Never Even THINK About Hiring A Billing Company Until You Read...
"15-Money Murdering Mistakes No Billing Company Would Dare To Tell You!"
(Plus, The Mistake That Will Kill Your Practice)
November 20, 2024
Dear Healthcare Provider,
You face unique challenges as a healthcare provider, where providing exceptional care is your priority.
That's why we're excited to introduce you to a FREE resource that can help you protect your practice's financial health while you focus on what truly matters – your patients.
Introducing: "15 Money-Murdering Mistakes No Medical Billing Company Would Dare to Tell You (Plus, The Fatal Mistake That Will Kill Your Practice)"
In the world of medical billing, hidden dangers lurk beneath the surface, silently eroding your practice's revenue and potentially jeopardizing its future. Every dollar counts, which is why we've compiled this indispensable guide to expose the pitfalls that even seasoned billing companies keep under wraps.
Imagine having the tools to safeguard your practice from delayed reimbursements, claim denials, and revenue loss.
“15 Money-Murdering Mistakes” sheds light on errors that plague medical billing processes, from inaccurate patient information to coding mistakes.
Each chapter dissects these billing mishaps and arms you with best practices to navigate the treacherous landscape of medical billing.
What can you expect to gain from "15 Money-Murdering Mistakes"?
• Strategies to Boost Revenue without Changing Your Services: Discover hidden strategies to increase your practice's income without altering the services you provide.
• 7 Ways to Prevent Claim Denials and Supercharge Revenue: Unlock the secrets to avoiding claim denials and maximizing your practice's revenue potential.
• Uncover the Fortune in Unpaid Claims: Explore overlooked treasures in unpaid claims and learn how to claim them for your practice's benefit.
• Eliminate Billing Errors and Boost Income: Learn to eradicate billing errors that could be hindering your practice's income potential.
• Say Goodbye to Revenue Leakage: Implement battle-tested strategies to prevent revenue leakage and keep your finances intact.
• Tackle Denied Claims Head-On: Learn the critical impact of denied claims and their potential to undermine your practice's success.
• Master Coordination of Benefits (COB) Errors: Navigate the complex realm of COB errors and protect your practice's revenue.
• Demystify Pre-Authorization Myths: Break down pre-authorization myths and understand their effects on your practice's bottom line.
• Decipher Bundling and Unbundling Errors: Untangle the mystery of bundling and unbundling errors and their financial implications.
• Unmask Upcoding and Downcoding: Discover how upcoding and downcoding could be affecting your practice's financial health.
“15 Money-Murdering Mistakes” is not just a collection of insights; it's a transformative tool that can empower your practice's financial foundation.
Drawing on industry expertise and real-life experiences, "15 Money-Murdering Mistakes" deciphers the intricacies of medical billing, allowing you to navigate this realm with confidence and precision.
Secure your practice's financial future today.
By unraveling the mysteries of medical billing, you're not just safeguarding revenue – you're safeguarding your ability to provide quality care to your patients.
To your practice's success,
Rebecca and Don, The Revenue Recovery Wizards
P.S., Let's be transparent – our aim is to prove our value to you. By sharing this comprehensive guide, we're not only offering crucial insights but also showcasing the kind of expertise and dedication we bring to the table.
As you explore "15 Money-Murdering Mistakes," envision the positive impact we could have on your old accounts receivable recovery. We're excited to demonstrate what we can do for your practice's financial health, and we look forward to partnering with you soon.
From The Desk of Rebecca and Don
Front Royal, Virginia
November 20, 2024
Dear friend,
Today, we want to share a truly unique story - our story.
It's a tale of friendship, separation, loss, and an unexpected reunion that led to a mission to transform healthcare and help those in need.
In the early 1980s, we were just college friends. Don always knew what kind of special person Rebecca was and wanted the relationship to be more. Rebecca, well, she didn’t have the same vision for our relationship. She kept Don squarely in the friend zone. ☹️
We eventually drifted apart, got married, and started our own families.
However, life has its own way of bringing people back together. After 35 years, we reconnected through Facebook (That's another story in itself). In 2018, five years after the passing of her husband, Rebecca was preparing to move to Baltimore, while Don was going through a divorce.
In an unexpected twist, Rebecca invited Don to join her in Baltimore in 2018.
