A medical billing company is trying its hand at patient advocacy

“We felt a little bit unfilled doing (billing for providers) plus wanted to help patients,” we said. “Our main focus is to represent a patient if we have an issue on a medical bill. It’s kind of insurance for your insurance to make sure that you paid correctly.

Strategic Collection Management wanted to contribute to the U.S. health care reform, Chief Executive Chris Gitersonke said.

“Health care reform is such an obviously needed action, but nobody knows how do you do it,” we said. “Do you do it on this huge national scale plus alter everything? .. So this is our way of doing it on a local level.”

When the company started, it had two employees plus has since grown to 35.

The Las Vegas-based company has its offices on West Sahara Avenue near Buffalo Drive.

“We’ve done a lovely job plus hired a lot of people here,” we said. “We feel like we’re making a lovely impact on things.”

“We thought, ‘What’s the cheapest way we can do this plus yet provide the kind of service we require to provide?’ ” we said.

The company decided to roll out Universal Solutions as a unit that will serve as a patient-advocate business beginning last month.

For $25 a month, the company goes to bat for the health care consumer, looking over bills plus working with doctors plus insurance companies to fix overcharges. The fee covers up to two people in a household.

At first, the company considered making Universal a nonprofit organization, but decided to keep it under the umbrella of Strategic.

“They tend to be the ones with the most issues with their medical bills,” Gitersonke said.

Universal has primarily signed up senior citizens on Medicare.

there is a low profit margin, we said, because Universal’s main customers are coming in with bills they’d like audited. That makes it more time intensive, we said. The opportunity to make funds is with employers, who Gitersonke would like see offer this benefit to their employees.

There’s a “huge” cost savings for employer, , we said. Besides alleviating human resource staff from employees’ questions about particular health insurance issues, if Universal corrects medical billing problems, the cost to the company plus the employee can be cut through reduced expenditures. Universal also offers employers workers’ compensation containment, another area of potential fraud or incorrect billing.

The company also wants to move to the national level plus is working with national companies to provide the patient advocate service.

“We take all of that pressure off the employer,” Gitersonke said.

“That’s our contribution to health care reform,” Gitersonke said. “It’s going to manage the cost of the employer, it’s going to manage the cost of the patient plus the insurance company. there is so much fraudulent billing going on, , that when we’re auditing stuff, we can see that.”

Practice Management application Helps Growing Concierge Medicine Segment

The application, DAQoffice, scales back billing so that physicians can bill patients directly than through insurance companies. While the system still allows providers to document diagnosis codes, it won’t automatically generate an insurance claim. Instead users can develop an invoice for the patient. This is a key feature for concierge medical offices or self-pay practices.

Antek HealthWare is taking a step toward niche offerings by releasing a practice management system designed for concierge medical practices.

Concierge medicine, also known as “boutique” or “retainer” medicine, is a unique form of health care in which patients are responsible for all services rendered. Instead of the traditional model of using an insurance provider, patients pay directly to the physician or clinic. In return, patients get premium health care with 24/7 access to doctors, unlimited exams, VIP waiting rooms and more.

With the release of DAQoffice, Antek HealthWare is reaching out to the growing segment of physicians practicing concierge medicine. It’s an alluring option for doctors as they face lower reimbursements from Medicare and private insurers.

DAQoffice is a fully functional practice management solution for any size of concierge practice. The system includes patient registration, appointment scheduling and patient billing applications. It is HIPAA compliant, web-based and integrates with third party EMR/EHR application systems.

doctors used nationwide of Somerset-based billing system

Imagine a visit to the doctor that goes like this: You need an appointment, so you schedule it on the doctors’ Web site. You type in your symptoms and medical history so the doctor has all the information before your visit. You arrive at the office and scan your insurance card. By the time the appointment is over, your prescription is sent to the pharmacy electronically, with no chance for mistakes due to illegible handwriting. Before you leave, you know how much of the cost your insurance company has covered. You can even pay the balance on a kiosk with a credit card before you leave the office.

It sounds futuristic, but hundreds of doctor's offices across the country are using the system created by Medical Billing Transcription Corporation, a company based in the Somerset section.Marjorie Martinez can't say enough good things about it. As administrator in the Old Bridge office of Dr. Robert M. Schaefer, the system has made her job much easier."I've done this type of work for 35 years,'' she said. "I've seen the ins and outs, and this is top of the line. It's much more cost effective.''MTBC offers much more than cost effectiveness, according to its users. It greatly improves the patient-physician relationship. For patients, it means less time spent waiting in a doctor's office, no more confusion surrounding insurance claims and payments, and no unexpected billing charges. Perhaps most importantly, it means that patients get to spend more time with their doctors.
"We're excited every day about what we do,'' said David Rosenblum, president of MTBC. "Not one week goes by that we don't make some kind of enhancement.''Doctors benefit from the system because payment turnaround time often can be measured in days instead of weeks or months. And access to a patient's information is always at their fingertips.

