Resources

Medical Business Office, Inc. (MBO), your Medical Billing Service providing end-to-end Revenue Cycle Management reminds you of all the promises of 2018.

Let’s face it, the healthcare industry as we knew it, no longer exists.  If you haven’t stayed up to date with all the changes, you won’t be able to keep your doors open.  As a client of MBO, we are ready to keep you up-to-date, and in compliance with all your billing matters.  Have you taken a look at the new rules set in place for 2018, by CMS?  What about the Quality Payment Program changes, aka MACRA?  Have you considered the new conversion factor of $35.99?  And what about the ICD.10 and CPT changes and revisions?  These things are crucial if you think about RAC Audits!

Did you see the OIG’s semiannual report for 2017 where they show they’ve recovered over 2 BILLION dollars?  With recoveries in that financial bracket, you can bet the audits are here to stay.  Today, more than ever, is crucial to your profitability that you stay educated, avoid the OIG and their hit list by eliminating billing errors.

Give us a call today at 573.634.7155.  Let’s join forces to ensure you are paid for what you’re entitled to and that your billing supports all the regulations set by CMS, leaving nothing on the table.

Medical Business Office, Inc. (MBO) is a professional Medical Billing Service providing end-to-end Revenue Cycle Management for physicians and facilities.

Back “in the day” when billing was simple, prior to so many government regulations, there wasn’t much of a need for a blog or a website.  Today, however, one depends on websites and blogs to help keep them abreast of what’s to come next in our maze of billing.

Today, I would like to discuss HIPAA and the 18 HIPAA Identifiers.  You already know about HIPAA and the goal of such.  Likewise, you already know that the privacy rules enforce policies designed to protect any/all individuals personal, identifiable health information from being transmitted in a manner that could be stolen and converted to compromise the individuals’ protected and personal health information.  As a provider, you are required to “de-identify” any information that could be used to identify, contact or locate a single person, even when used in conjuction with other sources.  When personally identifiable information is used with one’s physical, mental condition, health care or one’s payment for health care, it becomes Protected Health Information, aka PHI.

What are the identifiers outlined in HIPAA as requiring removal in order to de-identify an individual?

• Name
• Address (all geographic subdivisions smaller than state, including street address, city, county and zip code)
• All elements (except years) of dates related to an individual (including birthdate, admission date, discharge date, date of death and exact age if over 89)
• Telephone Numbers
• Fax Numbers
• Email address
• Social Security Number
• Medical Record Number
• Health plan beneficiary number
• Account Number
• Certificate or license number
• Any vehicle or other device serial number
• Web URL
• Internet Protocol (IP) address
• Finger or voice print
• Photographic Image-Photographic Images are not limited to images of the face
• Any other characteristic that could uniquely identify the individual

Medical Business Office, Inc. (MBO) takes HIPAA, security, privacy and compliance very serious.  In addition to providing a professional Medical Billing Service with end-to-end Revenue Cycle Management, all other components are part of our process.

Give us a call at 573.634.7155 and let’s discuss how MBO and your office can team up to streamline not only your billing, but ensure complete compliance.

Are you ready for January 2018 and the CPT changes?  This year you will encounter approximately 314 code changes representing a 35% increase over last year!

Medical Business Office, Inc. (MBO) is an established professional Medical Billing Service providing end-to-end Revenue Cycle Management Services.  Our clients no longer worry about whether or not their in-house billing department is prepared and on top of code changes, bundled coding, PQRS, MIPS and so much more.  WHY?  As your professional Medical Billing Service, the burden of compliance, regulations, coding, certifications, continuing education, insurance appeals and more lay in our office and out of yours!  MBO’s services allow you to take care of the patient, doing what you do best, while we do the rest!

Having been providing this service since 1985, our office simply becomes an extension of your office.  We take the time consuming tasks of billing, appeals, coding, registration, claims filing, billing statements, follow-up, claims denials and patient billing inquiries off your already over-runneth plate.

Payment delays a concern?  MBO guarantees a 98.5% first-pass claims.  This means claims will get to the carrier with 100% accuracy the first filing, resulting in quicker turn around of processing and payment receipt.

Billing delays?  When your in-house billing personnel have to attend conferences, what happens to your billing?  What about any other type of absence from the office?  Everyone gets sick.  Everyone takes a vacation.  Everyone has occasional personal matters taking them from the office.  Is your office set-up so there is back-up billing when your regular billing person is out?  MBO has long-term cross trained employees to ensure in a time of absence, billing continues on without interruption, and no delays.  MBO understands if billing is delayed, then payments are delayed and we’ve put together a system to eliminate billing delays.

