Medical Billing – Physician Credentialing

CMMS provides full-cycle electronic billing for medical practices as well as Physician credentialing to keep our providers’ carrier information up-to-date. In today’s Healthcare market, the physician is feeling the burden of Meaningful Use requirements, understanding EHR technologies, Quality Care reporting, the ICD-10 transition, reimbursement reductions and constantly changing contractual guidelines mandated by carriers. Meeting the billing requirements of Insurance Carriers as well as the expectations of the Patient is becoming increasingly difficult. CMMS provides the level of expertise physicians and practice owners need, allowing us to take care of the industry challenges while they provide quality healthcare to patients. Let us do the same for you!

Internal Billing & Compliance Audits

Medical practices are among the top 5 small to medium sized business that will experience FRAUD at least once during their tenure.  CMMS performs internal billing audits for both “in-house” billing departments and third-party billing services.  All too often – and when rarely a “check and balance” system exists; billing services can become complacent.  In a world where the rules are changing almost on a daily basis, a regular review of your current billing and best practices is always a good idea.  CMMS will audit most areas within your practice, regardless of software or EHR “type”.  Listed below are our most commonly named “problem areas”.

Reconciliation Processes                Back Office                    DOS vs. Days-to-Submission                 Charge Edits                   Coding & Compliance

Financial   (Batch to Bank)                 A/R                                  Time Value Of Money                                Accuracy                            ICD-9

Batch Claim Transmissions               Denial Trends                   Industry Standards                                   Timely Updates                   ICD-10