Re: Clean Insurance Claim and HSA Service Statement Billing Company Help

[Guest guest]

What EMR are you using? I would find out

what the “software” company is and look into purchasing it yourself

and how much it would cost for you to either do it yourself or hire someone

internally to do it for you. Do you have any staff that have “breaks”

in the day where they are looking for things to do? Are you solo? Do you have

a spouse that could do it for you?

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From: [mailto: ] On Behalf Of Dr. T

Sent: Thursday, May 06, 2010 6:34

AM

To:

Subject:

Clean Insurance Claim and HSA Service Statement Billing Company Help

I have a cash practice and an EMR. I need a billing

company that can pick up my EMR superbill in my EMR " outbox " and

prepare a clean claim for the insurer and a Statement of Services rendered for

the patient to submit to their insurer for reimbursement and to their HSA for

verification of HSA eligibility and then mail them to the patient. One company

would charge me a per item charge of $2-3, very reasonable, I thought, but

there would be a monthly charge of $150, for the software company that allows

them to do this electronically with my EMR.

Any suggestions of how to get a clean claim and HSA services statement to the

patient from a Superbill in an affordable manner?

Marc Tanenbaum

Priority Pediatrics, PC

Atlanta

[Guest guest]

Sounds like you are going to have to collect all the

patient's insurance information yourself, even though

you are a cash practice. This includes Plan name, Plan

address, Patient ID no, group no., whether they are the

insured or a dependent etc., plus verify eligability, and

store all that information somewhere, so you don't have to

re-collect it every time

they come in. You're already doing about 80% of the work

of billing insurance when you have to do all that. Kind of

defeats the advantages of a cash practice to a certain

extent.

I think something like EZClaim might do what you are

talking about.

Also my home grown TkFP EMR that runs on Linux can

print CMS 1500 forms quite nicely.

Caldwell

Tulare, CA

>

> What EMR are you using? I would find out what the " software " company is and

> look into purchasing it yourself and how much it would cost for you to

> either do it yourself or hire someone internally to do it for you. Do you

> have any staff that have " breaks " in the day where they are looking for

> things to do? Are you solo? Do you have a spouse that could do it for you?

>

>

>

> Pratt

>

> Office Manager

>

> Oak Tree Internal Medicine P.C

>

> www.prattmd.info

>

> _____

>

> From:

> [mailto: ] On Behalf Of Dr. T

> Sent: Thursday, May 06, 2010 6:34 AM

> To:

> Subject: Clean Insurance Claim and HSA Service

> Statement Billing Company Help

>

>

>

>

>

> I have a cash practice and an EMR. I need a billing company that can pick up

> my EMR superbill in my EMR " outbox " and prepare a clean claim for the

> insurer and a Statement of Services rendered for the patient to submit to

> their insurer for reimbursement and to their HSA for verification of HSA

> eligibility and then mail them to the patient. One company would charge me a

> per item charge of $2-3, very reasonable, I thought, but there would be a

> monthly charge of $150, for the software company that allows them to do this

> electronically with my EMR.

>

> Any suggestions of how to get a clean claim and HSA services statement to

> the patient from a Superbill in an affordable manner?

>

> Marc Tanenbaum

> Priority Pediatrics, PC

> Atlanta

>

[Guest guest]

Do you have a video of what it takes to fill in your CMS1500 form?

I gather it took you several years to get it to print exactly right.

> Sounds like you are going to have to collect all the

> patient's insurance information yourself, even though

> you are a cash practice. This includes Plan name, Plan

> address, Patient ID no, group no., whether they are the

> insured or a dependent etc., plus verify eligability, and

> store all that information somewhere, so you don't have to

> re-collect it every time

> they come in. You're already doing about 80% of the work

> of billing insurance when you have to do all that. Kind of

> defeats the advantages of a cash practice to a certain

> extent.

>

> I think something like EZClaim might do what you are

> talking about.

> Also my home grown TkFP EMR that runs on Linux can

> print CMS 1500 forms quite nicely.

>

> Caldwell

> Tulare, CA

>

>

>>

>> What EMR are you using?  I would find out what the " software " company is and

>> look into purchasing it yourself and how much it would cost for you to

>> either do it yourself or hire someone internally to do it for you.  Do you

>> have any staff that have " breaks " in the day where they are looking for

>> things to do?  Are you solo?  Do you have a spouse that could do it for you?

