At OptiMED, we’ve been in the business long
enough to know it’s not one-size-fits-all. That’s
why we’ve created a solution tailored to meet your
needs. We offer medical billing and management options that
are We work
it out to suit your leadership style. But the bottom line
is that more patient bills are
settled faster, with less strain on your staff. Revenues
up; headaches down.
OptiMED’s services range
from initial setup to ongoing billing, maintenance, training,
reporting, and more.
Our service
representative will provide a comprehensive study with
physicians and office
management to address all concerns about current practice
management processes in place. Prior to launch, we will
first fully integrate a practice computer system with OptiMED’s
to ensure a seamless transition and simulate daily workflow.
We will fully train your front office staff on proper procedures
necessary for reimbursement. Part of the process includes
a review and design of encounter forms (superbill) and
much more. Our attention to detail and ease with which
we communicate to your staff means a simpler transition
of your billing management functions. ^ top
OptiMED can review
all superbills for ICD-9 & CPT-4 coding accuracy.
Our AAPC Certified Professional Coders (CPC) have the
skills and knowledge to ensure compliance
with both the 1995 and 1997 E/M coding guidelines as well
as inpatient and outpatient procedure codes set forth by
CMS. In other words, we implement a system with cleaner
claims for a faster turnaround. ^ top
Once OptiMED manages the billing cycle, all claims
are reviewed,
scrubbed and clearinghouse inspected within 48 hours of
receipt. OptiMED then submits claims electronically to
over 1350 accepting insurance companies, including Medicare,
Medicaid, BC/BS, United Healthcare, Aetna and many more.
Secondary claims are electronically “crossed over” where
available. Carrier specific, electronic reimbursement averages
between 7-14 days. ^ top
OptiMED will submit paper claims on standard
CMS-1500 forms where detailed/complex billing and secondary/tertiary
billing is not accepted electronically. Our certified coders
are adept at handling complex issues.
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OptiMED’s
use of industry leading AdvancedMD’s software systems
allows us to quickly flag denied and unpaid claims. Our
system
notifies our reimbursement specialists of any unpaid batches
or individual claims, which are then handled with aggressive
follow-up. This process ensures that nothing goes unpaid
or unnoticed regardless of the amount or time that has
elapsed. Continuous, aggressive monitoring of aged accounts
is one of the key factors that separates OptiMED from our
competitors—and results in higher revenues for your
practice. ^ top
At OptiMED, our skilled and experienced reimbursement
specialists
are equipped to precisely determine what corrective action
is necessary and appropriate to resubmit or appeal denied
claims in a timely manner. And our extensive reporting
capabilities are always available for your review. Aging
reports, procedure analysis reports, and summary reports
are just a sample of the hundreds of up-to-date reports
available to you and your staff. ^ top
OptiMED will bill patients for uncollected
co-pays and balances
due according to their insurance coverage policies. We
will send four professional patient statements at 30, 60,
90, and 120 days. Our representatives will begin patient
telephone calls starting at 45 days to encourage timely
payments. On your behalf, we will arrange payment plans
with patients when necessary. OptiMED will discuss policies
and decisions with physicians or the designated office
manager and will work with any collection agencies when
applicable. ^ top
Our experienced
staff can directly handle all patient inquiries and quickly
provide correct
information, optimally freeing your office to focus on
patient care. ^ top
To increase productivity and decrease the time it takes
for you to
receive insurance payments,
OptiMED uses both electronic remittance advice (ERA)
and electronic funds transfer (EFT) services, where available.
This funds transfer technology frees time that allows
us
to focus more on complex denials and appeals that otherwise
might not get the extra attention needed.
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Both your practice and OptiMED will be equipped with simultaneous
real-time patient verification and eligibility access.
This technology ensures that your office and ours will
have the most current policy/benefit information available
upon check-in, including deductibles & co-pays. ^
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OptiMED’s
adaptation of the latest web-based software allows us
to seamlessly integrate
our systems with yours. Both your office and ours will
have real-time, secure access to all practice management
information. By integrating systems in an online environment,
it becomes easier to manage multiple offices, computer
systems, and appointment schedulers. This Application Service
Provider (ASP) model brings efficiencies, features, and
security not available in older, problem-prone systems
used by most billing centers today. ^ top
As
a no-cost, added value service to you, our staff will
prepare provider applications
for all insurance companies with whom you choose to participate.
This service includes gathering all pertinent information
and documentation needed for a successful application.
OptiMED will monitor this process until you are an “In
Network” provider. ^ top
OptiMED endorses
and is committed to all HIPAA privacy rules and regulations.
Our solutions
establish an environment that promotes high standards in
legal and ethical behavior. We monitor continuously changing
federal laws to keep our business associates ahead in an
evolving healthcare environment. OptiMED’s clients
are secure with the knowledge that we have implemented
a strict Code of Conduct and Compliance Plan and that all
staff members are committed to the highest business ethics.
We strictly adhere to regulations governing third party
billing centers as set forth by the Office of Inspector
General of Health and Human Services. ^
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Reports are vital
to managing a successful practice and planning for the
future. Accurately measuring
your practice’s financial health is essential in
today’s healthcare industry. OptiMED provides fully
customized, real-time, weekly and monthly reports which
allow decision makers to fully evaluate practice management.
Our reporting capabilities provide incisive data necessary
for informed, knowledgeable decisions. ^
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Accurate coding
is key when it comes to complying with government regulations
and optimizing revenue—even
on a daily basis. OptiMED offers coding audit services
which will provide your practice with valuable information
such as:
- Identifying
potential areas of lost revenue due to undercoding;
- Ensuring adherence to CMS
1995 or 1997 coding and documentation guidelines; and
- Optimizing reimbursement and
compliance through continuous evaluation. ^ top
OptiMED is determined to help position your practice
for current and future success.
With success in mind, we continuously address all physician
and staff concerns and update personnel on changing reimbursement
legislation and coding requirements. ^
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To ensure fast,
easy tracking and claims accountability, all claims are
batched and recorded
to each reimbursement specialist. This means your claims
receive consistent, personal attention. ^
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OptiMED can customize
your Superbills, Patient Registration Forms, and Authorization
for Release
Forms for your practice’s specific needs.
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Call today to set up a free initial
consultation:
Sarasota
(941) 927-2245
Boston (617) 803-7941 |