 codes, MBS identifies documentation and coding inaccuracies and establishes appropriate correction measures, including physician or coder education, to reduce the occurrence of income loss or compliance violations.
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Documentation and coding significantly impacts charges and the ability to collect from third party payors. In addition, compliance violations are of great risk to a practice without appropriate evaluation procedures in place to ensure effective compliance measures.

MBS optimizes reimbursements by effectively monitoring the usage of ICD-9 and CPT codes. Periodic analysis of documentation and coding allows us to recognize trends and recommend changes to improve the accuracy and completeness of medical charts. When necessary, education can be arranged to improve coding and documentation.

Fee Schedule Analysis
An analysis and adjustment of current fee-schedules, compared to industry and geographical standards, resolves fee-related deficiencies while keeping your practice competitive.

Accounts Receivable Analysis & Follow Up
MBS evaluates and oversees the accounts receivable management and follow up performed by the biller. We analyze aged receivables and offer solutions to convert accounts receivable into actual revenue.

Audits & Analyses
MBS pays close attention to all aspects of billing and collections ensuring proper and timely reimbursement.

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Comprehensive periodic audits identify potential problem areas related to payors, reimbursements, utilization of CPT codes, charges, payments, adjustments, data flow and accounts receivable. Using benchmarking and trend analysis, we help ensure optimal practice performance.

Registration & Insurance Demographic Analysis
MBS carries out quality assurance functions by sampling registration and insurance demographic information to ensure that billing data is correct and complete.

Data Flow Analysis
MBS monitors the transfer of information to identify data flow constrictions affecting prompt filing of insurance claims and statements.

Charge Capture & Audit Control Analysis
MBS evaluates audit control procedures to ensure all services provided are identified, coded and billed appropriately.

Fee Schedule Analysis
MBS utilizes geographic market area information and current Medicare allowable amounts to recommend adjustment of fees on an annual basis, or as necessary.

Documentation and Medical Coding Analysis
MBS monitors the usage of CPT codes to identify inconsistencies, which may affect reimbursements. We analyze the accuracy of coding specific to the guidelines applied by the payor and consistent with the documentation of medical records.

Financial Performance Ratio Analysis
MBS develops performance standards for monitoring and improving accounts receivable management. We track performance on a month-to-date, year-to-date and six-month moving average basis on standards established by MBS projections.

Explanation of Medical Benefits Analysis
MBS provides ongoing analysis of EOB’s from Medicare and insurance plans to identify any avoidable denials and determine if proper reimbursement was received from third party payors.

Aged Trial Balance Analysis
MBS assesses the status of a sample of open claims, identifying reasons for non-payment to recommend necessary steps to obtain reimbursement.

Managed Care Contract Analysis
MBS reviews the terms of prospective managed care agreements and monitors the associated risk factors. MBS evaluates the proposed reimbursement provision to determine the economic benefit or cost associated with participation.

Practice Performance Reporting
MBS attends monthly corporate meetings to discuss the findings of our analyses. The report is presented in written narrative with corresponding charts and graphs, allowing our clients to know exactly where their practice has been, where it currently stands, where it is heading and how MBS plans to achieve future goals.

Office Policy & Procedure Analysis
MBS evaluates and refines registration, patient tracking, benefit verification and data flow procedures to improve efficiency and effectiveness for the practice.

Credit & Payment Policy Analysis
MBS reviews and establishes collection policies and procedures to ensure productive and appropriate methods for collecting patient payments at the time of service.