Tired of Getting "Screwed" on Insurance Claims?

Cash Flow Specialists, Inc.

Toll Free (800) 669-2700

There are several solutions that your practice can implement to improve your bottom line. This report touches on several of them. We provide practices like yours with ways to streamline their operations, increase cash flow, reduce expenses, and manage their finances more effectively so they can achieve their goals, grow their practices and be more successful.

Doctors Have A Hard Time Collecting Insurance Reimbursements.

Most people know a large percentage of doctors' revenue comes from patients' insurance. Many people, however, do not realize that the process of filing insurance claims is cumbersome, time-consuming and expensive. Insurance companies make doctors jump through hoops to get paid. Then they pay out as little as possible. After all, every unpaid claim means more profit for the insurance company.

For doctors, filling out insurance claims is expensive. First, they must spend 10 to 15 minutes filling out a standard form, called an HCFA-1500, for every patient. With a heavy patient load, this chore could take doctor hours a day. If any part of the form isn't filled out perfectly, the insurance company will reject the entire claim and return it unpaid. The doctor then must determine the problem, attempt to fix it and resubmit it…and hope it passes through the second time.

The results of this frustrating routine are startling: 32% of claims are rejected, 5 to 15% are lost in the shuffle and never collected, and the average time it takes doctors to collect their money is 60 to 90 days. Medicaid claims take even longer.

This costly process also increases the doctor's overhead. The New England Journal of Medicine says a doctor's overhead and billing expenses account for 43.7% of his or her gross income. This translates into an average cost of about one and a half-clerical workers per doctor at an annual cost of $54,704, not including benefits. (California wages $17.53 hr.)

Medical Claims Recovery Service (MCRS)

Instead of doctors relying on their staff to file claims, they can now outsource the entire process to a medical accounts receivable management professional like us. MCRS works in partnership with the doctor's office for the quickest recovery of all claims payments.
Internal staff members focus their efforts on the recovery of the 60-day-old (or under) claims - thus maximizing their productivity.
Claims in excess of 60 days delinquent are assigned to MCRS. NRC will contact each delinquent provider multiple times on the doctor's behalf.
MCRS's contacts advise payers that they cannot continue to ignore the claim.
At doctors option, non-responsive insurers can be assigned - on a contingent fee basis - to the program's Secondary Contingent Recovery Division (SCRD) where full follow-through, including calls by specially trained medical collectors, will be used to recover doctor's money.
MCRS accelerates doctor's portfolio of delayed third-party provider/insurance claims while improving cash flow and profitability.
In-house efforts can total as much as $49 per claim and still not be recovered. A partnership with MCRS will result in a fixed fee of $9 or less per claim.

Here's how Doctor Will Benefit:

Benefit #1: Collects Money Faster: Electronic filing drastically reduces the time it takes to collect from the insurance companies from 60 to 90 days down to just 7 to 21 days. This is possible because electronically filed claims are handled by computers and therefore bypass all the human "gatekeepers" with insurance companies who typically bog down the process.

According to "Computers in Healthcare" October 1998 "about 80% of all healthcare claims originate in the physicians office, but only 23% of these claims are automated. The vast majorities are still handled manually. I'm researching current statistics (5/01) but the numbers don't appear to have improved.

Benefit #2: LOW Rejection Rate: The rejection rate for claims plummets from about 32% to less than 2%. Claims that aren't rejected move through the system faster, and get paid quicker. Unlike paper claims, electronically submitted claims can't be lost, because they produce an acceptance report from the carrier that ensures receipt.

Benefit #3: FREES Up Doctor's Time. Many doctors spend as many as one and half to twohours a day dealing with insurance claims or paying someone to do so. When doctors outsource the electronic medical claims filing to us they can concentrate on patient needs, as can their employees.

Benefit #4: IMMEDIATE Savings: The doctor saves money by outsourcing the billing to us. A recent survey in the Medical Group Management Journal showed that the average cost of internal billing practices was 11% of the practices' income. Our outsourced claims service, on the other hand, charges a range of $7.50 to $9.00 per account depending on the number of accounts purchased…usually less than 5% of the practices' income.

Medicare has been encouraging doctors and hospitals to use electronic claims filing for years, and gives special incentives for doctors who switch. Many managed care providers are also offering incentives to doctors who switch to electronic filing. It is estimated that within the next few years the number of doctors who use electronic filing will surpass 50%.

We Specialize in Medical Accounts

There are two vital areas where cash flow can be slowed or lost: Self-Pay Balances and Delayed/Denied Third-Party Claims.

Only NRC offers services to address these two critical cash flow needs for doctors' practice.