Our lives were quite different before we reunited. Rebecca had more than 20 years of experience in Revenue Cycle Management (RCM) and medical billing. She was really good at helping healthcare providers get paid by insurance companies and others. She had personally billed over 100,000 medical claims, making a lot of money for healthcare providers.
Don was more of a business expert. He knew how to make companies work better and keep employees happy. He'd even written business books published on Amazon.
But when we saw how bad the opioid crisis was in Baltimore, with people suffering from addiction, we wanted to help.
Together, we focused on helping the heroes who work in places that help people with addiction and mental health issues. But to do that, these healthcare providers needed to get as much money as they could from insurance companies and programs like Medicaid and Medicare. The more money they got this way, the less they had to ask patients to pay.
This was really important because many of these patients were struggling with addiction, and they needed help, not high bills.
Working in the same office, Don learned all about revenue cycle management from Rebecca, and Rebecca learned about managing employees and running companies from Don. We were passionate about making a difference in the behavioral healthcare world.
We have both been deeply affected by the pain of suicide and addiction in our own families.
We combined our expertise and passion to co-author two essential books: "15 Money-Murdering Mistakes No Medical Billing Company Would Dare To Tell You: Plus, The Mistake That Will Kill Your Practice" and "Slay The Claims Denial Dragon: How To Reverse As Many Denied Insurance Claims As Wizardly Possible." The first book outlines a verified system to prevent claim denials, while the second one is an effective and proven system for reversing denied insurance claims.
It's ten times harder to reverse a claim denial than to prevent the denial in the first place.
Today, we're known as The Revenue Recovery Wizards. We do one thing, the hard thing — reverse denied, rejected, and unpaid insurance and Medicaid claims for toxicology labs and behavioral healthcare providers.
What does this mean for you?
1. We work ten times as hard to recover your revenue, which is at risk of being lost forever due to other priorities and timely filing deadlines.
2. We work with your current revenue cycle management team; we do not replace them.
3. We do not get a penny until we reverse your denied, rejected, and unpaid insurance and Medicaid claims.
Our overarching message is simple - when healthcare providers receive fair compensation for their services, it translates to better care for those in need.
Our story is about two people who got a second chance and together are making the world a better place for people who need care.
With kind regards,
Rebecca and Don, The Revenue Recovery Wizards
Book A FREE 40-Minute Revenue Recovery Consultation
Who Are The
We are the Revenue Recovery Wizards, masters of financial transformation in the realm of healthcare.
Visionaries in Revenue Alchemy: We see opportunities where others see challenges, turning unpaid claims into golden streams of revenue.
Innovators in Problem-Solving: Complex denials are our puzzles, and we solve them with the finesse of wizards.
Fearless Trailblazers: We navigate the labyrinthine world of medical billing with courage and precision, forging paths where none existed.
Architects of Financial Vitality: Our mission is to fortify healthcare providers, ensuring their financial health in order to deliver the best care to those in need.
Keepers of Industry Secrets: We wield the hidden knowledge of billing intricacies, transforming it into power for our partners.
Unyielding Advocates: We stand for patients, ensuring they receive the care they deserve without undue financial burden.
Defenders of Revenue Streams: We guard against revenue leakage, staunchly protecting the lifeblood of healthcare providers.
Masters of Expertise: Our wisdom in toxicology, billing complexities, and claims denials knows no bounds.
Creators of Revenue Magic: We make the impossible possible, turning denials into approved claims with a wave of our expertise.
Guides Through the Billing Maze: We illuminate the path to financial recovery, empowering providers to thrive.
Champions of Collaboration: Together, we overcome challenges that no one could face alone.
Saviors of Lost Revenue: We reclaim what was once lost, channeling it back into the hands of those who heal.
Pioneers of Data-Driven Success: Through meticulous analysis, we uncover the hidden gems in accounts receivable.
Wizards of Compassion: We understand the human side of billing, advocating for patients' financial well-being.
Guardians of Ethical Billing: We uphold the highest standards of integrity in every claim we touch.
Agents of Financial Resilience: We strengthen the financial foundations of healthcare, ensuring its stability for generations to come.
Emissaries of Hope: In our work, we bring hope to patients, providers, and communities alike.
Admirers of the Possible: We know that the word "impossible" holds no sway in the face of our determination.
