MEDICAL BILLING

Web Based Medical Billing Service

At Group J our mission is simple – to increase your practice revenue. To accomplish this, we have put together a unique integrated solution that combines web-based practice management software and best-in-class medical billing services. This solution will decrease denials, enforce payer contracts and increase practice volume. The result is an increase in your revenue.

 

Group J's services include:


Denial Reduction:

Our web-based software includes a rules engine. These rules eliminate coding and demographic errors at the point of billing.

Enforcing Payer Contracts:

On average, commercial insurance carriers underpay claims by 7%. With our payer contract compliance software and client specific payer knowledge base we are able to identify and appeal all underpaid claims.


Our web-based solution is designed to meet the needs of a wide range of hospitals and practices with specialty-specific templates that further ensure maximum efficiency for your practice.

Group J uses the latest advancements in secure, web-based platform technology that ensures safe, reliable data integrity and HIPAA privacy and security compliance.

 

Electronic Claim Submission

One of the largest issues in the medical billing process is the timely collection of payments due. We submit your claims electronically to significantly improve collection time. Our electronic claims submission process is available to all practices regardless of size with no additional equipment expense. The quicker your claims are submitted to carriers, the faster you receive your payments. Security is always an issue with electronic submissions. We maintain a compliance plan, which helps to ensure the safety, confidentiality, and integrity of your data. We can provide your practice with the highest quality medical billing services while complying with HIPAA requirements.

 

Group J submits claims daily. Our accounts receivable department works diligently to pursue all outstanding amounts from both patients and carriers. We always maintain the highest level of professionalism when interacting with your patients. We will review your EOBs to ensure that your reimbursements are accurate. In addition, we will post your payments electronically to our web-based system, which allows for immediate submission of secondary claims. We pursue all secondary and tertiary carrier claims, as well as follow up on all disputed claims until a resolution is found.

 

Credentialing Services

Credentialing has a well earned reputation as a labor-intensive, tedious process that until recently was primarily performed in the hospital setting. In order to comply with the current requirements of regulatory governmental agencies and insurance providers, credentialing has taken on a new dimension. The process is more complex, requiring sophisticated new software and computer programs. Credentialing is no longer a part-time assignment; it requires the full-time attention of trained credentialing specialists.

Group J's extensive network of contacts with insurance companies gives us the knowledge necessary to perform credentialing services in a professional and timely manner. Our experience in Medical Billing and Credentialing will benefit your practice by increasing your cash flow. Group J's credentialing software allows for a quick turnaround time with insurance and hospital applications.

 

Monthly Reporting

Not only is it important to maintain good cash flow for hospitals and physician practices, it is equally important to have current knowledge of your receivables. Group J provides accurate monthly reports that allow practices to track AR. You will see the status of all outstanding claims and balances due. This helps to maintain a healthy cash flow and manage payables.

 

Cash Deposit Reconciliation Reporting

Group J performs a monthly reconciliation of cash, checks and electronic deposits received by the practice to insure the reliability of the accounts receivable file, and that all the cash transactions have been correctly posted for the month. Cash control is a critical function of any practice.

 

Collection and Follow-Up Services

All claims are professionally filled out and submitted on a timely basis. Once a claim is submitted we track its progress until payment is received. In order to receive maximum payment from insurers many claims are resubmitted until payment in full can be achieved. Group J uses the latest technology allowing us to manage account follow-up through insurance or private pay. Post collection services are also available to our clients.

 

Governmental Insurance Follow-Up

We ensure clean, compliant claims when submitting to governmental programs. Follow-up is performed using a variety of tools including web sites and governmental program systems. We have direct connect capabilities to the Medicare intermediaries, which results in taking days off the process. Our highly trained staff is well versed in governmental program billing and reimbursement and compliance.

 

Managed Care & Commercial Insurance Follow-Up

We have extensive experience in managed care and commercial insurance receivables. Group J has a proven track record of collections for our healthcare organization clients. We use the most up to date technology and processes available to adjudicate claims timely and in an effective manner. We provide immediate focus to problem accounts while allowing clean claims to pass through the normal processing cycle. Our system alerts us to accounts that are in need of follow-up and prevents accounts from aging unnecessarily.

 

Workers' Compensation / Auto Insurance

Group J is experienced in managing Workers' Compensation and Auto Insurance receivables for healthcare organizations. We utilize our advanced technology and a disciplined approach to this often manually intensive process. Our experienced staff is skilled at working directly with employers, Workers' Compensation carriers, commissions and review boards to successfully expedite claims.

 

Clean-Up Projects

Accounts receivable clean-up projects can seem overwhelming, especially when resources are limited. Group J provides a focused solution that includes analysis, advanced technology and highly trained staff to identify problems with aged receivables and expedite the adjudication of these accounts.

 

Group J's collection process dramatically reduces collection issues. However should issues arise we start by providing a clear paper trail of the claim. We follow up with professional phone calls to the party in question. Should repeated efforts fail to provide acceptable results, Group J will report delinquent claims to the appropriate credit bureaus. Should litigation become necessary we will work with attorneys to provide all necessary material.

 

Medical Practice Management

Group J's medical management team offers practices the management knowledge and finance expertise they need to tackle hard questions and solve tough problems. We can help you maximize financial performance, prepare a cash flow forecast, monitor key performance benchmarks, map out a strategic plan or conduct a merger analysis.

Medical practices face unprecedented demands to reduce clinical and administrative costs while meeting tighter compliance and security mandates. Group J offers a practice management system that can simplify the day-to-day operations of your medical practice.

 

Group J offers a wide variety of management solutions that help you to operate your practice more efficiently and more profitably:

  • Centralized record keeping and management
  • Streamlined billing processes to improve cash flow
  • Complete scalability to accommodate growth
  • Lower total cost of ownership
  • Billing consulting
  • Coding and chart audits
  • Audits of insurance payments, write-offs, appeals
  • Internal collection methodology
  • Accounts receivable and fee schedules
  • Office policies and protocols
  • Physician and staff training in coding, procedures and documentation
  • Analysis of practice profitability