Author Topic: Missing anything?  (Read 2053 times)

easternbikes540

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Missing anything?
« on: September 03, 2009, 03:33:34 AM »
So I think I have a pretty good idea of what I need to get started. I have picked CollaborateMD as my software, I have prepared a compliance plan. I have E&O Insurance lined up. I have two other businesses and this one is for my wife who has been billing for over three years. She wanted to do this for herself instead of someone else, but I am totally oblivious to the medical billing business. So, I know how to advertise and own some printing presses and brochure folders, so advertising shouldn't be a problem for me since I can fairly cheaply mass produce business card, brochures and put together mailing as I do this for myself all the time. I have plenty of office space from another company so I plan on setting up shop next to the other company. I have a lawyer who writes my LLC's so I will be using him for this and then registering the business. My question I guess I'm getting at is: is there anything I am missing. I know I will learn a lot as I go, but again I am clueless in this industry and don't want to forget a major part of start up. Any advise, input or opinions would be helpful. Thanks to all who have helped me in the past on this forum. There is a lot to be learned in this industry hopefully my wife's background in billing and my background in business will work out for us.

Steve Verno CMBS, CEMCS

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Re: Missing anything?
« Reply #1 on: September 03, 2009, 05:49:10 AM »
I dont know what your local business requirements are such as equiring occupational licenses.

How do you plan on getting data from the provider?  

How do you plan on storing PHI materials such as charts, EOBs, and correspondence.

Have you addressed the Red Flag Rules in your plans?

Do you have copies of your provider's health insurance contracts?

Do you have copies of the providers financial plan so you can address uninsured discounts, time payment plans, and financial hardship.

Does the provider use a debt collection agency and what will you have to do when the patient reveals insurance or the debt collection agency refers the patient to you.

How will you handle refund of overpayments

Does your Medicare and Medicaid vendor require you to enroll as a billing agent.  Have you worked with them on EDI requirements.

Just came to mind:

i the provider using a lock box and if so. how will you get this information?

« Last Edit: September 04, 2009, 03:47:58 AM by Coding4aliving »
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easternbikes540

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Re: Missing anything?
« Reply #2 on: September 03, 2009, 11:53:47 AM »
1Q.How do you plan on getting data from the provider?

1A. Are you asking how will I get the initial database from the provider upon start up into my software or how will I be receiving superbills and charts. The reason I am choosing to go with collaboratemd is because they claim to be able to import data from all databases and other software.

2Q.How do you plan on storing PHI materials such as charts, EOBs, and correspondence.

2A. For these materials I am under the impression that they require a fireproof locked cabinet or filing cabinet with locks. I also have a storage space in my office building that only I have access to and am planning on using that to store old charts, superbills, eobs and anything HIPAA sensitive.

PMRNC

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Re: Missing anything?
« Reply #3 on: September 03, 2009, 01:06:56 PM »
Quote
1A. Are you asking how will I get the initial database from the provider upon start up into my software or how will I be receiving superbills and charts. The reason I am choosing to go with collaboratemd is because they claim to be able to import data from all databases and other software.

Be careful.. I don't import data because I like my databases setup just so.. and I don't care what company does it, there's no such thing as a good clean conversion... usually if you are taking over the billing you are taking over someone Else's headache.. bad data in..bad data out.

What I think Steve meant was how will you be receiving your daily/weekly work.. (fax, pickup, Mail, FedX. etc)  Myself personally I leave this up to the client but I prefer fax.
Linda Walker
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www.billerswebsite.com

Pay_My_Claims

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Re: Missing anything?
« Reply #4 on: September 03, 2009, 01:58:11 PM »
yes, i love safe Fax.......... ;D

PMRNC

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Re: Missing anything?
« Reply #5 on: September 03, 2009, 09:46:32 PM »
I've been through many a conversion and NONE of them were cut/dry. New billers usually don't really understand that the formation of your data is extremely important and that starting off with GOOD data in a CLEAN database is the BEST way to do it. As you go along you will see what I mean, the better the data going IN..the better the reports!
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

easternbikes540

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Re: Missing anything?
« Reply #6 on: September 04, 2009, 02:50:38 AM »
Makes sense.. For receiving data daily I figured fax would be best. That's how my wifes work does it, but I will have no problem letting the customer pick what he/she feels is best.
So are you suggesting that when you get a new client you manually enter all the data into your database? Sounds like the best way to ensure its input the way you want it.

Steve Verno CMBS, CEMCS

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Re: Missing anything?
« Reply #7 on: September 04, 2009, 03:55:32 AM »
data:  EOBS, payments, correspondence, copies of insurance cards, charts, superbills, attorney requests

We tried fax with one client. It didnt work.  We would be missing pages. Th cover sheet said 11 pages and 2 came across. Some came across fuzzy, some came across with the top half of one document and the bottom half of another document as the pages stuck. Some had to be resent due to the fax machine being out of paper. Someone decided they needed paper for notes and took it from the fax machine.     Some came across with partial info due to the non removal of a staple. In some cases, we didnt get anything due to a wrong number dialed. 
I'l have a double chubby chuck, a mexicali chilibarb, and two cherry cokes
Left hand Blue, Right Leg Green
You got your peanut butter on my milk chocolate.
Dont cut the blue wire! 
I love spam.