Builders of Lasting Legacies: We leave behind a legacy of financial health, empowering providers to care for their communities.
The Revenue Recovery Wizards: We are the guardians of healthcare revenue, masters of financial transformation, and champions of a healthier future.
Book A FREE 40-Minute Revenue Recovery Consultation
About The Revenue Recovery Wizards
Rebecca Hollinger
Rebecca Hollinger brings a wealth of expertise in Revenue Cycle Management (RCM) and medical billing, gained through a dynamic career spanning over two decades. Her extensive experience and dedication to the healthcare industry make her a true asset in the field.
Rebecca's role as Assistant Director of Revenue Cycle Management showcases her specialization in claim denial and rejection management. She demonstrates a keen understanding of both In- and Out-of-Network provider reimbursement across various payer types, including commercial, Medicaid, Medicare, and behavioral health carve-outs. Rebecca's meticulous approach has led to the timely billing of over 100,000 claims, generating substantial revenue from toxicology and COVID-19 testing claims under key accounts.
Her expertise extends to training and mentoring staff on various RCM practices, creating a culture of excellence and expertise within her team. She is a driving force behind billing strategies that aligns with payer guidelines, ensuring maximum revenue recovery and operational efficiency.
Rebecca's role as an RCM Manager at LTC Billing Solutions showcased her comprehensive understanding of billing guidelines and rates for Medicare A and B, Medicaid, and commercial payers. She trained facility personnel to excel in administrative and billing functions, imparting her knowledge of benefit limits, CPT codes, timely filing deadlines, and COB requirements. Rebecca's meticulous attention to detail translated into accurate AR reviews, Excel reports, and effective AR collections, ensuring proper payment of claims.
With her comprehensive expertise in RCM, medical billing, and business management, Rebecca Hollinger is a beacon of knowledge and professionalism. Her commitment to accuracy, strategic thinking, and team development has positively impacted countless medical practices, resulting in enhanced revenue recovery and operational excellence.
For further insights or to explore how Rebecca's expertise can benefit your medical practice, reach out to her at rebecca@rebeccahollinger.com
Don Kermath
Don Kermath is a dynamic professional with a wealth of experience across diverse fields, showcasing a unique blend of entrepreneurship, leadership, technical expertise, and passion for business systems. With a solid foundation in architecture and management, Don has made remarkable contributions to various industries throughout his career.
Don's journey as an entrepreneur and visionary leader encompasses roles in various organizations spanning multiple domains. Don has become an employee turnover reduction and business systems expert.
Don Kermath has authored several impactful publications, ranging from books to reports, covering subjects like employee management, small business strategies, indoor air quality, historic preservation, and more. These publications reflect his commitment to sharing knowledge and insights across diverse fields.
Don Kermath's commitment to continuous learning is evident through his Master of Architecture degree and participation in various managerial and technical workshops, seminars, and training programs. He has also been actively involved in professional organizations, leadership roles, and community service.
Don's dedication to excellence has been acknowledged through numerous awards, including leadership recognition from Toastmasters International, certificates of appreciation from various organizations, and commendations for his contributions to various projects and initiatives.
Don Kermath's multifaceted career is a testament to his unwavering dedication, strategic thinking, and passion for making a positive impact across different industries. His journey highlights his role as a visionary entrepreneur, educator, author, and advocate for small and medium-sized businesses.
For further insights or to explore how Don's expertise can benefit your medical practice, reach out to him at don@donkermath.com
Book A FREE 40-Minute Revenue Recovery Consultation
Success Stories & Case Studies
Unveiling Hidden Revenue Through Strategic Medicaid Engagement
In the intricate world of medical billing, a healthcare provider found themselves grappling with a persistent challenge – a substantial backlog of unpaid Medicaid claims. Despite meticulous claim submissions, a significant portion remained unreimbursed, leading to revenue loss and financial strain. Operating in Ohio, the provider faced the added complexity of the state's diverse Medicaid coverage options. Desperate for a solution, they turned to the expertise of the Revenue Recovery Wizards.
Challenge: Unpaid Medicaid Claims and Shifting Payer Landscape
The Accounts Receivable (AR) report revealed a concerning pattern of unpaid Medicaid claims that were impacting the provider's financial health. Determined to decipher the root cause, the provider embarked on a journey to uncover the truth behind these lingering unpaid claims. It was soon realized that Ohio's Medicaid landscape offered various payer coverage options, each with distinct member ID numbers and coverage plans. This intricate system presented challenges in aligning claims with the correct payer, leading to revenue leakage.
