Ingram & Associates

Medical Billing & Collections Extended Business Office (EBO) Services

Ingram has performed a wide variety of short term and long term customized engagements that extend your business office Accounts Receivable capabilities.

Highly Flexible Accounts Receivable Service Options

Extended Business Office (EBO) and accounts receivable services are a major part of Ingram & Associates' Revenue Model Optimization programs and services. These programs are geared toward organizations that have a need for expertise and resources focused on the unique aspects of the billing, collections and follow-up cycle for insurance payers and self-pay/private pay books of business.

EBO and accounts receivable services can address a variety of scenarios based on your organization’s specific needs including:

Early-Out Self Pay (EOSP) Account Resolution Services
Insurance Billing & Follow-up
Interim Project Staffing
AR Clean U p and Conversion Support Programs

These programs are specifically designed to supplement your hospital’s internal efforts, by functioning as an extension of your business office, operating seamlessly with your internal operations and tailored to your specific and changing needs.

In addition, we offer several specialty services to support your Accounts Receivable initiatives. They include Revenue, Reimbursement & Recovery (R3) programs, designed to evaluate and correct issues related to your outbound flow of billing, coding and charge data to your FI to determine mistakes in payment resulting from errors in outbound data.

Early-Out Self Pay (EOSP) Account Resolution Services

Collecting self-pay or co-pay balances after insurance from your patients is one of the most difficult and costly tasks that your Business Office staff faces. Self-pay collection processes require specialized training, experience and systems to maintain good patient relations while ensuring that you are collecting payments on services performed for your patients. Today's economy and the ever changing healthcare environment has caused your patients to become responsible for bigger portions of their bills, causing in turn, your bottom line to become more and more dependent on your ability to effectively collect these self-pay balances.

Our self-pay programs are designed to efficiently process accounts that have patient-responsible balances after insurance and 100% straight self-pay patient accounts. We assume complete responsibility for processing self-pay accounts from the day they become self-pay until they are totally resolved. This allows your internal staff to be re-directed to more important business office collections activities and to be free from the significant day-to-day efforts of answering patient accounting telephone calls. All services are provided transparently to your patient population, as an integral part of your hospital business office process.

We utilize comprehensive collections systems and state-of-the-art technologies (FACS by Ontario Systems) to maximize efficiencies and provide unparalleled benefits to our clients. This includes predictive dialers, automatic call tracking & recording (where available by state law) that give you maximum control and confidence in patient complaint management. Lastly, balance and age driven collection protocols and a sophisticated set of measurement reports are utilized to ensure our overall success.

Insurance Billing & Follow-up - Commercial / Managed Care / Government

Our medical billing and collections experts include teams devoted exclusively to various areas of insurance collections expertise including team for commercial and managed care payers, and government ayers.

We utilize a unique and dedicated set of resources to support hospitals that have a desire to achieve maximum results from their collection processes. Our staff is focused by, not only the distinct class of account (commercial, managed care, government and self-pay) but also by individual payer, balance and age to ensure accounts are worked by the most qualified of staff. Our methods are designed to support, either temporarily or for the long-term, your existing efforts, by selecting specific accounts based on age, balance or even payor, to be out-sourced to our highly skilled and focused collections team. Our teams may be brought on-site to help in your collection efforts, or utilized on a remote basis, helping to eliminate some of the high costs of travel, based on your specific needs.

We utilize a very unique and thorough collection management process that also allows you to monitor performance results on a daily basis and to track service quality. We provide you the highest level of customer communication and demonstrate our confidence in our ability to deliver “best practice” results.

Interim Staffing Solutions

Filling billing office positions in difficult markets coupled with the hiring processs, employee turnover or other reasons is a major challenge. These positions often require skilled professionals where “temp” resources just won’t fill the gap. We offer billing, collections and management resources on a per-diem basis to fill short-term needs available either on-site or on a remote basis.

Revenue, Reimbursement & Recovery Programs (R3)

In today’s complex healthcare environment, significant time and effort has been spent by hospital provider organizations in their pursuit of the best strategies for effective optimization of their revenue model. To that end, a tremendous amount of time has been spent on addressing issues related to reimbursement accuracy from the payer. Most recently, organizations have focused significant effort in this area (traditionally known as Managed Care Underpayment) based on evaluating inbound payments for services billed as compared to a payer’s contractual terms in order to improve cash and profitability. Significant progress has been made to date by providers in this area through the creation of internal managed care/underpayment departments, through the implementation of software systems and through the use of contracted vendor services to perform underpayment detection and recovery.

While these efforts have provided benefits by improving inbound payment accuracy from the payer, they have still left an unfortunate void for providers in answering the more fundamental and difficult question –“How do I determine if the final claim I submitted was, in fact, correctly billed, charged or coded in the first place?” Attempts have been made by charge “scrubbing” vendors to match missing charges based on existing charges found on your bill. These programs are very ineffective for several reasons. First, these programs assume that the charge found on your claim and used to try to match a missing related charge is either missing as well or assumes the charge was right in the first place. Second, any issues that may be found are still left to your internal hospital team to research, validate and ultimately re-bill any corrections – leaving little benefit to you in finding your real issues or reducing your teams’ workload.

