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WHAT WE DO...

SERVICES OFFERED

Complete medical billing and accounts receivable management

By achieving higher levels of reimbursements, our clients have seen a noticeable improvement in their income as well as significant savings in billing costs. We eliminate unnecessary billing stress and headaches.

At APS, we take a very professional and courteous approach to our client's and their patients because we see ourselves as an extension of your practice. Our goal is “keeping a pulse on your practice’s revenue” to create maximum reimbursement by:

  • Entering charges and payments within 24-48 hours of receipt – including review, entry, and submission to insurance carriers.

  • Submit all claims electronically through our clearinghouse, which drastically reduces the percentage of manual errors by insurance companies and creates faster payment.

  • Follow-up on all unpaid insurance claims on a 10-30 day cycle to ensure claims are being processed correctly and expeditiously.

Accurate and compliant coding for maximum reimbursement

Utilizing compliant and accurate interpretation of the Evaluation and Management guidelines, our certified coders can handle all your E&M coding needs and other code abstraction. In addition, we will provide code review for the CPT, ICD-9 and/or HCPCS codes and the application of appropriate modifiers on your current Charge master.

Other Services

  • Physician Credentialing:

    The provider enrollment/ credentialing process with the payors can be an extremely tedious, and if not done properly, can COST YOU LOTS OF MONEY IN LOST REVENUE.

    Our outstanding team of consultants brings years of experience and will handle the entire process for you from start to finish with real time updates throughout the process.

    We can quickly credential you with the necessary payers and always ensure our clients receive fair compensation from the insurers. Whether you are a Community Hospital, multi-specialty group, or a solo practitioner, let our experts help you expand your business or start you off on the right foot. We provide the services on the highest PROFESSIONAL level and QUICK TURNAROUND TIME and have MANY SATISFIED CUSTOMERS!

  • Physician Education:

    Physicians often have a poor understanding of the documentation requirements and how they affect coding. This has a significant impact on the proper assignment of DRGs, APCs and of CPT-4 E/M or procedure codes. This can result in loss of revenue and lack of compliance with coding guidelines.

    APS has a wealth of experience in providing education to physicians. Based on assessment of specific documentation patterns and coding needs, APS works with the physicians to gain their cooperation in providing needed documentation.

    APS has years of experience working with physician groups in providing education and gaining cooperation. APS can help educate your medical staff and establish lines of communication with your physicians in order to maintain needed documentation for coding.

    The goal is complete and accurate documentation to support complete and accurate coding resulting in full capture of revenue and compliance with coding guidelines.

  • Compliance Auditing:

    Healthcare providers are faced with a proliferation of compliance requirements related to patient information security, operational practices, service delivery procedures, and electronic health record management. Regulatory compliance requirements and industry standards include JCAHO, ARRA, HIPAA, HITECH, and other national and state regulations for patient safety. Apart from regulatory pressures is the need for healthcare providers to prepare themselves for Medicare and Medicaid audits such as the RAC, MIC, and ZPIC audits .

    APS ensures that healthcare providers successfully meet regulatory requirements by streamlining the various components of their healthcare compliance programs - including tracking regulatory changes, implementing policies and procedures, defining and assessing controls, identifying and assessing the risk of non-compliance, and performing internal audits. The solution also helps improve patient safety by supporting quality programs through document control, compliance training, on-going auditing, and recording and reporting issues and non-conformance incidents and the resulting corrective actions.

  • Fee Schedule Analysis:

    A fee schedule analysis may be just what the doctor ordered to increase practice revenue. Fee analysis can help pinpoint low fees for immediate revision. Comparison of a medical practice's fees to established averages could determine the appropriateness of the fees. In addition, linking the fee schedule to RVUs can result in consistent pricing.

    In recent years, establishing physician fees has become more scientific with a method used as much for setting fees as analyzing codes and insurance contracts. When was the last time you looked at your fee schedule?

    The service involves:
    Relative value unit comparison analysis, Geographic comparison analysis, and Identification of appropriate and/or missing CPT codes

    The benefit includes:
    Capturing the maximum fees from insurance companies; Analysis of codes billed or to be billed, capturing unused or misused codes; Relative value unit comparison to gain knowledge for future or current insurance contract negotiations.

    The result of regular fee schedule analysis can be an increase in practice revenue.

 

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