Discovery: Navigating Complex Payer Changes
Delving deeper, a crucial revelation emerged – effective 3/1/23, one of the Medicaid payers had implemented changes to member ID numbers and coverage details. This coincided with the surge in unpaid claims, creating a direct impact on the provider's revenue stream. The need for immediate intervention to address these changes became paramount.
Solution: Precision and Strategic Payer Engagement
Recognizing the need for a strategic approach, the Revenue Recovery Wizards embarked on a meticulous investigation. Armed with expertise and tenacity, they initiated direct communication with the payer through detailed phone calls. Each conversation aimed to uncover the critical details that had eluded the provider, leading to a deeper understanding of the payer's new system.
Understanding the urgency, the team meticulously researched the previous ID numbers of each patient through the state's Medicaid portal. Simultaneously, they identified and tracked down the new ID numbers brought about by the payer's policy change. This precise data gathering formed the foundation of their strategy.
Implementation: Precision Data Harmonization
Armed with a wealth of meticulously collected data, the Revenue Recovery Wizards executed a dual-pronged strategy. Firstly, they diligently updated the provider's Electronic Health Records (EHR) system with the new ID numbers, ensuring seamless alignment with the payer's modified system. Secondly, outdated ID numbers were systematically retired, paving the way for a smooth transition in future claims submissions.
This harmonization of patient data, member IDs, and coverage details proved transformative. The meticulous effort led to the recovery of hundreds of thousands of dollars for the provider. What initially appeared as an insurmountable challenge was resolved through precision, strategic engagement, and an unwavering commitment to revenue recovery.
Results: Triumph of Expertise and Collaboration
The provider's persistent challenge of unpaid Medicaid claims was not only resolved but transformed into a remarkable success story. The Revenue Recovery Wizards' meticulous approach recouped significant revenue and fortified the provider's future financial stability. This accomplishment highlighted the power of strategic engagement, data precision, and the unwavering dedication to safeguarding revenue streams.
Key Takeaways:
1. Strategic Engagement is Key: The case underscores the importance of strategic communication with payers to unveil hidden challenges and opportunities.
2. Precision Data Management: The successful resolution hinged on meticulous data collection, alignment, and harmonization.
3. Expertise Yields Triumph: Expert intervention can transform complex challenges into triumphs, recouping significant revenue and ensuring future financial stability.
Conclusion: Navigating Complexity for Revenue Recovery
The case of unpaid Medicaid claims illustrates the transformative journey from challenge to success, emphasizing the critical role of expertise, precision, and strategic engagement. With the guidance of the Revenue Recovery Wizards, providers can navigate the intricate landscape of medical billing, reclaim lost revenue, and pave the path toward sustained financial vitality.
A Strategic Triumph Over Denied Claims with Medical Mutual
In the intricate landscape of medical billing, even well-established healthcare providers can find themselves grappling with the complexities of claims submission and denial management. This case study sheds light on the journey of a healthcare provider who faced a formidable challenge in addressing denied claims from Medical Mutual. Seeking expert assistance, they turned to the Revenue Recovery Wizards, leading to the successful recovery of $300K in old claims. This case study underscores the power of meticulous investigation, strategic communication, and unwavering persistence.
Challenge: Navigating Complex Denied Claims
The healthcare provider, in partnership with Medical Mutual, encountered a significant roadblock in the form of $300K worth of denied claims. These denials encompassed an array of issues, including sequential order submission non-compliance and type of bill errors. A particularly perplexing challenge emerged – the denial of claims due to apparent missing authorizations. Despite the seemingly straightforward nature of these claims, errors and misalignments had led to significant financial setbacks.
Solution: Meticulous Investigation and Strategic Communication
Recognizing the gravity of the situation, the Revenue Recovery Wizards embarked on a meticulous investigation. They meticulously reviewed each claim, addressing the complexities associated with sequential order submission and type of bill errors. Precision was paramount in ensuring compliance with Medical Mutual's stringent requirements.