The NRC Tandem Program is a full-service collection program designed to recover delinquent self-pay balance accounts. The service utilizes custom contacts, and professionally trained medical collectors will conduct multiple call campaigns. These specialized contacts enable doctors to effectively meet the challenges of slow-paying and delinquent debtor-patients while preserving doctors' image and reputation.

The Tandem Program works to maintain doctors' practice self-pay cash flow and NRC's proprietary Medical Claims Recovery Service (MCRS) to swiftly recover outstanding, third party, provider claims.

MCRS provides formal written demands on your delayed and/or denied third party payer claims. NRC's ongoing contact will give doctors practices outstanding claims higher payment priority, and doctors' cash flow will be substantially increased.

Working together, Tandem and MCRS provides total protection against delayed and lost revenues....

Reduces the cost of funding your receivable portfolio
Improves the efficiency of your internal staff
Speeds cash flow, improving practice profitability and income distribution

MCRS - a State-of-the-Art Solution to Recover Delayed Insurance Claims

MCRS is an effective way to recover delayed money, and it's easy to use in your practice:

This Internet-based, online service gives your practice the speed and efficiency of electronic claims recovery, updating and reporting.
No forms to mail. Use your Internet provider and NRC's secure Web site to enter new accounts and update account status 24 hours a day, seven days a week.
You save staff time and the expenses associated with mail and telephone follow-up.
There's no software to install or maintain, and MCRS is password protected for security.

Your practice will benefit from this new level of receivables protection for a low fixed fee of $9.00 or less per account for each claim submitted.

MCRS Provides:

A cost-effective way to accelerate your cash flow and the fastest recovery of delayed/denied third-party provider claims.
Solutions to reduce internal staff time and expenses while improving practice profitability and cash flow.
Total protection for the practice's receivables when combined with NRC Tandem Program for self-pay balances.

MCRS includes a 100% Money back Guarantee in the form of a bonded bank voucher - In accordance with the voucher's terms if the service fails to return 300% of your investment within 120 days from the date of the last activator from your system is received, keep what you have collected and submit the money back guarantee for a full refund.

Accelerate Your Cash Flow!

Patient Payment Plan Collecting Money from Patients.

Although a large percentage of a doctor's revenue comes from insurance companies, there is also a significant portion that comes directly from the doctor's patients. Patients often can't pay for treatment right away. This forces the doctor to extend credit to patients, and causes the doctor to either write off tens of thousands of dollars a year in uncollectible bills, or to refuse to treat patients who can't pay in full at the time of service. It's a no-win situation for most doctors; they have to either refuse to treat patients or accept people who probably won't pay.

Getting paid is challenging. Not every visit is fully covered by insurance. Even when patients have insurance, they typically have to pay at least 20% of the bill themselves, which can amount to thousands of dollars. 31% of Americans don't carry health insurance, so they have to pay out-of-pocket. Statistics show that doctors only collect half the money patients owe them.

Doctors all over the country are caught in this predicament. One doctor recently said 67% of his receivables were outstanding past 90 days. From a business standpoint, this is a serious problem.

The Solution

Our Professional Billing Plan is an Instant Cash Flow System for doctors. Our plan allows doctors to collect significantly more of their money, without alienating or harassing patients, while reducing overhead. Our Professional Billing Plan allows patients to make affordable monthly payments, which are collected via automatic deductions from the patients' checking accounts.

The average collection of physician fees using traditional methods is 49%. The average collection of physician fees with our Professional Billing Plan is 98%.

Health Clubs, utility companies and insurance companies have been using automatic bank deductions (also called pre-authorized checks) since 1974.

Most doctors, however, don't know it's available to them or how to take advantage of it.

Easy to Implement, Immediate Results

We can either print a paper draft or with your patient's permission, draft electronically on the same day of the month - every month - and then hand deliver the paper drafts or automatically deposit funds in your account if you choose the electronic option. Patients sign a simple form authorizing the doctor to do this. That's why it's called pre-authorized checking.

Doctors are elated when they outsource this service to us. They have no invoicing to mess with, no waiting for checks to be mailed in, no embarrassing follow-up calls for staff members to make. Either checks on their desk ready to deposit if they opt for the paper system or an electronic entry. No mess. No fuss.

Credit can be extended to patients because the Patient Payment Plan will collect the fees on exactly the same date every month. And because doctor is willing to extend credit practice income will increase by an average of 20%.

Other Services for Medical Professionals

Practice Set-Up Fees

We charge a set-up fee of $500 for the time and energy it takes to establish your Patient Payment Plan account. This fee also includes a service to collect NSF checks.

On-Call Support Services We provide support services on an emergency basis.

Consulting Services We charge by the project to assist with delinquent insurance payments, office automation, accounts receivable management, practice building, etc.