In today’s reimbursement world, average denial rates among providers are greater than 10% with best practice being at or below 5%. So how do you effectively analyze and assign workflow to prevent timely filing for possible rebills or appeals; with some timely filings being as low as 60 days? TECHNOLOGY
At Medco we utilize our proprietary Payor Compliance™ software suite. Payor Compliance utilizes contract management solutions and denial workflow based on granular denial code analysis to effectively identify trends causing revenue leakage. Thus, MAXIMIZING clients’ reimbursements! The Secret to Success? Using CARC code CO16 as an example. CO-16 translates to “Claim/service lacks information or has submission/billing error(s)” Every payor will utilize this denial code along with many others differently. To further define these type CARC codes, some payors will assign a RARC code along with the CARC code. Such as, utilizing M76, which is defined as “Missing/incomplete/invalid diagnosis or condition” or MA112, which is defined as “Missing/incomplete/invalid group practice information.” Analyzing denials based on sub codes allows quick identification of the root cause of the denial and allows the denials to be worked much more efficiently. In some cases, multiple accounts can be corrected at the same time. Why utilize a contract management solution to further analyze opportunities? Continuing with the CO-16 above, utilization of contract management calculates the expected reimbursement for each claim. Stated above CO-16 is utilized differently among payors. A RARC code for M119 along with the CO-16. RARC code M119 is defined as “Missing/incomplete/invalid/deactivated /withdrawn NDC number.” However, the service being billed is not payable according to your contract with said payor. By knowing your expected reimbursement you can review if the claim was paid appropriately even with a denial given on the claim. This would eliminate the time for a collector to rebill or appeal a denial where you would not be expecting any further reimbursement. Try it today! Contact MedCo to discuss analysis of your AR and to take advantage of effectively resolving your AR and lost revenue! About MedCo Headquartered in Huntsville, AL, MedCo has over 25 years of experience providing world-class customer service and higher than standard performance in the healthcare revenue space. MedCo is a technology based RCM company with particular areas of expertise in Patient Access, Early Out, Bad Debt, AR improvement and Lost Revenue recovery. The company boasts many long term clients as proof of performance in the industry. For more information visit www.medcoservices.com or call 1-844-528-4338
0 Comments
MedCo is excited to announce the expansion of our sales team. Jeff Brown and Gail Locke have joined the MedCo sales team as VP of Sales.
“We are excited to be adding additional talent to our sales team. Jeff brings strong sales leadership and will be responsible for launching our newest solution Health QRS, as well as growing our RCM business. Gail has tremendous legal and bad debt experience and will be focused on our bad debt solution. With these two additions, MedCo is posed to continue its growth beyond 2020 and be the valued partner that healthcare providers can count on,” says Executive Vice President of Sales, Greg Wilder. Mr. Brown has over 30 years of experience in the healthcare sector specializing in physician practice management and operations. The last 20 years of his career have been focused on emergency medicine and trauma services. His administrative experience includes responsibility for all operations at a level 1 trauma center treating in excess of 140,000 patients annually. He has also been instrumental in business development for some of the largest managed service healthcare companies in the country. His experience also includes sales and management of all national account relationships for the largest EMR vendor in emergency medicine serving patients in every state. Mr. Brown has an extensive background in analytics, revenue cycle and best practices and is committed to the cultivation and development of long term relationships. He received his BA in Health Service Administration from Auburn University. Mrs. Locke’s passion for Hospital Revenue began when she started her career working part-time at a local hospital in Pensacola, Florida at the young age of seventeen. Since then she has gained extensive knowledge of Patient Accounting, Reimbursement, Managed Care and Internal Cash control. Before joining the sales team, Gail was the Client Services Manager and then part of the development team for MedCo’s bad debt division. Gail has been with MedCo for over 4 years and holds a BA in Accounting from Athens State University. Each year MedCo likes to find different ways throughout the year to give back! This holiday season MedCo decided to have a little fun with our company Food Drive by adding a friendly competition for our employees. “Being an Alabama based company; most of our employees have to choose a football team at birth. Around here you either say Roll Tide or War Eagle; and if you know anyone from Alabama you know that it is a very serious choice,” President and CEO, Joe Uptain says jokingly.
MedCo had two donation boxes for their employees to donate to; one for the Alabama Fans and one for the Auburn fans. Much like the Iron Bowl game, the team who filled up their box with the most donations won bragging rights for the year! The Auburn fans ran away with it this year! All the food donated was given to Manna House of Huntsville to help those in need during this Holiday Season. “MedCo has always enjoyed giving back to our community in any way we can, and it is great to see our employees get involved and excited about such a wonderful cause,” says Uptain. Chicago, IL- MedCo Services, Inc., a leader in Revenue Cycle Management, announced today at Becker's Hospital Review 5th Annual Health IT + Revenue Cycle Conference its strategic partnership with HealthQRS.
