Billing Services

Periodic billing compliance audits can help your organization avoid potential violations of federal, state and internal corporate compliance guidelines, as well as highlight operational practices that may cause duplication of work or poor cash flow. Warning signs that may prompt your organization to consider an external billing compliance audit include:

• Increasing number of Medicare claims selected for medical review
• High occurrence of denied claims
• Business office or billing staff turnover
• High occurrence of payment adjustments
• Poor cash flow

BKD National Health Care Group can perform a billing compliance audit under client-attorney privilege if there is suspicion of compliance violations or as part of your organization’s corporate compliance plan. In addition, we can act as an independent review organization for providers subject to corporate integrity agreements. Our services include:

• Conducting interviews with billing staff
• Testing billing transactions for consistency with medical documentation and payment accuracy
• Reviewing billing reports to identify payment posting accuracy
• Reporting findings and recommendations to legal counsel

Periodic billing operations assessments can help you identify potentially inefficient practices that may contribute to poor cash flow, payment inaccuracies or other significant billing problems. Warning signs that may signify your organization’s billing operations are stagnating may include:

• Increasing accounts receivable balances
• Inconsistent cash flow
• Business office or billing staff turnover
• High occurrence of payment adjustments
• Inability to obtain reliable billing reports

BKD National Health Care Group’s billing operations assessments can identify areas of inefficiency and enhancements to your billing practices. Our assessments include:

• Conducting interviews with billing staff
• Evaluating billing software systems
• Testing sample billing transactions
• Evaluating billing reports to determine effectiveness
• Evaluating days in accounts receivable and other billing performance measures compared to industry standards
• Recommending practical strategies and procedures to improve cash flow and payment accuracy
• Reporting findings and recommendations to staff and management to facilitate open communication and cooperation in implementing new procedures

Finding qualified billing staff and maintaining the technology to bill electronically can be difficult. BKD National Health Care Group can help home care and long-term care facilities improve their billing operations and cash flow through these solutions:

• Bill all or selected payers, including Medicare, Medicaid, insurance and private payers, for your organization’s services
• Bill coinsurance and deductible amounts for third parties and/or private payers
• Follow up on primary, coinsurance and deductible claims
• Train staff to maintain detailed accounts receivable aging and other financial reports to assist in monthly reporting of accounts receivable and revenues
• Review supporting documentation and recommend improvements to comply with Medicare and other payer requirements