Billing > Billing
Charging a Fee - Need assistance asap!
PMRNC:
--- Quote ---Is this a primary care practice? You do want to be sure that you are tracking the monthly checks and withholds if the practice is contracted with capitated plans.
--- End quote ---
I'm doubting that number on capitation out here on East coast, let alone NYC.. Capitation has been dwindling over the years big time out here.
RCC:
I was doing a practice analysis and that was one of the figures they gave me? Thanks
PMRNC:
What was the % of withholds.. you also have to remember that GOOD data in is good data out. I can't tell you how many times I've done a practice analysis only to have the practice put crap data in and expect a miracle with reports coming out. LOOK at "WITHOLDS" when dealing with capitation.. HOPEFULLY the practice was diligent in their data.
Remember that NO software in the world can work with crappy data.. sorry to be blunt but I've seen medical billing companies and doctors expect a miracle with data and reports but never TRACKED their data properly. I NEVER take an account I can't get into their system to run my own numbers.. I don't trust someone Else's means of data.
RCC:
Thanks. Right I only can go on what they told me and they already have a biller, I just reached out to them and they allowed me to do the practice analysis and asked for their reports, they said the biller never gives them any. So I asked for them to get one so that I can see for myself. But I am not sure what I am looking for, I wanted to see the aged reports to see and show them where they were losing money.
PMRNC:
--- Quote ---Thanks. Right I only can go on what they told me and they already have a biller, I just reached out to them and they allowed me to do the practice analysis and asked for their reports, they said the biller never gives them any. So I asked for them to get one so that I can see for myself. But I am not sure what I am looking for, I wanted to see the aged reports to see and show them where they were losing money.
--- End quote ---
What kind of experience do you have.. when I'm asked to analyze a practice I ask for following reports:
Full A/R by patient and by carrier
Full report of all managed care adjustments
Medicare/Medicaid/WC/PI for last year
carrier contracts - might seem like overkill but I know what to look for in problem contracts
Staff/office report - those involved in billing process, hours worked on average, etc. This helps me find problems within the office
over 90 day claims analysis
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