Medical Billing – Physician Credentialing
CMMS provides full-cycle electronic billing for medical practices as well as Physician credentialing to keep our providers’ carrier information up-to-date. In today’s Healthcare market, the physician is feeling the burden of Meaningful Use requirements, understanding EHR technologies, Quality Care reporting, the ICD-10 transition, reimbursement reductions and constantly changing contractual guidelines mandated by carriers. Meeting the billing requirements of Insurance Carriers as well as the expectations of the Patient is becoming increasingly difficult. CMMS provides the level of expertise physicians and practice owners need, allowing us to take care of the industry challenges while they provide quality healthcare to patients. Let us do the same for you!
Internal Billing & Compliance Audits
Medical practices are among the top 5 small to medium sized business that will experience FRAUD at least once during their tenure. CMMS performs internal billing audits for both “in-house” billing departments and third-party billing services. All too often – and when rarely a “check and balance” system exists; billing services can become complacent. In a world where the rules are changing almost on a daily basis, a regular review of your current billing and best practices is always a good idea. CMMS will audit most areas within your practice, regardless of software or EHR “type”. Listed below are our most commonly named “problem areas”.
Reconciliation Processes Back Office DOS vs. Days-to-Submission Charge Edits Coding & Compliance
Financial (Batch to Bank) A/R Time Value Of Money Accuracy ICD-9
Batch Claim Transmissions Denial Trends Industry Standards Timely Updates ICD-10