Common Questions

No matter what your practice’s claim volume is, it may be a good idea to outsource your billing. Most billing services charge either a percentage of collections or a fee per claim, or both to fit any budget. If your practice is spending more than 10% of income on billing-related expenses, it may be more cost-effective to outsource your billing. If your practice is spending less than 10%, chances are you are not capturing all billing-related expenses and the “hidden costs,” that come with in-house billing. One of the biggest hidden costs for providers doing in-house billing is the average 25-30% practice income loss due to internal billing department mistakes. This is just an average and the loss can sometimes be even greater.

Click here for additional benefits of outsourcing your billing and to see how much you’re really spending on your billing costs.

Understanding and navigating the constant changes with insurance and government guidelines requires knowledge and expertise that only expert billers have. Submitting claims to carriers is not the most difficult part when it comes to maximizing your revenue cycle; the hardest part of what expert billers do is following up on unpaid and denied claims that insurance carriers are trying to avoid paying.

Having over 10 years of hands-on experience, as well as the educational background in dealing with the terminology payers try to use to erroneously avoid paying claims is what sets Colorado Medical Revenue Services apart from other billing companies.

Click here to learn more about the specialties we support at the Colorado Medical Revenue Services

Colorado Medical Revenue Services supports various EHR software. If we do not support your practice’s EHR we can manually extract your practice’s data into our billing software instead. If we decide that it makes more sense to bill through your software, that can be set up. We currently work with:

– Athenahealth
– Cerner
– Epic
– Greenway Health
– NextGen Healthcare
– Practice Fusion
– WebPT

If in doubt, just ask and we can see what fits best to meet your practice’s revenue cycle needs.

Our billing and collection services are just a small piece of what Colorado Medical Revenue Services can do for your practice’s revenue cycle and cash flow. We also offer full revenue cycle management, coding audits for compliance, consultation, and provider credentialing and enrollment services as well. Reach out to learn how we can help support your practice.

Colorado Medical Revenue Services provides personalized, boutique customer service to our clients. We usually charge a percentage of collections, which will vary depending on specialty, claims volume, and other factors regarding the scope of services needed for your practice. We customize plans to fit your practice’s budget. We can also offer our clients to pay a flat dollar amount per claim if that makes more sense for your specific needs and budget. This can be assessed more during the initial strategy session.

Setting up new clients takes time and energy in order to make sure they are set up and operational. It also takes a lot of resources. Many billing companies charge a separate set-up fee upfront for this extra work, but here at Colorado Medical Revenue Services, we consider it a cost of doing business with your practice.

Because of this, our service agreement requires a minimum six-month commitment. We require a six-month minimum commitment to guarantee that we recuperate that cost, however, we do have specific performance terms in our agreement. If we fail to perform to the best of our ability then you as the client are not held to this commitment.

Click here to contact us or call us at (720) 989-1050. You can also schedule a billing strategy request here.

Monthly practice management reports are key to easily identifying collection performance. Colorado Medical Revenue Services reports data to clients both by month and YTD cumulative basis. These reports will have key collection statistics, such as collection amounts per visit, and collection percentages. Providers can use these reports month-to-month to spot whether their financial trends are steady, increasing, or declining

With over 650 standard and configurable reports, there is really not a report we can’t provide. Monthly practice management reports are key in tracking a practice’s collection performance so most providers find that the in-depth monthly report that Colorado Medical Revenue Services provides our clients meets the needs of tracking key collection performance indicators alone. This report includes a monthly and YTD compiled summary of billing activity that includes charges billed, collections received for those charges, adjustments made, visits, and aging. Providers can find even more useful collection statistics in this summary, such as average days to collect, collections as a percentage of charges, dollar amount collected per visit, charges per visit, and more.

All clients will have a dedicated billing and accounts manager assigned to their practice. This individual will always be the main point of contact and will handle all incoming phone calls from the practice and its patients, as well as following up on unpaid and denied claims; reporting errors found and directly coordinating with practice staff in getting issues resolved and claims paid

More often than not, when insurance doesn’t pay for a claim it’s due to it simply being the patient’s responsibility for non-covered services of the plan or having unmet deductibles, etc. In these instances, we would transfer the balance to the patient and send a statement. However, there are times that insurance carriers deny claims by mistake or even deny claims for false reasons, such as “not medically necessary.”

When these instances happen, we put together chart notes, referrals and prescriptions and draft up and send appeals to show medical necessity or dispute whatever the erroneous denial may be. We always carefully review denials to determine what the best course of action is in getting claims paid with the least turnaround time.

Colorado Medical Revenue Services will send clients their monthly practice management report and invoice in arrears between the 1st and 10th of the month and payment is due 10 days from the date of the invoice.

Although we will be doing most of the demanding, time-consuming work, when it comes to maximizing and increasing your practice revenue and cash flow, it is extremely important for you as the provider to do your part in ensuring a smooth and efficient billing and revenue cycle process. To do this, we ask that clients maintain their EHR, such as making sure to create patient charts, updating demographic details and insurance details at the point of intake, and making sure you are providing Colorado Medical Revenue Services with correct information. It would be a good idea to run eligibility with the insurance carriers at the time of intake. If a plan requires authorization or a referral prior to a member being seen by the provider, it can be secured and managed and avoid claim denial for no authorization or referral present.

Providers need to make sure they are signing and finalizing notes in their queue on a regular basis to ensure that no visits are being missed for billing. It is important for providers and office staff to make sure copays are being collected at the time of service, and also, to the best of their ability any coinsurance amounts or unmet deductibles if known, which can be found during the insurance eligibility check. Provider clients will need to remit reports of patient payments that were collected to Colorado Medical Revenue Services at least once a week in order for patient accounts to be credited correspondingly.

It is imperative that clients have EOBs and copies of checks forwarded to Colorado Medical Revenue Services. We can retrieve ERAs for EFT payments your practice receives, but you have to provide us with copies of your paper remittances. Utilizing a lockbox service with the bank of your choice is something we would highly recommend. With lockbox services, the money goes directly into the provider’s bank account and then we are able to retrieve scanned copies of your EOBs and checks for posting all without the provider having to lift a finger. Clients who choose not to use lockbox services can also have their copies of EOBs and checks mailed directly to Colorado Medical Revenue Services or can fax them directly as well.