Certifications.  Do you pay for all certifications, CEU’s, conferences, exams and supplies for your billing folks?  As a client of MBO, this is an expense completely eliminated.

Reporting.  Doctor want a report that seems impossible to retrieve?  MBO has a robust reporting module designed to extract the most complicated billing data requested.  MBO clients expect nothing less and they get what they request.

The benefits of outsourcing your billing are endless.  MBO would love an opportunity to speak with you about the benefits of letting the professionals handle the very task that will keep your doors open.  Having been providing this service since 1985, we know what it takes to succeed.

Give us a call at 573.634.7155 and let’s discuss in further detail what your needs are and how MBO can help meet those needs.

Medical Business Office, Inc. is a Professional Medical Billing Service providing end-to-end Revenue Cycle Management Services to Physicians and Facilities since 1985!  It’s part of “what we do” to be active members of industry related organizations in order to stay on top of revisions, compliance, regulations as well as proposed and upcoming change considerations in all aspects of our clients’ interests.  This involves having a voice in Washington on your behalf.

Today, MBO would like to share with you the information learned from one of our organization’s known for keeping us “in the know”.  HBMA, is an organization designed for billing services, touching on all core billing matters including governmental relations.

I am taking one, of many, articles shared with HBMA members, regarding CMS’ recent changes on how your MAC Audits Provider’s Claims.

CMS Makes Changes to How MACs Audit Provider’s Claims
The Centers for Medicare and Medicaid Services (CMS) is taking steps to require Medicare Administrative Contractors (MAC) to provide education to providers on incorrect claims before referring those providers to other program integrity contractors.

The Provider Compliance Group (PCG) is the office within CMS responsible for this new approach, called “Targeted Probe and Educate.”

The HBMA Government Relations Committee met with PCG staff during its June visit to CMS headquarters in Baltimore, MD. PCG staff presented on TPE during that meeting.

Under this new program, when conducting an audit, MACs will randomly select between 20 and 40 claims from a provider. MACs are supposed to target only the providers who have the highest claim error rates compared to their peers. After selecting the claims, which are fewer than MACs have been allowed to select in the past, the MACs are required to provide education to the provider on the incorrect claims it identified through the audit.

MACs must conduct three rounds of these audits before they can refer a provider to one of CMS’ other program integrity contractors such as Recovery Audit Contractors (RAC), or Zone/Unified Program Integrity Contractors (Z/UPIC).

This new program reflects the PCG’s goal of reducing the administrative burden of audits on providers and targeting the few bad actors in the program while sparing the majority of providers who are compliant with Medicare billing policies.

MACs are only one piece of a larger Medicare program integrity contractor framework. CMS is also making reforms to the RAC program which perform post-payment reviews of Medicare claims. CMS is requiring RACs to facilitate a discussion period with the provider to discuss the RAC’s findings and allow the provider to submit a corrected claim before the RAC takes action against the provider. Allowing the provider to submit a corrected claim is something HBMA has been promoting to CMS for several years.

These reforms will hopefully help alleviate the growing backlog of appealed claims pending before the Department of Health and Human Services (HHS). Most of these appeals are for hospital inpatient status determinations that were challenged by RACs. However, the backlog also affects other providers who want to have their appeal resolved quickly so that they can resubmit a claim within the one-year timely filing deadline after the appeal determination.

Medical Business Office, Inc. takes great pride in exhausting every level of appeal necessary to insure our clients are paid for the service they provide.  Likewise, we are dedicated to passing on the education to our clients so as to keep them in compliance with all payers, including governmental agencies.

If you haven’t been able to keep up with all the changes, or you aren’t sure you’re in compliance, or if you would just feel better knowing you can concentrate on patient care while MBO takes care of the rest, give us a call at 573.634.7155.  We provide Professional Medical Billing Services with end-to-end Revenue Cycle Management Services for our clients’, in turn our clients reap the benefits of peace of mind, knowing they are in compliance.

I’ve said this before and I’ll say it again.  It’s not a secret that Medical Business Office, Inc. (MBO) is a professional, established and reputable Medical Billing Service offering end-to-end Revenue Cycle Management services for Physician Practices and Independent Diagnostic Testing Facilities (IDTF’s), and as such, we want your business……. Or do we?