HealthQRS’ founders were the former founders of nTelagent, the first holistic retail application for point-of-service healthcare. HealthQRS was founded to create a retail healthcare platform that addresses the needs of all stakeholders in healthcare: consumers, providers, payers as well as government. HealthQRS’ retail platform allows for an “Amazon-like” shopping experience for consumers. As part of the partnership, MedCo will provide sales and marketing as well as customer service and helpdesk support. The partnership will combine two highly proven revenue cycle companies intending to provide both providers and patients cutting edge technology and world class support. “Since day one we have been an IT-centric company. A couple of years ago we recognized the need to be more consumer-focused as the healthcare industry transitions. “We began looking for an IT solution that could complement our existing Pre-Services service line offerings. HealthQRS does that and so much more. We are excited to partner with HeatlhQRS and this industry changing product,” says Joe Uptain, president and CEO of MedCo. The HealthQRS solution offers an entire online retail experience with one, easy-to-use platform. In fact, HealthQRS developed the only complete e-commerce platform for healthcare on the market. Consumers use a HealthQRS app to schedule their own appointments from their smart phones and can see actual out-of-pocket expenses before they schedule. The platform has many other modules, including scheduling, pre-registration, eligibility, verification, price estimation, charity, check-in, referral management, patient tracking and more. “In today’s healthcare environment, providers are being mandated to provide pricing transparency and operate on smaller margins than ever before. Patients on the other hand, are being forced to become consumers of healthcare due to high insurance plan deductibles. The HealthQRS platform allows providers to operate more efficiently while providing an Amazon-type experience for the patient. Our goal is a win-win for all parties,” says Earl Winter, President of HealthQRS. About MedCo Headquartered in Huntsville, AL, MedCo has over 25 years of experience providing world-class customer service and higher than standard performance in the healthcare revenue space. MedCo is a technology based RCM company with particular areas of expertise in Patient Access, Early Out, Bad Debt, AR improvement and Lost Revenue recovery. The company boasts many long term clients as proof of performance in the industry. About HealthQRS HealthQRS was founded to provide a retail platform to address consumerism in healthcare that includes patient payment, navigation and engagement. The platform ensures pricing transparency for patients and helps service providers collect the patient’s financial responsibility in a consumer-friendly fashion which increases revenue and cash flow while reducing bad debt. HealthQRS provides a scalable and customizable cloud-based platform that seamlessly integrates into retail patient processes and systems. The solution is so much more than revenue-cycle management. HealthQRS can be used as a marketing tool for providers because no one else is offering a full-scale retail experience for consumers in healthcare. HealthQRS makes the entire retail process of healthcare easy for all stakeholders such as consumers, employers, employees and payers. For more information visit www.medcoservices.com and www.healthqrs.com To register for an upcoming HealthQRS webinar visit https://register.gotowebinar.com/rt/3649897419894614797 or call 1-844-528-4338. ![]() MedCo is excited to announce that Greg Wilder will lead the Sales team! Greg will fill the slot vacated by Wallace Harmening’s recent promotion to Chief Revenue Officer. Greg has over 25 years of sales, management, business development and executive leadership experience in the Healthcare Industry. The majority of his career has been focused on providing solutions and services with an emphasis on revenue cycle management applications. He has held various leadership roles in both large fortune 500 corporations and small start-up ventures; as well as having extensive experience in developing strong client and strategic partner relationships. “When Greg joined our team we envisioned this day. Our explosive growth over the past 18 months has allowed us to fast track this move. We look forward to continued growth under Greg's leadership” says Harmening. Greg has a BA from Lipscomb University in Nashville, TN and currently resides in Brentwood, TN with his wife Dana. ![]() During the recent 25th Anniversary celebration, MedCo announced Brandy Simpson has been promoted to Vice President of Revenue Optimization. "I am so proud of Brandy" says Joe Uptain, MedCo President and CEO. "One of my favorite characteristics about MedCo is how many employees who have previously left for education or other opportunities always find their way back. I hired Brandy about 15 years ago to assist us with answering the telephone. After moving up the ladder to the position of Client Services Manager, she received an opportunity to work for a health facility that would help expand her knowledge in the revenue cycle area, while attending college. Through her dedication, intelligence and perseverance; Brandy found her way back to MedCo in 2017 with her degree and a wealth of experience and knowledge. We are so excited to have her back as a part of our team and our vision to Exceed Expectations as a Revenue Cycle Management company." Please join us in congratulating Brandy on her new role! ![]() During the recent 25th Anniversary celebration, MedCo announced Terri Edger has been promoted to Vice President of Operations. Terri previously served as Director of Call Center Operations. During her 5+ years with MedCo, she has also held the Director of Client Services role as well as others. "As our company has grown from one to many over the last 25 years we have continually adapted and evolved to maintain our core values and objectives. During this time we have been fortunate to have outstanding people that help us achieve our goals. Terri Edger has been an integral piece of our organization and we are thrilled to extend her proven leadership to other parts of the company during this exciting time of growth for our company. Terri is committed to excellence" says Joe Uptain, MedCo President and CEO. Please join us in congratulating Terri on her well deserved promotion! |