REVENUE CYCLE MANAGEMENT
Fee Schedule Development & Maintenance
Coding, billing and collection efficiencies impact your bottom line only to the point where you collect the payment negotiated in your third party payer contracts. Too often, practices accept a third party payer’s standard reimbursement rates or an amount only marginally above the standard rate. In some cases, the payers’ standard reimbursement rates are even lower than the Medicare fee schedule.
Typically, it is much better to secure higher reimbursement rates initially and ask for smaller increases at renewal than to accept low rates up front expecting to negotiate larger increases later. The MRI team has experience with payers and understands their negotiation processes. As our client you can leverage our knowledge and use your practice’s strategic importance to secure higher reimbursement rates. We have negotiated significant rate increases for many clients from the largest payers in their region. And, we have achieved these results for clients whether they were participating with payers for the first time or had long contract history. Depending on your practice’s specific payer mix, MRI’s negotiated rate increases can improve bottom-line revenue. We will be happy to negotiate on your behalf or review any third party payer contract your practice may be considering.
Overall reimbursement rates can be positively impacted if you have a complete and appropriate fee schedule and sound fee schedule policies. When it’s time to establish or update your fee schedule, you can rely on the insight of the MRI team to help identify the methodologies that will work best for your practice and guarantee compliance. Whether you prefer a relative value unit (RVU) reimbursement or cost-based charge setting methodology, our experts will help you develop the right fee strategy to capture the maximum reimbursement possible. And because there are many myths in healthcare related to fee schedule development and compliance, MRI will share with you the most current regulatory references regarding fee schedule policies and work to develop a fee schedule that complies with your specific State regulatory parameters.
Additionally, our access to national and regional databases allows us to provide charge recommendations that are specific to the major insurance carriers in your area, as well as your local market. By continually monitoring specific insurance carrier profiles, we provide you with the data needed to support fee increases. We provide the following:
We offer sophisticated file management capabilities with a range of solutions to meet your needs, including secure FTP, scanning, XML or HL7 interface, as well as faxing or emailing files directly into our system. MRI’s system automatically attaches all medical records, face sheets, and other information to your account. All data is maintained electronically therefore no files are lost or mixed up. This drastically reduces days off the A/R cycle through rapid claim submission, while increasing collections by ensuring that no document is lost.
MRI offers complete software solutions including electronic medical records (EMR/EHR), practice management software, and document management. In addition, we can interface to your existing EMR, RIS, LIS, HIS, or other system via HL7 interface.
MRI provides consulting services for new start-ups and existing practices. We train your staff on how to improve your entire billing process. There are no upfront costs and we collect a fee based on a percentage of the increased revenue.
We protect your practice against incorrect medical codes, data entry mistakes, and missing information, all of which can amount to costly delays, denials, and re-submissions. Most importantly, MRI reduces your compliance risk with accurate coding. MRI is HIPAA compliant and uses several proprietary methods to ensure protection of patient information.