Insurance Reimbursements and Billings Program

Maximize Your Insurance Reimbursements & Billings Program. CECOP USA has partnered with OMS to bring you the Cash & Coding Review.

Maximize Your Insurance Reimbursements & Billings Program

CECOP USA has partnered with Optical Medical Solutions (OMS) to bring you the Cash & Coding Review. This review is designed to enhance your clinical and administrative processes while increasing your profits.

We work remotely with your practice to evaluate the Revenue Cycle Management (RCM) and Accounts Receivable (AR) workflow. Specifically, we review and assess operations, coding, and documentation of the medical record, collect information and reports relevant to daily operations.

A summary of the key areas we look into is listed below. We document the findings in a detailed report leading to an action plan. The action plan is full of recommended processes to correct any coding, billing, AR management or compliances that could be costing you money.

  • Accounts receivable review.
  • Medical record audit of ten records (looking into compliance and code choice/utilization).
  • Medical record review includes an audit of what was billed tied to the corresponding.
  • Explanation of Payment (EOB/ERA) validating proper claim filing and reimbursement.
  • Coding and documentation review.
  • Review of billing/collections processes.
  • Summary report of findings and recommendations.
  • Follow up meeting to review report findings and define areas of implementation for practice benefit.

Example of Potential Savings: 

The three areas of opportunity we commonly see in all practices assessed are coding/billing, AR management, and compliance.

The numbers and examples below are from an average practice of $750K - 1MM, 1.5 FTE docs and average 4 staff. The values are annualized. Medical patient care is less than 20% of billed patient care provided (based on AR contribution of insurance payables).

  • Coding and Billing – $30,000 unbilled or wrong codes
  • Accounts receivable management errors - $49,000
  • Compliance and Risk mitigation - $50,000 conservative audit savings

For one business, that totals $129,000 that they could be using to grow their business or put towards their bottom line.

The Insurance Reimbursements & Billings Program for a low monthly fee of $199 per month per location. (12 month commitment)