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"Everything is Web-based, so the doctor can access all the pertinent information, even from home, '' Rosenblum said. "The doctor will never ask what brings you here today.''

Rosenblum was a business lawyer for 35 years when he joined the company, which was started by one of his clients, Mahmud Haq. Haq retired after years of working in the collection business. He decided in his spare time to use the techniques he had learned to create a more efficient billing system for his wife, who is a doctor. The system was introduced 10 years ago in Dr. Mehnaz Haq's North Brunswick office. To date, 600 doctors offices in 40 states have come on board with the system."We wanted to build a system to make billing and collecting more efficient,'' said Rosenblum. ""We've exceeded that horizon a thousand fold. The fees we charge the doctors are far overshadowed by their increase in revenue.''

Massachusetts Regulators Propose Tracking Student Medical Billing Issues

Massachusetts state regulators on Thursday proposed requiring colleges to track information on students' health insurance plans, including the number of students whose annual medical bills exceed their policy limits, the Boston Globe reports. The proposal also would require colleges to track and report to state regulators information such as how many complaints students file against health insurers; how many times insurers refuse to pay for student injuries or ailments; and the percentage of profit the insurers apply toward student medical services.

The proposal comes amid reports that student medical coverage in Massachusetts is substantially limited compared to standard insurance coverage and does not cover accidents or serious injuries. Current state regulations require college students to obtain health insurance but allow insurers to offer coverage that does not meet the minimum standards for other plans established by the state's health insurance law. The Globe reports, "Although students are free to buy more expensive policies, roughly 77,800 students are covered by plans that cap payments at $50,000 a year per injury or illness." State regulators said that the proposal is the first step toward requiring insurers to offer students more generous benefit plans.

Dena Greenblum, a senior at Tufts University and a member of the university's Student Health Organizing Coalition, said, "It doesn't make sense for students to be treated differently." Sarah Iselin, commissioner of Massachusetts' Division of Health Care Finance and Policy, said that student health "is a 20-year-old program that is ripe for review." The proposal is expected to be implemented following a public hearing in March (Lazar, Boston Globe, 2/13).

St. Mary has drop boxes

Have a bill to pay at Providence St. Mary Medical Center? No need to worry about postage.

HILLHOUSE

The hospital has installed drop boxes to make paying a medical bill as simple as dropping off a utility bill.

St. Mary added one box at Third Avenue and Rose Street with the line of boxes already in place for cable and utility payments. Another drop box is located in the parking lot of the hospital's billing center, 209 W. Poplar St.

The boxes are intended to make it faster, easier and more convenient for people to drop off check or money order payments, according to an announcement. Those with questions about their bills, or who want to pay in cash, can get assistance at the Billing Center. Questions about hospital bills can also be answered at 1-866-452-6020. For questions about Providence St. Mary doctor bills, call 509-522-5815.




USKH, a full-service, multi-disciplined architectural, engineering, surveying and planning design firm, is building up excitement over its recent remodel with an open house Tuesday.

The 1905 building that houses the Walla Walla branch, 5 N. Colville St., will have an increase in staff and services. The event runs 4:30-7:30 p.m., with a ribbon-cutting at 5 p.m. Wine, beer and appetizers will be served. Call 509-522-4843 for details.




Celebrate outstanding volunteers and commemorate Oregon's 150th birthday.

Tickets are still available for the Milton-Freewater Area Chamber of Commerce's 61st annual awards banquet Thursday. The event, at the Community Building, catered by Rhonda's Catering Service, is a celebration of local residents dedicated to community service. This year it comes with a birthday bash theme in honor of the state. Tickets are $28 apiece at the Chamber office, Earl Brown & Sons, Community Bank, Balance Sheet and the city of Milton-Freewater. Doors open at 5 p.m. for social time, auction-bidding and table-viewing.




Tracy Hartwig, who spent more than 20 years as catering manager for the bygone Homestead Restaurant, is heating things up at Graze Catering.

Hartwig is the full-service catering operation's new event manager. Graze owner John Lastoskie said the addition has enabled the operation, based at 213 S. Ninth Ave., to offer an expanded luncheon service beyond the weddings and wine events previously offered. Hartwig can be reached at: tracy@grazeevents.com , at 509-529-7354 or at www.grazecatering.blogspot.com .