>>

>>

>>

>> Pratt

>>

>> Office Manager

>>

>> Oak Tree Internal Medicine P.C

>>

>> www.prattmd.info

>>

>>   _____

>>

>> From:

>> [mailto: ] On Behalf Of Dr. T

>> Sent: Thursday, May 06, 2010 6:34 AM

>> To:

>> Subject: Clean Insurance Claim and HSA Service

>> Statement Billing Company Help

>>

>>

>>

>>

>>

>> I have a cash practice and an EMR. I need a billing company that can pick up

>> my EMR superbill in my EMR " outbox " and prepare a clean claim for the

>> insurer and a Statement of Services rendered for the patient to submit to

>> their insurer for reimbursement and to their HSA for verification of HSA

>> eligibility and then mail them to the patient. One company would charge me a

>> per item charge of $2-3, very reasonable, I thought, but there would be a

>> monthly charge of $150, for the software company that allows them to do this

>> electronically with my EMR.

>>

>> Any suggestions of how to get a clean claim and HSA services statement to

>> the patient from a Superbill in an affordable manner?

>>

>> Marc Tanenbaum

>> Priority Pediatrics, PC

>> Atlanta

>>

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

Graham,

I have a little Flash movie I made a couple of years ago

that documents the features of Tkfp. It goes from the schedule

through the process of writing a note using the templates, prescribing

some meds, and finally generating a claim form for the encounter.

http://alcald.homelinux.org/TkfpDemo.html

Basically to generate a claim, Tkfp collects the info from the form on

the " Demographic " tab, which you can see near the first part of the

movie. During the note generating process, the provider adds one or more ICD-9

codes, and at the end, the provider is asked to select one or more CPT codes for

the encounter.

The CMS 1500 insurance form is then generated. In the movie near the end, you

can see the form briefly in " postscript " format which can be printed out on

paper. Postscript is very similar to .pdf in that it's designed for printing in

a consistent manner on

many different types of printers.

The postscript is generated using an open source Python module called

" Report Lab " . I found a HCFA1500 form using Report Lab that someone had already

done, and was able to modify that. I actually started working on all this in

1996. So it has been around a long time, and predates some of the more well

known EMRs that subsequently eclipsed it in popularity. This is because it was

designed and run on Linux which intimidates a lot of people. The HCFA 1500 form

was

stable from about 1990 until about 2 or 3 years ago when they went to

the CMS 1500, which required some re-programming to account for the

NPI number and few other changes, but fortunately I was able to

modify the code so that it can print the new CMS 1500 properly. I

send most of my claims electronically using a " print image " format

that can go to OfficeAlly or MDOn-line. But I still have to print

some claims on paper, because there are some insurance plans I deal

with that are not on the payer list for OfficeAlly or MDOn-line.

> >>

> >> What EMR are you using?  I would find out what the " software " company is

and

> >> look into purchasing it yourself and how much it would cost for you to

> >> either do it yourself or hire someone internally to do it for you.  Do you

> >> have any staff that have " breaks " in the day where they are looking for

> >> things to do?  Are you solo?  Do you have a spouse that could do it for

you?

> >>

> >>

> >>

> >> Pratt

> >>

> >> Office Manager

> >>

> >> Oak Tree Internal Medicine P.C

> >>

> >> www.prattmd.info

> >>

> >>   _____

> >>

> >> From:

> >> [mailto: ] On Behalf Of Dr. T

> >> Sent: Thursday, May 06, 2010 6:34 AM

> >> To:

> >> Subject: Clean Insurance Claim and HSA Service

> >> Statement Billing Company Help

> >>

> >>

> >>

> >>

> >>

> >> I have a cash practice and an EMR. I need a billing company that can pick

up

> >> my EMR superbill in my EMR " outbox " and prepare a clean claim for the

> >> insurer and a Statement of Services rendered for the patient to submit to

> >> their insurer for reimbursement and to their HSA for verification of HSA

> >> eligibility and then mail them to the patient. One company would charge me

a

> >> per item charge of $2-3, very reasonable, I thought, but there would be a

> >> monthly charge of $150, for the software company that allows them to do

this

> >> electronically with my EMR.

> >>

> >> Any suggestions of how to get a clean claim and HSA services statement to

> >> the patient from a Superbill in an affordable manner?

> >>

> >> Marc Tanenbaum

> >> Priority Pediatrics, PC

> >> Atlanta

> >>

> >

> >

> >

> >

> > ------------------------------------

> >

> >

[Guest guest]

What EMR is in use? Don't most of them print up an invoice? That's all my patients have needed.

