Medical Billing Automation

We advise all doctors to have a “strong billing contingent.”  Here’s what that means:

  1. They know how to find missing patient information.
  2. They know how to determine charge codes based on medicaldocumentation.
  3. They know how to work denials.

In this business, we deal with the same mistakes and problems on a regular basis. The wrong insurance, incorrect birthday, missing the place of service—we see these mistakes ALL THE TIME.

That’s why we invented Charge Review. It’s a tool for the coders and billers. We use it every day to deliver an industry-high collection rate with less operational costs.

The most powerful piece of Charge Review is automation. We kept correcting the same mistakes. As our billing company grew, those corrections were costing us hours and hours of labor. We determined that we could automate a lot of the errors we see every day, turning our repetitive changes into a customizable rules engine. Today, we have hundreds of rules for our billing company, the sum of which saves us countless hours. For example, our rules engine removes SELF PAY if there’s another insurance on the patient’s record. Any part we can automate, we do. What would you automate and how many hours could that save you?

Having eliminated all simple errors, we are left with claims consisting of common errors. We take the most common mistakes and organize them according to missing data. So every claim that’s missing facesheet data redirects into one bucket, allowing you to work through them all at once. And every claim that needs patient demographics is organized by place of service, allowing you to make one phone call to that facility for all the patient demographics you need. Think of it as organizing chaos. Instead of having mountains of work, organize it bucket by bucket. Once you have the buckets labeled, you can assign different levels of urgency, dedicate specific employees to each, and standardize the process of resolving the missing data.

Thus, the benefits are twofold: (1) automation corrects simple errors and (2) organizes the rest.  Automation is the reason we’re able to operate at our current profitability margin, and in the grand scheme of things, we are only at the beginning of the automation enhancements to medical billing.