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GroupONE Billing Center will help you take control of your entire practice work flow and claims management processes. GroupOne Billing Center eliminates unnecessary claim denials and delays through a complete integration of workflow, billing and reimbursement management. This, along with the inclusive electronic medical record package integration, will help the billing center effectively and efficiently communicate with your staff and third party payors. Clean claims and a practice specific rules engine will increase your bottom line. |
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A new way to practice medicine — an innovative way to maximize collections. |
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ACCOUNTABILITY, Provided by GroupOne
Billing Center |
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True Workflow management including patient access to provider’s office via website, scheduling, document management, scanning, document routing, pharmacy call backs, electronic fee ticket, electronic medical records, recall, etc.
Billing Center professional coders update the informational database and are in constant contact with you regarding payor specific, practice specific and patient specific information by CPT code. This provides the most comprehensive client specific data to ensure clean claims and corporate compliance.
“Real-time" rules engines updates CCI edits, bundling and LMRP updates and searches for diagnosis compatibility.
Eligibility verification services are available within Group One Billing Center based upon payor specific capabilities and access. |
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Traditional Model
Percentage of net collections fee rate.(Current users.)
Subscription Model
Percentage of net collections and/or a set monthly fee rate.
"Turn-key" Model
Client purchases/leases. Lease payment is inclusive in the percentage of net collections fee rate. Other services include practice management, HIPAA compliance, and coding consultation.
Examples of our claims management services include the following: |
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The GroupOne Billing Center creates the charge in the system after review and verification by Certified Professional Coders of the coded charges, submit insurance claims via electronic means (and paper when applicable) to the appropriate payors, generate patient statements on a monthly/weekly basis, and maintains data files. |
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The Billing Center submits 100% of claims by electronic means with the only exception being those payors who do not accept electronic claim submission or appealed claims requiring additional documentation to the payor. |
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The GroupOne Billing Center allocates payments, denials and denial codes, and determines appeals in payment variance from negotiated contract to actual insurance payment. |
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GroupOne Billing Center’s team of experienced reimbursement specialists follows every claim from submission to adjudication ensuring proper handling of each claim submitted for payment. |
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On-line real time status of claims is tracked for continued reimbursement management of all claims. Claims submission date, re-filing of claims, as well as, follow-up billing and collection notes are all tracked and help to hold the billing staff accountable for all transactions and action occurring in the system. |
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GroupOne Billing Center’s experienced reimbursement specialists proactively research claims when payors fail to adjudicate claim within the specified time frame. They visually alert staff to follow-up on these claims promptly. |
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The billing center reactively researches denied claims, re-files and updates the practice internal database to alert staff to changes in payor requirements. |
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Staff members of the GroupOne Billing Center have on-line and immediate accessibility to information requested by the payors to help expedite claims adjudication with the least amount of interruption in the clinic office. |
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Contract and fee schedule management provides a detailed account of the true accounts receivable for the practice. It also provides an easy visual assessment of the variance between the scheduled payment amount and actual payment made by the payor. Both the contract and fee schedule management tools within Group One Billing Center are an excellent resource for the provider to ensure accurate and appropriate payment is received.
Management of all denied claims helps determine where deficiencies lie in coding and billing practices. Denial management is handled by individual payor and individual provider in the system and is used as a tool for the provider or office staff to correct coding and billing errors up front instead of correcting the claim when denied. This helps to ensure claims are "clean" when filed to the insurance company.
The reporting package is developed specifically for each clinic based on need and desire of the physician(s) and administrative staff. The system is set-up to automatically email monthly and annual reports to the appropriate recipients including the physician, the administrative staff and/or any outside entities such as the clinic accountant.
"Turn-key" practice management and consulting installation of the office product in the client’s office.
Providing HIPAA compliance, operational, and technical practice applications.
Integration of other technological solutions including handheld PDA’s and patient/physician educational videos and products, transcription services are available. |
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| “My practice consistently collects over $850,000 a month – up from $525,000 on average, in the last 5 months we have added an additional $1,200,000 to our bottom line” |
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