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Equinox Provider Practice Solutions

Billing Integrity

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 WHO’S MONITORING YOUR BILLING INTEGRITY?

If your billing company is not coordinating with you to support your compliance and billing integrity initiatives, then you should give us a call.  Equinox PPS is experienced in revenue cycle and compliance.  We offer the following services to support billing integrity. 


WHY SHOULD THE SMALL MEDICAL PRACTICE HAVE A COMPLIANCE PLAN?


In June 2018, the OIG excluded 587 physicians and identified $2 billion in losses to the Medicare and Medicaid program.  Every $1 spent to investigate fraud, waste and abuse yields $4 in recovered funds.


  • In today’s reimbursement environment, every dollar is at risk.  Monies lost to a compliance problem can’t be simply recovered by increasing your fees
  • Lack of preparation and new risks can cost you money and reputational risk at a time when you can least afford to lose either
  • Early identification through compliance training and monitoring is the best strategy to mitigate those risks


COMPLIANCE PROGRAM SUPPORT

  • Annual Risk Assessment
  • Charge Capture Review
  • Coding & Clinical Documentation Review
  • CLIA Pre-Audit Reviews (in house labs)
  • Quarterly Revenue Cycle Review Updates
  • Coding Updates 
  • Training  & Education

Revenue Cycle Solutions

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Sometimes small administrative tasks can fall through the cracks, while large ones can seem to be more trouble than they’re worth. Many physicians believe that by selling their practice, they eliminate these practice management headaches.  Becoming an employee instead of a small business owner can come with its own set of problems.  Sometimes that which was meant to be an empowering decision can become a debilitating one—as decision-making is limited and the economics no longer bear out. 


At Equinox Provider Practice Solutions we focus on managing your revenue cycle so you can focus on managing patient care.  Having a partner that is focused on the revenue cycle goal result in small tasks getting done quickly and large ones seem easier to resolve.  Our account services include:


Claims Support: we consistently reviewing payor acceptance, rejections and denial reports to identify process improvements, customize edits and ways to minimize payment delays.


Account Follow Up & Appeals: we track and trend payer remittances  to ensure timely and accurate reimbursements.


Payment Posting & Credit Balances: we reconcile money matters to ensure your payments are correctly posted and account balances are accurate.  

                 

                                 REVENUE CYCLE OPTIMIZATION SERVICES     

                             Quarterly Business Review & Recommendations 

                                            Policy & Procedure Development 

                              Assessment and Maximization of EMR Functionality


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