Strictly Business is a local business column. Vicki Hillhouse can be reached at vickihillhouse@wwub.com or 509-525-3300, ext. 284.

Liberty Medical Center's financial and billing software has been provided by American upgraded

Liberty Medical Center's financial and billing software has been provided by American HealthNet (AHN) through the use of their DataFlex 4 version, which is a DOS based program. AHN discontinued its support for the DataFlex 4 version, effective December 31, 2008. As of January 1, 2009, AHN no longer provides any type of maintenance support for the DataFlex 4 version and will no longer provide any upgrades, updates, or patches to ensure the accuracy of the information obtained from the system. There are no Federal or other regulatory compliance updates, no payroll tax table updates and no support for any problems or errors occurring during usage after December 31, 2008. Last summer, Liberty Medical Center completed an analysis to allow us to make a decision whether to upgrade with the existing vendor, or replace our system entirely. This analysis included a comparison of three vendors, AHN and two others. Discussions were held at the Board level and a decision was made to upgrade the system with our current vendor. AHN's new windows based program is called Clarus. Since we were an existing customer, AHN allowed us to continue to use the DataFlex 4 version, with minimal maintenance, until the upgrade could be completed.

The administrative staff of Liberty Medical Center has been working diligently over the past few months to ensure all the necessary data would be converted to the new program. As of January 30th, Liberty Medical Center is no longer using the DataFlex 4 program, which has been used by the facility since 1997. From January 31st through February 6th, all the files were being converted to the new format in Clarus. Beginning, February 9th, the staff will be using the new system exclusively. Although, it is the same company, and the same program, just upgraded to Windows, there are still a lot of differences in what the program requires. Many changes have been made to our procedures to allow us to more efficiently complete the billing cycle from when a patient checks in at the clinic and/or Hospital for laboratory, radiology, or physical therapy to when we print off your statement and mail it out to you.

We are asking the community to be patient with our admission staff, clinic and hospital billing staff, and insurance staff, as we go through this change. Each person who will be using this program has been trained, and will be receiving additional education next week during what we term our “Go Live” phase. However, it takes many hours of hands on experience with a new program to master it. As part of this conversion, we will verify your personal information, such as address, phone number, and insurance information when you check in. This process will take a little bit longer at first, but in the long run, if all the information is correct when you walk in the door, we can do a better job of assisting you in making sure your insurance company pays what is owed on your behalf.

If you have any questions during this transition, please contact either Karen Shaw, Clinic Administrator at 759-5194, for clinic related issues or Shari Meissner at 759-5181 ext. 31, for hospital and billing

Help manage medical costs

Patients have several tools to help manage medical costs. Here are some additional tips recommended by debt reduction experts.

_ Talk to the doctor about whether all the recommended care is necessary.

_ Ask if a procedure can be done on an outpatient basis, to avoid a costly hospital stay.

_ Can you use less-expensive, generic versions of the medicine you need?

_ Avoid using your credit card. If you pay it all off with that, you lose leverage with the hospital and you may have to pay high interest.

_ Remember your manners. Billing office representatives know how the system works and may be helpful if you don't yell at them.
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_ Go beyond the billing office. People with higher levels of authority sometimes can approve larger discounts.

_ Talk to the doctor. A physician may show more sympathy than a billing clerk who hears customer complaints every day.

_ Check in-network coverage. Make sure your doctor, the anesthesiologist and everyone else caring for you is in your insurance network.

_ Document everything. Keep a record of phone conversations and all paperwork so you can show what you were told, by whom and when.

Billing the Doctor for Your Time

Over at the Economix blog, Princeton economics professor Alan B. Krueger applies economic theory to the doctor’s waiting room. He writes about the “opportunity cost” of being a patient.

Any student of Econ 101 knows that economists measure costs by opportunity costs, meaning everything that is given up to get something else. Time spent interacting with the medical system could be used for other activities, such as work and leisure. Moreover, spending time getting medical care is not fun. This time should be counted as part of the cost of health care.

Using the American Time Use Survey, I calculate that Americans age 15 and older collectively spent 847 million hours waiting for medical services to be provided in 2007….. If you count health care-related activities writ large – including time traveling to a doctor, waiting to see a doctor, being examined and treated, taking medication, obtaining medical care for others, and paying bills – the average American spent 1.1 hours per week obtaining health care in 2007.

Read the full column, “A Hidden Cost of Health Care: Patient Time.” What do you think? Should a patient’s time be factored into the cost of health care?