Hospital-based Multi Specialty Billing Services

Hospitals are expanding their physician footprint on a regular basis. As a result, many hospitals now have employed and/or affiliated multi-specialty physician groups. However, “multi specialty” in one hospital is usually quite different than multispecialty at another hospital: the mix of specialties, financial structure, governance and other factors are often more different than similar. As a result, coding, billing and reporting needs are very different.

Regardless of the makeup, AdvantEdge multi-specialty billing services meet the needs of these complex groups. Comprehensive revenue cycle management solutions start with interfaces to ADT, EMR and electronic charge capture systems to minimize errors and delays in the billing process. Where coding is required, certified AdvantEdge coders review physician and other provider reports and generate the appropriate CPT and/or ICD-9/10 codes. The rigorous workflow includes charge entry, claims scrubbing, claims filing, payment posting, denial management, patient billing, A/R follow-up and comprehensive reporting. The workflow is specific to each specialty in order to maximize collections and to capture all of the information needed for reporting, such as PQRS measures.

Since each multi specialty group is structured differently, billing technology must be highly flexible and adaptable. AdvantEdge uses its own Virtual Manager system which can be configured to deal with any combination of tax IDs, specialties, locations, reporting groups, and users. Many systems lack this flexibility which results in limited reporting and, in some cases, difficulty in posting payments to the correct group or sub-group.

Hospitals and the physician heads of each department require reporting tailored to their unique local circumstances. In addition to analyses of charges, adjustments, payments and A/R, productivity (e.g. RVU) and quality measures are needed. With current data that can be summarized or viewed by drilling down, the AdvantEdge InfoEdge dashboard has the power and the flexibility to meet these needs. User profiles can be set up for administrators, department chiefs, location heads, analysts and even for individual physicians. Each user sees only the information for their respective scope. All of the information is HIPAA secure, easy to access and view and can be downloaded to Excel for additional analysis.

Compliance is another dimension that requires attention for multi-specialty groups. At AdvantEdge, compliance is built in to every workflow, with each employee receiving extensive compliance training on a regular basis (minimum of once per year). Just as important, every member of the AdvantEdge team knows that coding and billing must always be done in a fully compliant manner, even when that means “stopping the line” to confirm that work is being done correctly. An active Compliance Committee, with representatives from every office, handles daily questions with frequent feedback and education.

AdvantEdge hospital multi-specialty billing services include ClientFirst service: a dedicated Client Manager responsive to the group’s needs and working every day as a partner with the group.

Call us now at 877 501-1611 to learn more.