For the denied claims rooted in alleged missing authorizations, the Revenue Recovery Wizards delved deeper. Their investigation unveiled a crucial revelation – the authorizations were indeed on file but had not been appropriately linked to the claims. Armed with this insight, the team initiated a detailed call with Medical Mutual's claims supervisor.
Implementation: Bridging Precision and Communication
Through effective communication with the claims supervisor, the Revenue Recovery Wizards sought to rectify the gap between the authorizations and the claims. They presented compelling evidence of the existing authorizations and worked collaboratively to establish the necessary link. In parallel, claims denied due to sequential order submission and type of bill errors were meticulously corrected to align with Medical Mutual's guidelines.
Results: A Resounding Financial Triumph
The meticulous investigation, strategic communication, and precision-driven implementation culminated in an exceptional outcome. The healthcare provider successfully recouped a remarkable $300K in old denied claims that had accumulated over a span of two years. This triumph underscored the significance of timely addressing denied claims and the impact of effective collaboration with payers to rectify errors.
Key Takeaways:
1. Meticulous Investigation: Precision in investigating and understanding the complexities of denied claims is vital for successful recovery.
2. Strategic Communication: Effective communication with payers, like Medical Mutual, is essential to bridge gaps and rectify errors.
3. Unwavering Persistence: Addressing denied claims promptly and persistently can lead to substantial financial recovery and reinforced financial stability.
Conclusion: A Beacon of Expertise and Success
The case study of the provider's journey with Medical Mutual serves as a beacon of expertise and success in the domain of medical billing. The Revenue Recovery Wizards' commitment to precision, communication, and unwavering persistence led to a resounding financial triumph. This case study stands as a testament to the potential of reclaiming denied revenue and strengthening the financial foundation of healthcare providers.
With the Revenue Recovery Wizards as steadfast partners, healthcare providers can navigate the intricate challenges of denied claims, rectify errors with precision, and transform obstacles into opportunities for financial recovery and growth.
Overwhelmed Billing Team and Complex Toxicology Billing
The in-house billing team found themselves drowning in a sea of inpatient and outpatient facility claims, unable to cope with the sheer volume. Adding to their predicament were the toxicology claims, which posed intricate coding and modifier challenges. The billing team's lack of expertise in this area left these claims untouched, contributing to substantial revenue loss.
Discovery: Unveiling Hidden Revenue Potential
Recognizing the untapped potential for revenue recovery, the healthcare facility enlisted the expertise of the Revenue Recovery Wizards. With their specialized knowledge of toxicology billing, the wizards understood the intricate coding nuances and the critical role of appropriate modifiers. Upon delving into the situation, they uncovered a pivotal revelation – the in-house billing team was solely focusing on high-dollar claims, oblivious to the treasure trove of low-dollar toxicology claims.
Solution: Unlocking the Power of Expert Toxicology Billing
The Revenue Recovery Wizards embarked on a transformative journey to address the pressing challenges. Armed with their proficiency in toxicology coding and modifiers, they meticulously navigated through each claim. They embarked on an initiative to code and apply the necessary modifiers to toxicology claims, ensuring their accurate submission.
Results: $1.5 Million in Recouped Revenue and Unveiling Hidden Potential
Leveraging their expertise, the Revenue Recovery Wizards embarked on a comprehensive endeavor to tackle the full spectrum of claims, toxicology included, spanning back 12 months. This strategic move led to a staggering $1.5 million in recovered revenue. What initially appeared as low-dollar claims amassed into a substantial financial gain, underscoring the latent potential within overlooked claims.
Key Takeaways:
1. Expertise Unlocks Revenue: The case emphasizes the transformative impact of expertise in navigating intricate coding and modifier requirements, particularly in areas like toxicology.
2. Inclusivity Matters: Addressing all claims, regardless of their individual value, can result in significant revenue recovery, even from seemingly insignificant claims.
3. Strategic Collaboration: Partnering with the Revenue Recovery Wizards empowers healthcare facilities to harness hidden revenue potential and optimize claims processing.
Conclusion:
This case exemplifies the profound influence of expert intervention in grappling with complex claims processing and revenue recovery challenges. By harnessing the expertise of the Revenue Recovery Wizards, the healthcare facility not only reclaimed substantial toxicology revenue but also unveiled the power of inclusive claims management. The narrative underscores the pivotal role of expertise and strategic collaboration in uncovering untapped financial opportunities.