MBO has been in business since 1985.  Our reputation is that our clients are with us long-term.  Having been in business as long as we have, we’ve seen a lot of changes both in the Medical industry (think regulations) and in the Medical Billing industry (think regulations).

It is the belief of MBO that when entering into a relationship with any practice or facility, that the relationship be healthy.  A very smart lady once told me the relationship is kind of like a marriage.  There must be trust, communication and continuous learning in order to have a successful relationship.  Trust is not automatic, it is earned.  Like the Medical Practice, the Billing Service has compliance and regulations that must be followed completely.

When a practice considers whether to keep an in-house billing department or outsource to a specialized Medical Billing Service, there are several factors to consider.  If the practice only considers immediate costs, then you’re not really comparing costs.  Let’s talk about costs first.  It’s not uncommon to come to the conclusion that your own billing department costs less when compared to outsourcing to a Medical Billing Service, resulting in clouded and inaccurate comparisons. Often times practices fail to consider the costs associated with the billing system, maintenance for the billing system, upgrade costs, office space, utilities provided for that space, healthcare benefits for employees, retirement plans, paid vacations, paid holidays, human resources for hiring, terminating, training and educating.  And speaking of educating, what about the costs to send employees to seminars and conferences? Not only are you paying the employee to attend, but you bear the full cost of the educational event, plus mileage, hotel costs and food (at a bare minimum), and what’s going on with your billing while that person(s) is out?  Do you budget for the CEU’s your certified coders are required to have?  Do you bear the costs to get a current employee certified with AAPC?  What happens if they take the test, pass and then 6 months later they go to another practice?  What happens if they take the test and fail? Are you just out your investment? And what about those vacations?  Employees take vacations, they have big events that take them from the office and what happens to your billing in their absence?  Does your billing sit there awaiting their return, or does your billing get shuffled to someone else less familiar with correct billing, making you vulnerable to inaccurate and non-compliant billing commonly resulting in delayed (or worse, lost) revenue?  At this point, you are now paying double because you are paying someone their benefit time to be off, plus you’re paying someone to temporarily handle your billing in their absence.  There are also administrative costs associated with billing (think credentialing, managed care contracting and negotiations, CAQH update and maintenance, CMS re-validation etc) that are typically overlooked when trying to come up with the true costs of having your own billing department.

How is a Medical Billing Service any different from your own billing department?  While I won’t speak for other Medical Billing Services, I will speak for MBO.  It is our long-term routine practice to cross train each employee and have them regularly perform other duties so as to prepare for unscheduled absences.  If your dedicated account representative is out of the office, there is a back up (at least 1, but usually more) that knows your account and all the variances to ensure billing stays on track and in compliance.  You no longer pay “double”, once for the employee’s benefit time to be off work and then again for the employee trying to perform the tasks at hand.  All costs associated with education, continuing education and new certifications are already factored in to all billing rates over time. For example, if you have to pay $1,000 for someone in your billing department to get their CEU’s, you won’t see that cost from MBO.  These costs are factored in and are deducted from our profit margins. Your office will always have an assigned person that they can refer to for all matters. No more dealing with human resources, no more lost productivity in an absence, no more taking patient phone calls about their billing, no more sending out statements or filing insurance claims, no more delays in follow-up for delayed claims, no more appeals for denied claims, and because MBO utilizes the most current high tech and state of the art equipment and processes, you will also benefit from our guaranteed 98% first-pass claims, which gets you paid faster.  MBO has long-term employees, most have been with us over 15 years.  Neither you, your staff or your patients will ever deal with a language barrier or off-shore response, we are right here in the United States located in Jefferson City Missouri and we welcome your visit to see what we’re about.  In the beginning of this blog, I referred to us as a professional Medical Billing Service providing end-to-end Revenue Cycle Management Services.  What exactly does that mean? Think credentialing. Think CAQH.  Think managed-care negotiations. Think re-validation. Think accounts payables. Think specialty reporting. Think month-end reports. Think I.T. and programming.  These are labor intensive tasks that most billing departments don’t handle.  Quite frankly, it’s the same at MBO.  We have individuals dedicated to administrative tasks but are not part of the actual billing processes.  Simply put, MBO is YOUR professional Medical Billing Service dedicated to YOUR practice and YOUR success, after all, if YOU succeed, MBO succeeds.  It’s a win-win arrangement.  MBO would love to be part of your winning team.  Call us at 573.634.7155 and let’s discuss in further detail how MBO can meet the specific needs of your practice.