XTRA Department utilizes a low key, professional approach to collecting accounts. The company philosophy of treating everyone we contact with .dignity and respect. serves us well to build alliances with patients and insurance carriers. These alliances result in prompt, appropriate remittance for our clients.
We offer the following services
- Aged Receivables Clean-up
- Billing and Billing Backlogs
- Managed Care Follow-up and Recovery
- Indemnity Follow-up and Recovery
- Medicare Billing and Follow-up
- Self-Pay Recovery
- Early-Out and Pre-Collections Recovery
- Installment Payment Programs
- Office Staff Training
When accounts are initially assigned to XTRA Department we begin the collection process by assigning accounts based on payer mix and outstanding balances.
We review all accounts to determine if payment has been received. If so, reimbursement is compared to the managed care matrices to verify that the claim has been appropriately paid. We appeal all underpayments and will pursue collections until the hospital is fully reimbursed at the contract rate. If payments have not been received we contact the insurance carriers to determine what needs to be done to get claims paid and follow through accordingly. We are successful in securing retroactive authorizations and appealing denied services. As necessary, we rebill insurance carriers utilizing our billing software that edits all bills to ensure that only .clean claims. are submitted. We will continue our follow-up until accounts are resolved.
To ensure that positive patient relation are maintained we review all private pay accounts to determine if arrangements have been made on the amount due. If so, the patients are contacted to remind them of the balance and to verify payment schedules. If there are no arrangements the patient is contacted and payment for the balance due is requested. Based strictly on parameters established by the client, we may offer discounts or accept payment arrangements. Accounts are canceled back when it is determined that the patient is unwilling or unable to resolve their account. If we determine the patient has MediCal or other program coverage, we will verify eligibility, bill for the services and follow through accordingly.
If the patient requests financial assistance, we will send the hospital charity request form, along with information on how to complete the document. When the appropriate information is received back from the patient, we will forward the completed financial assistance forms to the appropriate client designee for review and approval. Once approved an adjustment form for the balance of the account will be prepared and submitted for data entry.
We have vast experience with recovery of workers. compensation receivables. We have a strong understanding of State of California regulations and maximum allowable reimbursement.
As with all payers, we review the accounts to determine if payment has been received. If so, we then determine if the services were reimbursed at a contract rate or at the Official Medical Fee Schedule (OMFS). If a claim is paid at the OMFS, we enter charge and payment data onto our Fee Calculation software to determine correct reimbursement has been received. If so, we prepare adjustment request forms and forward them to the client for review and processing. If the services are underpaid, we submit an appeal to the payer, requesting additional reimbursement. We continue our follow-up until accounts are resolved.
As with all other accounts assigned to us, we review accounts to determine if the claim has been appropriately paid.
Our review includes verifying that each line of an outpatient claim has been processed and that the inpatient claims are paid at contracted rates. If retroactive treatment authorizations are required, we will work with the appropriate client designee to coordinate submission of a TAR to the field office.
Our review includes verifying that the claims are appropriately paid including outlier accounts. We will submit medical records as needed and follow-up with the intermediary until the claim is paid or denied. If there are disallowed or unbillable late charges on an account, an adjustment request form will be prepared and submitted to the client for review and approval. Denied claims will be presented to the appropriate client designee to determine if we should submit an appealed or accepted the decision. Once Medicare pays we submit crossover claims as needed.