Archive for Wednesday, January 18, 2012

$25,000 from city to help Heartland Community Health Clinic improve billing process

January 18, 2012


Lawrence-based Heartland Community Health Clinic will receive a one-time payment of $25,000 from the Lawrence City Commission to help the nonprofit company better bill insurance companies for services provided at the clinic.

Commissioners approved the special funding request on a 4-1 vote at their Tuesday evening meeting.

The $25,000 will be used to help hire a medical billing employee for the clinic, which is located in the former Riverfront Mall building in downtown Lawrence. The new position will allow the not-for-profit center to submit more claims to insurance companies for services provided.

The city will pay for the request using money it receives from liquor tax money from the state. City Commissioner Mike Amyx voted against the request because he said competition for the special alcohol funding is competitive, and the city was forced to turn down several worthy requests during last summer’s budget process.

A representative of Heartland Clinic said he expects the billing position to be self-sufficient with a year. The organization requested money from both the city and the county to help cover start-up costs for the position.


Bursting 6 years, 3 months ago

Money well spent, this is a good place with good people. Now that they will be able to bill insurance companies this Health Clinic could be booked. I remember going several years ago but had to wait for an appointment because of doctor availabilty, I think they even had days without a doc in.

My question is, how many doctors will be on staff and how available will they now become to keep the clinic busy enough to pay for this much needed position and improvements in the future

markgermanos 6 years, 3 months ago

While I agree this is a step forward, I feel trying to do medical billing in-house is an inefficient way to accomplish this task. Contracting out medical billing is a very attractive option. Let me present some examples why this would be attractive.

ICD-10 coding mandates are lurking. During the second half of 2012,doctors’ offices will have to prepare for the ICD-10 coding structure. The coding will become much more complex and yes, there will be a deadline to implement the new coding. That leaves you between a rock and a hard place. You can choose option “A” of training your own staff by yourself or option “B” contracting out the service to a medical billing company that is already up to speed on the new codes. Suppose you choose option “A.” You see patients 40 hours a week, want to spend more time on your marketing and realize you need CE. When will you have time to train your staff and yourself the new billing structure? You won’t.

January, 2013 will arrive and you will be in trouble. Staff will submit claims in the old ICD-9 coding and those claims will be denied. You will have to learn ICD-10 and train your staff. All this while seeing patients, improving your marketing and getting your own CE. It is a very tall order.

Option “B” contracting out billing makes more sense. The medical billing company is responsible for working with insurance companies and collecting on your payments. You can focus on your marketing and continuing education.

Accountability. When you contract out the medical billing, you can hold the billing provider accountable. They get paid a commission on what they collect for you. The more you collect, the more they get paid. The incentive for promptness, accuracy and follow-up is obvious. Fewer delays. Insurers can delay payment to a doctor. These delayed payments can occur if the insurer doesn’t think the diagnosis is medically necessary or the diagnosis is incorrect. They could reach this conclusion if the diagnosis is expired, using a wrong code or doesn’t match the procedure code that you submitted. For example a doctor might bill for an electrocardiogram and use the diagnosis of a sinus infection. It wouldn’t make sense to bill this together because a sinus infection wouldn’t be a reason to have electrocardiogram. This is one example of why a claim could be denied. Also, if you submit the claim on paper, that could delay payment. When the claim is submitted on paper, someone at the insurer has to type the details into their system. It takes more time and delays your payment.

For more details, contact Brian Shaw at 866-976-1011.

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