Frequently Asked Questions

Table of Content

  1. Corporate Background and Focus
  2. Control and Risk Management
  3. Quality Assurance
  4. Claim and Payment Processing
  5. Technology
  6. Pricing
  7. Getting Started

A. Corporate Background and Focus

  1. Q: What medical practices does Billing Depot serve?
    A: Billing Depotuniquely provides any medical practice with an industrial-strength solution at a fraction of the cost. Billing Depot shields the practice from three kinds of risks, namely, process, personnel, and technology (Control and Risk Management section below), and allows the physician to focus on building and maintaining outstanding service reputation with the patients. Billing Depot, via its unique business partnerships with market leaders in medical billing, has designed a process that gets 57% of claims paid within the first two weeks of service (Figure 1). This approach allows Billing Depot to leverage ‘best-of-breed’ strategy, whereby best qualified personnel use best available technology to deliver top quality service to the clients.

Figure 1. Billing Depot Advantage

  1. Q: How much do you collect in billings?
    A: Billing Depot, together with its business partners serve 87 medical practices nationally and process $94,000,000 in annual medical billings in approximately 3,700,000 annual claims.

3. Q: How do you manage personnel risks? Do you have enough billing specialists for my practice?

A: Billing Depot has access to over 300 billing specialists whose expertise spans the entire gamut including claim submission, validation, coding, demographic and insurance data entry, charge posting, follow up on claims with payers, statement sending, and payment posting. Ready access to such a large pool of qualified people practically eliminates personnel risk associated with motivation, teamwork, vacations, sick days, and turnover.

  1. Q: What services do you provide?
    A: The scope of Billing Depot services spans the entire gamut, including claim submission, validation, coding, demographic and insurance data entry, charge posting, follow up on claims with payers, statement sending, and payment posting.
  1. Q: Do you focus on any medical specialties? Is the billing system equipped with latest codes for every specialty?

A: Billing Depot provides medical billing service to every practice, except anesthesiology. Its claims processing system has a built-in knowledge base of medical codes for every practice and is periodically updated according to latest Medicare and AMA publications.

B. Control and Risk Management

  1. Q: Would Billing Depot diminish in any way my current level of control over my claims processing?

A: While in-house billing provides the perception of control, it actually increases the risk of losing business-critical knowledge, raises concerns about data security and reliability, impedes process accuracy, and ultimately limits billing transparency.

Payment operations risk has three key aspects: personnel, technology, and process. Billing Depot addresses each of these risks in the following way:

  1. Personnel Risk: In-house billing knowledge is often concentrated in the hands of a few critical people. In house personnel requires continued management, including search for qualified personnel, on-going training, motivation, teamwork, payroll taxes, HR benefits, vacations, sick days, andturnover.

Billing Depot employs multiple people with expertise in every aspect of claims processing, so that losing any one of these critical people does not put the entire operation at risk. Since Billing Depot focuses on billing only, its personnel stay current on all the latest regulations and procedures.

  1. Technology Risk: In-house billing technology requires buying software and managing systems setup, downtime, backups, and replacement. O
  2. ften, in-house technology is inadequate in terms of security and backups.

Billing Depot uses state-of-the-art technology currently processing over 100,000 claims per month nation-wide, including daily claims processing for major medical centers such as New York University. Because of such large-scale processing, Billing Depot uses a highly sophisticated data center, backs up its data every 15 minutes, and keeps it HIPAA compliant, including encryption and access control.

c. Process Risk: In-house billing operations, due to its inherently small scale, does not have the same process-improvement opportunities, thus often repeating the same mistakes over and over. It cannot afford labor division – and subsequent perfection of varied skills and procedures. Billing Depot uses economies of scale and employs specialists in coding, follow-up, etc. Since Billing Depot focuses on billing only, it has developed and perfected a proprietary Billing Workflow which implements a standard Straight Through Billing process, whereby the majority of operations are automated while the exceptions are flagged, routed to the specialists, and tracked for resolution. Best of all, Billing Depot implements every process improvement across ALL clients, and consequently shares every opportunity to reduce your practice’s A/R and rejection rate.

In summary, Billing Depot is focused on - and has implemented special processes for - increasing both the scale and the quality of claims processing. We turn claims processing into a commodity by creating, growing, and sharing the benefits of economies-of-scale across all of its clients. As a result, Billing Depot reduces operations risk in your medical practice, improves its cash flow, and allows you, the physician, to focus on health care. Such massive benefits are not achievable in principle for any individual medical practice because of the relatively small claims volume and the corresponding limitations of personnel and technology resources. As Billing Depot continues to grow both its client base and its claims processing volumes, each of our clients continues to reduce operations risk and improve cash flow.

  1. Q: What is Straight Through Billing?

A: Straight Through Billing automates the majority of the claim flow and focuses the billing follow-up specialists to exceptions only. Straight Through Billing requires Workflow Management knowledge base claim validation, and connectivity to every process participant, including on-line reconciliation and tracking.

