CPS Healthcare Solutions takes the hassle factor out of billing, enhances income and provides cash flow stability to your practice. CPS partners with your practice to provide a seamless extension of your office that is invisible to your patients. Your office can stay continuously connected to the billing software and scheduler and can print reports on demand to your local printer.
CPS helps the provider to practice more profitably, by collecting more of your receivables and eliminates the stress associated with in-house management of billing and collection.
- CPS will prepare and submit claims utilizing electronic claims submission for all insurance carriers that are capable of receiving electronic claims. Claims can be filed directly to Medicare, Medicaid, and Anthem BCBS, eliminating any third party clearing house and providing faster service.
- Answer Insurance inquires and patient phone calls regarding claims and statements. CPS has a toll free phone number for out of area patients to utilize for account inquires.
- Statement and collection letters
- Post payments, charges, and adjustments to each patient account with line item posting for better tracking of payments per CPT code.
- Audit claim payments for correct reimbursement
- Appeal incorrectly paid claims
- Denial management - Monitor and appeal incorrectly denied claims
- Accounts receivable follow up.
- CPS has over 100 standard reports and can create custom reports tailored to the specific needs of your practice. We help practices analyze their reimbursements for specific services and compare the reimbursement with the cost of the service. CPS also provides color graphs of your practice’s most important data.
CPS includes practice management with its billing services. Some of the services that are provided include:
- Development of a comprehensive billing and collection plan based upon your practice and your needs
- Development of office forms
- Assist Client with Credentialing and Contracting with insurance companies, including Medicare and Medicaid.
- Assist Client with Fee Schedule development and maintenance.
More information about what practice management means for your practice click here.
Expertise in billing requires knowledge of coding and bundling rules, as well as of state regulations. In our rapidly changing medical environment, keeping current with all the changes is absolutely necessary, but often can be difficult, time consuming, and costly, particularly for a single practice. Correct coding can maximize reimbursement and clear claims process more rapidly, resulting in faster payments. Correct coding also prevents fraud and retroactive refunding of claim payments.
Calculations for expected insurance payments are time consuming and require knowledge of RBRVS units, GCPI adjustments, budget neutrality factors and other complex rules. CPS teaches reimbursement calculations to other providers in Northern Colorado and can monitor payments to assure correct reimbursement.
Submission of electronic claims improves cash flow and is required by Medicaid. CPS can assist with obtaining and filing insurance authorization forms for electronic claims and deposits, can perform electronic testing and can provide IT support necessary for smooth electronic billing. AMA statistics show the average cost for in-practice filing is $11 per claim.
Billing service fees determined as a percentage of receipts are invariably less than the costs incurred with retaining these functions within a practice.
Patient calls regarding balances are handled by CPS in a prompt and courteous fashion without interruption to your staff’s busy workday.
CPS provides monthly financial analysis of your practice and compares your practice to national bench marks so that you know exactly how your practice is performing.
Correct coding and knowledge of bundling rules improves your cash flow by decreasing the number of claims rejected or denied by insurance companies.
- The need to hire and train billing personnel
- Hardware costs
- Software costs
- Maintenance, support, and upgrade costs
- Billing related phone calls
- Billing related postage
- Interruption of accounts receivable cash flow due to staff vacation and absenteeism
- The costs of statements, envelops, forms, printer toner, and other supplies