To: Sent: Mon, May 10, 2010 2:36:03 PMSubject: Clean Insurance Claim and HSA Service Statement Billing Company Help

Dr. T,

I’m still not sure I understand where you are going with the billing forms.

My understanding is that…

1. You are cash only.

2. But want to offer a completed CMS 1500 for the patient to submit to their insurance.

Is that correct?

If correct, then…

1. Why can’t your Practice Mgt system print out the CMS 1500 after you are done entering their insurance information and CPT and ICD9 codes?

If you don’t have the option for a Practice Mgt printout….

1. Why not hire someone to fill them out for you in batches – daily or weekly – probably cheaper than using a billing service.

After the first 100 claims – the person doing them should pretty much have the hang of the rote placement of the codes, insurance address, etc.

See attached for info on filling out CMS 1500 – they make it sound more complicated than it probably is.

Locke, MD

I

[Guest guest]

Dr T said he uses Practice Fusion.

 

Dr. T - have you considered doing the billing inhouse and buying software to work with it?

 

http://www.practicefusion.com/pages/medical_billing.html

 

http://www.kareo.com/

 

http://www.kareo.com/pricing

 

I still say buy a software pdf program that will allow you to fill in a 1500 locally and be done with it - especially if you don't need the tracking of AR, etc.

 

http://www.practicefusion.com/

 

Locke, MD

[Guest guest]

Dr. T,

 

I’m still not sure I understand where you are going

with the billing forms.

My understanding is that…

 

1.      

You are cash only.

2.      

But want to offer a completed CMS 1500 for the patient

to submit to their insurance.

 

Is that correct?

 

If correct, then…

 

1.      

Why can’t your Practice Mgt system print out the

CMS 1500 after you are done entering their insurance information and CPT and

ICD9 codes?

If you don’t have the option for a Practice Mgt printout….

 

1.      

Why not hire someone to fill them out for you in

batches – daily or weekly – probably cheaper than using a billing

service.

 

After the first 100 claims – the person doing them

should pretty much have the hang of the rote placement of the codes, insurance

address, etc.I read the 60 page manual yesterday, and I think it says that the date where you have SOF should be DDMMCCYY or DDMMYY without the / as shown in your example.Also they have spelled Diagnostic wrong!

 -- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

Graham,

That sounds good! I'm not sure if OfficeAlly can accept a .pdf.

They do accept what they call a " print image " file, which is just

the same information that appears on the CMS 1500, but in a plain

text file, where you consistently place the items on the same line

in the same location. They have software that can " map " your

print image files and convert them to the ANSI X12 and forward it on for you.

It should not be to hard to output what is on your .pdf

CMS1500 to a plain text " print image " file if they are not able to

accept the .pdf.

> >

> >

> >

> > Graham,

> >

> > I have a little Flash movie I made a couple of years ago

> > that documents the features of Tkfp. It goes from the schedule

> > through the process of writing a note using the templates, prescribing

> > some meds, and finally generating a claim form for the encounter.

> >

> >  http://alcald.homelinux.org/TkfpDemo.html

> >

> > Basically to generate a claim, Tkfp collects the info from the form on

> > the " Demographic " tab, which you can see near the first part of the

> > movie.  During the note generating process, the provider adds one or more

 ICD-9 codes, and at the end, the provider is asked to select one or more CPT

codes for the encounter.

> > The CMS 1500 insurance form is then generated. In the movie near the end,

 you can see the form briefly in " postscript " format which can be printed out on

paper. Postscript is very similar to .pdf in that it's designed for printing in

a consistent manner on

> > many different types of printers.

> > The postscript is generated using an open source Python module called

> > " Report Lab " . I found a HCFA1500 form using Report Lab that someone had

already done, and was able to modify that. I actually started working on all

this in 1996. So it has been around a long time, and predates some of the more

well known EMRs that subsequently eclipsed it in popularity. This is because it

was designed and run on Linux which intimidates a lot of people.  The HCFA 1500

form was

> > stable from about 1990 until about 2 or 3 years ago when they went to

> > the CMS 1500, which required some re-programming to account for the

> > NPI number and  few other changes, but fortunately I was able to

> > modify the code so that it can print the new CMS 1500 properly. I

> > send most of my claims electronically using a " print image " format

> > that can go to OfficeAlly or MDOn-line. But I still have to print

> > some claims on paper, because there are some insurance plans I deal

> > with that are not on the payer list for OfficeAlly or MDOn-line.

> >

>

> --

> Graham Chiu

> http://www.compkarori.co.nz:8090/

> Synapse - the use from anywhere EMR.

>