OUR PROCESS

Q. What is your process to work on unpaid claims at In Touch Billing?

At In Touch Billing, we follow a unique mechanism to get you paid.

Phase I

The Detective Phase - Initial Assessment of your Outstanding AR

We identify and analyze everything done in the past, before we start work. We work closely with clients to create an ‘adjustment policy’, which creates a foundation for all future work. We also analyze timely filing limits and several other factors.

Phase II

The Moneyball Phase - Like Getting You Paid Before The Claim is Submitted

We go several steps beyond traditional billing services. We know the filing/appeal limits for all major carriers, we verify all information is correct, and we identify the right person to contact at the payers end. We proactively analyze all documentation, all codes and modifiers before the claim is submitted. It’s as if we get you paid even before the claim is submitted.

Phase III

The Policing Phase - Pressuring the Payers to Pay You with our Proprietary 3-pronged Approach

Submitting a claim with the right codes isn’t enough. We use a combination of letters, faxes and phone calls with proprietary scripts to get you paid. Not only do we appeal claims that have exceeded the timely filing limit, we become your advocates by putting payers on the defensive for you. We don’t allow the payers to dictate terms. We take control of the process since we advocate for you. For example, did you know that you have a right to complain to the OIG, if the payer is not paying you within a designated time frame? The payer is legally obligated to respond within a designated time period.

Q. What makes you different?

What makes us different is everything we do before and after your claim is submitted. We prime you for success even before we submit a single claim.

Pre-launch

We audit your practice before you come on board.

Launch

We spend the first 60 days understanding your billing patterns and collaborating with your staff.

Post-Launch

We provide recommendations to optimize your claims and improve reimbursements. We renegotiate payer contracts. We verify benefits. We credential new providers.

Q. What is the best way to ensure shared success?

Collaboration between In Touch Billing and your staff.

We collaborate with your front desk and handle all payer communication and patient communication. Your staff is part of our shared vision of success. Your staff and our staff demonstrate humility and cooperation for joint success.

Your staff collects patient payments and focuses on building patient relationships. Your staff helps your practice get more referrals.

Q. How do you prioritize unpaid claims?

We prioritize all unpaid claims based on:

1High Dollar Claims with High Aging

Claims with a high dollar amount approaching the timely filing limit.

2High Dollar Claims with High Recency

Claims with a high dollar amount more recent in nature. Usually, these claims are denied because of singular factors (missing modifiers, payer guideline updates.

3Low Dollar Claims with High Recency

These claims have higher probability of payment since they are more recent in nature.

4Low Dollar Claims with High Aging

These are important to handle, but only after the 3 categories above are handled.

Q. How do you communicate your follow-up efforts with our Clinic on unpaid claims?

We maintain two sets of notes:

1Internal notes

These are maintained at our end after each of the 30 day follow-ups. The payer typically asks us to 'call back next week' or says 'no update' yet and that's why we keep these notes internal. This is done to avoid unnecessary clutter in the 'call notes' section of In Touch Biller Pro. However, if you would like us to place these 'internal notes' every 30 days inside In Touch Biller Pro going forward for all your unpaid claims, we are happy to do so. Just notify your representative and we will add these internal notes to In Touch Biller Pro for you.

2In Touch Biller Pro call notes

These are documented inside the ‘call notes’ area in the patient record in In Touch Biller Pro, when there is a change in status from the payer, or if the payer provides a different set of instructions in order to release payment. Essentially, the note is no longer 'internal' but is made visible to the client through the call notes timeline. Sometimes, the timeline gets dragged out by certain payers. For example, if a payer asks us to wait 30 business days, or if a payer asks us to send an appeal letter and follow up with the claims adjuster after mailing the appeal letter, or if a payer asks us to resend the claim to the 'reconsideration department' and so on.

Q. What is the best way to ensure shared success?

Proactive claim denial management is a more efficient strategy than reactive measures.

We encourage clients to schedule a ‘monthly AR meeting’ to discuss the 'big picture' and ‘needle movers’ with your account.

Please set aside 20 minutes every month to review your AR with your In Touch Billing representative. On these calls, we'll proactively discuss questions related to claim denials, identify areas to improve collections, and make best practice recommendations for your front desk and clinicians. We are also open to feedback about the work we do, so we can collaborate more effectively.

Q.What is your process to work on appeals at In Touch Billing?

We monitor denial rates on a daily basis. We anticipate payment based on the date the claim was submitted. If the payment is not received, we can anticipate a denial and prepare an appeal proactively.

For each client, and for each claim, we use a specially designed appeal letter. This is precisely crafted to trigger an instant response from the payers.

We are aware of all the ‘payer tricks’ like downcoding claims, and we appeal aggressively with supporting documentation. As long as the claim is supported by medical necessity, we will get you paid. We will retrieve supporting documentation and make sure all ICD-10, CPT codes and modifiers are submitted correctly.

Q. What is your approach to prevent claims that are “NOT ON FILE” with the payer?

With Workers Comp and Auto Payers, this is an ongoing issue.

Once the paper claim is mailed out with supporting documentation, we follow up on day 7 to verify receipt. If needed, we mail / fax out claims again and continue to follow up until receipt is confirmed by the payer.

Q. Do you have a performance benchmark?

With our streamlined AR processes, multi-layer audit and stringent claims follow up mechanism, our benchmark is that the AR above 90 days should be at or below 10% of your total AR.

Q. How do I schedule my monthly AR review call?

A dedicated account manager at In Touch Billing will coordinate with you and schedule a 20 minute AR review meeting each month.

We use our decades of insight to provide you with a comprehensive collection report. We work closely with you to proactively identify issues, implement fixes and prevent denials. The goal is to help you get paid more, faster.

In 10 minutes, we’ll show you how In Touch Billing can slash your billing costs and boost revenue.

Schedule this no-obligations call. Ask for a FREE billing audit to learn new ways to increase revenue and reduce denials.

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