  1. Q: What is Billing Transparency?

A: Billing Transparency provides 24x7 Internet browser-based observability of both the entire process and each individual claim, including payment status, identified errors, and actions performed on the claim. Transparency leverages effective workflow management, knowledge-based claim validation, and connectivity to all process participants, including on-line reconciliation and tracking.

Typically, in-house billing offers only limited billing transparency. Billing Depot provides Real-Time visibility of the status on all claims. With Billing Depot, your practice always knows your current A/R and rejection rate. More importantly, Billing Depot provides simple tools to identify specific claims and business processes that impact your payment delays and rejections – thus immediately improving your bottom line.

  1. Q: What is Workflow Management?

A: Workflow management allows labor separation according to personnel specialization and includes automated claim routing and response-request reconciliation.

  1. A highly intuitive filter system and a built-in tracking mechanism define Vericle® workflow management. The filter system allows automated routing of select claims to specific follow-up officers according to their skills, responsibilities, and denial taxonomy. The built-in tracking mechanism tracks every action performed on the claim along with the performer name and time-stamp.
  1. Response-request reconciliation matches the error (and the payment) with the claim and marks specific field that caused the identified problem. Vericle® provides an online editor that displays the complete claim including the error and allows interactive editing of the claim to resolve the problem on hand.

C. Quality Assurance

1.Q:What aspects of the billing process are measured?

A: Billing Depot measures collections and payment delay. Examples of posted data includes claims paid within certain periods, percentage of accounts receivable beyond 60 or 120 days, and percentage of revenue gain over past collections. For instance, in January 2005, 6-months measures showed:

57% of claims paid within 15 days

97% of claims paid within 60 days

2% Accounts Receivable beyond 120 days

27% Revenue gain over past collections

Note the definition of the delay measure: in contrast to many other billing agencies, which measure the time elapsed from claim creation until payment by the primary payer, the Billing Depot delay measure starts at service delivery and measures the entire period until receiving payments from both payers and the patient (Figure 2).

Figure 2. Computation of Days in Accounts Receivable

2.Q:Which processing quality metrics are collected?

A: Billing Depot continuously measures and reports the status of the entire process using Vericle Status Report. It shows the total number of claims submitted, total $ paid, total $ amount outstanding, total number of claims failed, and the distribution of failed claims by error kinds, starting with formatting errors, submission errors, procedure-to-procedure and procedure to diagnostic errors. Each error group can be further interactively drilled in for review of specific claims and individual errors making up that group. This report is available 24 x 7 on line and it is the backbone of Billing Depot transparency.

3.Q:Which claim quality tests are performed?

A: Vericle® uniquely tests data both pre- and post-service, ensuring highest quality submissions and drastically reducing rejections. It flags invalid claims and explains the errors for on-line editing using on-line HCFA form before submitting to payer, thereby dramatically reducing days in Accounts Receivable.

Vericle® also provides comprehensive audit log, which details all tests run on each claim.

  1. Pre-service tests include demographics and eligibility at the point of patient scheduling or check-in process.
  2. Post service tests include:

1)Built-in Data Integrity - Prevents invalid data entry

2)Pre-submission tests such as format, missing data, and Local Medical Review Policies (LMRP)

3)LMRP, Correct Coding Initiative (CCI), and payer-specific edits run automatically on all applicable claims

4)Eligibility testing is run on all claims for a participating payer

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5)Custom edits for specific practices

4.Q:What is the process to report problems and track their resolution?

A: Billing Depot uses TrackLogix, a web-based ticketing system, to report problems and track the date of the report, the owner of the problem, the requestor, and problem description. TrackLogix tracks each change in the ticket and provides status reports, individual workbench, and an intuitive customization capability to match the needs of specific practice.

D. Claim and Payment Processing

  1. Does Billing Depot submit claims electronically?

A:Yes. We submit claims electronically to over 1,000 major payers.

  1. Q: How will you get patient info in order to do billing? Will we enter entire info in our computer and you have access to it?

A: Since both Billing Depot and provider office share the same system, all information (including patient information) is accessible by both Billing Depot and office staff in Real-Time. Thus, depending on Provider’s preference, it is entered either by the provider’s office or by Billing Depot upon receiving a faxed patient registration form.

