Billing and Collections
ABS's billing and collections program includes:
- Data entry and verification
- Coding
- Claims submission and follow-up
- Payment posting
- Collections
- Follow-up
- Performance reports
Start-up practices require attention to details that permit the practice to bill and
collect payments from day one. ABS ensures the newly formed anesthesia group
emerges in the marketplace in an efficient and organized fashion with minimum
distraction to the practice and its individual providers. This allows the providers
to concentrate on building the practice and the all-important relationships with
surgeons and facility administrators and staff.
ABS uses anesthesia-specific billing software designed to accommodate the
nuances of anesthesia billing. The software provides timely, accurate and consistent
management reports that make the decision-making process easier for clients.
We encourage direct access by our clients to their practice data and reports. This
enhances our team relationship and ensures transparency in all of our activity.
ABS constantly updates technology to enhance business, improve revenue and
reduce overhead for clients.
Our billing software automatically checks for errors such as invalid
codes and the appropriateness of the code selection. ABS's electronic
clearinghouse provides automated edits to screen all claims for accuracy
and completeness prior to submission.
Compliance is critical to the continuing success of any practice and to our
reputation and function. It is incumbent upon the owners and management of ABS
to ensure compliance with all of the laws, rules, regulations and requirements related
to billing and payments from third party payers. Our responsibility extends to both
governmental and private payers.
ABS fulfills our responsibility by:
- Regular review of relevant publications and industry journals
- Review of the Federal Register, Medicare and Medicaid bulletins and
notices and publications from HCFA, the OIG and major insurance
companies
- Participation with the national and state Medical Group Management Associations and anesthesia societies
- Attendance at industry and specialty conferences
- Updates and regular communications with our peers and colleagues
Tony Hollingsworth, President and Chief Executive Officer for ABS, is
our Compliance Oversight Officer and remains available to our staff and
clients for consultation, review of specific incidents or reports of
potential abuse or error. ABS encourages open and frequent communication
with our clients, staff and advisors. When clients become aware of
billing concerns, we ask that they share the information with us so we
can follow-up to determine its relevancy and implications.
ABS’s Corporate Compliance Plan was developed in consultation with an
expert healthcare attorney to ensure that we have addressed all of the
required elements as directed by the Centers for Medicare and Medicaid,
the Office of the Inspector General for HCFA and state regulators.
Beyond the legal requirements, we are committed to quality improvement.
ABS’s Corporate Compliance Plan calls for regular process and
documentation audits of our billing service and our clients’ practices.
Random zero balance accounts are audited against the medical record and
payment information to ensure documentation supports the services billed
and the payement received. ABS contracts with an expert coder to review
the work of our own coders. Records are randomly selected and evaluated
for the appropriateness of the code selection and missed charges or
other anomalies on the billing record that may have implications for
inappropriate or inaccurate coding. Routine audit services are included
in our agreements, and if a potential problem is identified, we may
recommend the client contract with an outside auditing firm.
ABS is in compliance with all published HIPAA standards, including
the acquisition of National Provider Identifiers, Privacy Standards,
Electronic Health Care Transactions and Code Sets and Security
Standards.