Revenue Cycle Management

Revenue Cycle Management (RCM) involves all administrative and clinical functions that contribute to the Capture, Management, and Collection of patient service revenue.

Capture: Prior to every new patient visit your office staff must Verify Benefits and when required Obtain Authorizations to avoid claim denial. Co-pays should be collected prior to each patient visit.

Management: Data Input Must be Accurate to Avoid Delayed Payment or Denied Claims. Claims should be tracked and EOBs reviewed prior to Posting Payments.

Collection: To Maximize Practice Revenue, Accounts Receivable should be continuously evaluated until paid. To avoid erroneously inflating the AR, any negotiated discounts should be written off when posting payments. Patient Statements are generated or Account Balances Collected prior to the next office visit.

We Balance the Day Sheet - You Deposit the Money

We review every patient encounter prior to electronic claims submission. Explanation of Benefits are reviewed, payments posted and statements mailed. Patients call us toll free with billing questions.

Verify Benefits and Obtain Authorizations

Dramatically improve your collection rate. Verify insurance benefits and obtain authorizations prior to rendering services.

Employee Theft

A 2009 Medical Group Management Association (MGMA) survey reveals that medical offices loose an estimated $25 million annually from theft and embezzlement. Podiatry Billing Services posts all transactions, including cash, which dramatically reduces the opportunity for embezzlement.

AR Days

Accounts receivable days is the number of days from the time a charge for service is filed to the time it is collected. The measurement is a good indication of collections and cash flow.

Satisfy Meaningful Use

Podiatry Billing Services has partnered with CollaborateMD and practice fusionTM web-based solutions for medical billing and Electronic Health Records. Access your patient financial records and medical records via the internet. Satisfy Meaningful Use and Earn Stimulus Money. Avoid Penalties.

Starting a Practice

Begin the process by acquiring a State License. Most applications are available online. The following links direct you to the DEA, NPI and Medicare Websites.

• DEA (Drug Enforcement Administration) License

• NPI (National Provider Identifier)

• Medicare PECOS (Provider Enrollment, Chain and Ownership System)

• Medicare PECOS (Check Provider Status)

Reimbursement Guide

• AMA CPT Search

ICD-10 Transition

• Implementation Guide

Physician Compliance Program

The existence of an effective compliance program can provide evidence that any mistakes are inadvertent. Suggested components for a voluntary compliance program:

 • Conduct internal monitoring and auditing

 • Implement compliance and practice standards

 • Designate a compliance officer or contact

 • Conduct appropriate training and education

 • Respond appropriately to detected offenses and develop corrective              action

 • Develop open lines of communication

 • Enforce disciplinary standards through well-publicized guidelines

Download: OIG Compliance Program

APMA Manuals

APMA HIPAA Manual 2013

APMA Summary of Changes in HIPAA

Improve Office Efficiency

• FlowChart

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