  1. Q: Will we continue to collect co-pays at time of visit? What about receipts – sometimes hand written are not enough for patients – sometimes they need print out of charges and payments to submit to other insurance.
    A: Yes, you will continue to collect co-pays at time of visit. The system provides Real-Time patient statements on-line.
  1. Q:Authorizations – Refunds: will we need to advise you of any referral #’s or Pre-authorization #s for OU and OR testing?
    A: Provider’s office supplies referral numbers and/or authorization numbers to Billing Depot when required by payers for specific CPT codes.
  1. Q: Will you be coding off chart notes?
    A: Our Certified coders can code off chart notes or directly from a super-bill, depending on the client’s preference.
  1. Q: How will you get hospital information?
    A: Provider’s office faxes hospital information to Billing Depot. If more information is needed, Billing Depot contacts the hospital directly.
  1. Q: Are all of your employees certified coders? Are they all bonded?
    A: Most coders are certified, and bonding is available upon request.
  1. Q: For payments (cash and checks) that come in directly to the office (e.g., Co-pays), and not billed by Billing Depot, how are these entered into the system? Are these payments captured in the office and faxed to Billing Depot?
    A: These payments are either entered by the provider office or sent to Billing Depot for entry – Provider’s preference.
  1. Q: How are payments reconciled?
    A: One of two ways, depending who receives checks and EOBs:
  2. If Billing Depot receives the checks and EOBs then it records them and sends to the Provider (as frequently as requested by provider office – normally twice a week).
  3. If the checks and EOB’s are sent directly to the Provider, then the Provider copies them and sends to Billing Depot for payment recording.
  1. Q: How are secondary carriers billed?
    A: If payers support crossovers, secondaries are billed electronically (some Medicare).
    If no crossover, Billing Depot prints secondary and attaches primary EOB.
    If Patient still has a billing responsibility, Billing Depot bills the Patient.
  1. Q: How are collections handled?
    A: Billing Depot invoices patients several times (based on provider’s preference); followed up with phone calls; and, after predetermined number of weeks, Billing Depot transfers the account to collection agency.
  1. Q: Who performs claim follow up?

A: Status checks, missing EOBs, and other low-level follow-up work are automated when possible or handled by the general staff. Highly trained and specialized billers analyze high-level problems such as LMRP, CCI, and other coding issues. The senior personnel communicate with the provider’s office and determine the proper course of action.

  1. Q: How follow ups are tracked? How do you make sure you do not lose claims?

A: Vericle® automatically tracks all follow up work. It also collects and reports all automated events, user notes, and logs. Once claims are in the system, they can never be lost, only written off. Vericle® automatically reports all write-offs in real-time to the provider.

  1. Q: In case more information is needed from the provider, how do you receive it?

A: Vericle® features a sophisticated provider-biller workflow engine, which both routes and tracks all information requests and responses between the provider and Billing Depot. Whenever Billing Depot needs information about a claim, Vericle®’s engine routes that claim, along with the request, to the appropriate responsible party. The physician and office staff members have a single interface to provide the correct information for each claim. Once the information is provided, the claim is automatically routed back to the responsible biller so that the claim can be corrected and re-filed promptly.

E. Technology

1.Q: What software does Billing Depot use?
A: Billing Depot uses Vericle® technology, which includes software, state-of-the-art data center, and all of the processes required to operate the software including security, backups, disaster recovery, etc. Our main systems partner, Vericle®, has reengineered and automated the highly complex and arcane process of medical billing. Rather than extending existing approaches and systems, Vericle® applies processes and software tools previously used for automating complex financial processes. Using state-of-the-art intelligent computing, decades of medical billing expertise, and Internet connectivity, Vericle® has created an engine to dramatically increase efficiencies of the entire billing process. See

2.Q: What kind of hardware/software do I need to monitor my account as Billing Depot services it?

A: All you need is access to the Internet and a web browser. (Recommended: Microsoft Internet Explorer v5.01 or Netscape v7.1)

3.Q: Is it safe for my financial and patient data to be available over the Internet?

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A: Yes. For transmission, Vericle® uses the same state-of-the-art security technology you use when shopping, banking, or trading stocks on-line. Specifically, Vericle® has VeriSign SSL 128-bit certificates to communicate between your browser and our servers. Additionally, all staff members trained on Protected Health Information (“PHI”), as defined by HIPAA and required to sign confidentiality agreements. Protective measures include physical security of documents, shredding protocols, Cisco routers with Firewall protection, Medicare ANSI X12 Transaction and Code Sets, Per-project/participant access levels (login/passwords), Automatically filtered views based on project membership, Fine-grained access privileges: add, edit, view claims, GUI-Based Configuration of Privileges, and Audit Trail.

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5.Q: Where and how is my information stored?

A: All information is stored in a fault-tolerant set of database servers that are backed up continuously at no extra charge. Our databases are stored at MFN Data Center, one of the highest security data centers in the US.

6.Q: If I practice at multiple offices, can I access my accounts from any of these locations?

A:Yes. As long as you have access to the Internet and a web browser, you can log into Vericle® and monitor your account from anywhere and at any time. You can monitor your account from home.

7.Q: Must all of the office computers be connected online to the Billing Depot software?
A: There is no special software to install, update its versions, make backups, and maintenance fees. There is only one requirement: all office computers needing access to the system must be on the Internet. (We can assist your office in building a network.)

8.Q: Is there a written procedure for staff to follow for input (demographics), updates, etc?
A: Vericle® maintains a specially-designed and continuously updated knowledge base of over 1,000,000 rules and validations. Initial on-site training is provided.