Our Revenue and Reimbursement Recovery (R 3) Program is designed to do just that. We offer the first practical solution to helping providers answer these vital questions and to gain insights into your business and improve reimbursement and profitability. Our approach has forensic healthcare experts using sophisticated analysis tools to find those problems in your outbound data and to correct them. This remains one of the last untapped areas of opportunity for significant improvement in revenue, cash and profitability – and one that traditional internal revenue integrity and claim audit groups cannot effectively address.

Ingram’s Technology & Expertise Approach

Our solution embraces advanced technology combined with our team of forensic healthcare experts to tackle this complex problem. Accomplishing this task can be daunting, since the key to unlocking this opportunity is in the ability to discover the problems you don’t yet know exist. This is the dilemma of the traditional revenue integrity methodology that utilizes audits of random charts and claims to try to determine your accuracy. Unfortunately, finding these types of issues are analogous to finding the “needle in the haystack” – and reviews of even 500 claims will not adequately identify even a small percentage of the issues that most providers organization know exist – but just don’t know what they are or where to look. It is estimated that 2-4% of a hospitals’ annual revenues fall victim to this problem.

Ingram starts with technology – utilizing sophisticated multi-dimensional cube analysis tools in conjunction with traditional transactional-based relational databases to provide the needed research and analysis platform essential to any true investigational effort with data. These important tools provide our analysts with the means to analyze all of your historical claims data and to identify those anomalies in your book of business – with instantaneous access to any combination of data intersections to identify and pattern claims “outliers” for further investigation. Our “Investigator Cube” provides simultaneous access to an unlimited number of data dimensions at the touch of a button to allow patterning across payer, diagnosis, CPT, procedure, date of service, length of stay, ratios for payments and charges and a host of other variables important to problem identification. In this way, our team of forensics experts can research all of your “data outlier” claims to identify and separate real issues from explainable variances that may occur in your claims. The traditional revenue integrity audit process relies on the hope that a random sample audit might uncover an issue or two. Ingram allows you the opportunity to pinpoint and research potential problem claims for real insight and broad problem identification in your outbound billing, charging and claims process.




	Medical Billing & Collections Extended Business Office (EBO) Services Ingram has performed a wide variety of short term and long term customized engagements that extend your business office Accounts Receivable capabilities. Highly Flexible Accounts Receivable Service Options Extended Business Office (EBO) and accounts receivable services are a major part of Ingram & Associates' Revenue Model Optimization programs and services. These programs are geared toward organizations that have a need for expertise and resources focused on the unique aspects of the billing, collections and follow-up cycle for insurance payers and self-pay/private pay books of business. EBO and accounts receivable services can address a variety of scenarios based on your organization’s specific needs including: Early-Out Self Pay (EOSP) Account Resolution Services Insurance Billing & Follow-up Interim Project Staffing AR Clean U p and Conversion Support Programs These programs are specifically designed to supplement your hospital’s internal efforts, by functioning as an extension of your business office, operating seamlessly with your internal operations and tailored to your specific and changing needs. In addition, we offer several specialty services to support your Accounts Receivable initiatives. They include Revenue, Reimbursement & Recovery (R3) programs, designed to evaluate and correct issues related to your *outbound* flow of billing, coding and charge data to your FI to determine mistakes in payment resulting from errors in outbound data. Early-Out Self Pay (EOSP) Account Resolution Services Collecting self-pay or co-pay balances after insurance from your patients is one of the most difficult and costly tasks that your Business Office staff faces. Self-pay collection processes require specialized training, experience and systems to maintain good patient relations while ensuring that you are collecting payments on services performed for your patients. Today's economy and the ever changing healthcare environment has caused your patients to become responsible for bigger portions of their bills, causing in turn, your bottom line to become more and more dependent on your ability to effectively collect these self-pay balances. Our self-pay programs are designed to efficiently process accounts that have patient-responsible balances after insurance and 100% straight self-pay patient accounts. We assume complete responsibility for processing self-pay accounts from the day they become self-pay until they are totally resolved. This allows your internal staff to be re-directed to more important business office collections activities and to be free from the significant day-to-day efforts of answering patient accounting telephone calls. All services are provided transparently to your patient population, as an integral part of your hospital business office process. We utilize comprehensive collections systems and state-of-the-art technologies (FACS by Ontario Systems) to maximize efficiencies and provide unparalleled benefits to our clients. This includes predictive dialers, automatic call tracking & recording (where available by state law) that give you maximum control and confidence in patient complaint management. Lastly, balance and age driven collection protocols and a sophisticated set of measurement reports are utilized to ensure our overall success. Insurance Billing & Follow-up - Commercial / Managed Care / Government Our medical billing and collections experts include teams devoted exclusively to various areas of insurance collections expertise including team for commercial and managed care payers, and government ayers. We utilize a unique and dedicated set of resources to support hospitals that have a desire to achieve maximum results from their collection processes. Our staff is focused by, not only the distinct class of account (commercial, managed care, government and self-pay) but also by individual payer, balance and age to ensure accounts are worked by the most qualified of staff. Our methods are designed to support, either temporarily or for the long-term, your existing efforts, by selecting specific accounts based on age, balance or even payor, to be out-sourced to our highly skilled and focused collections team. Our teams may be brought on-site to help in your collection efforts, or utilized on a remote basis, helping to eliminate some of the high costs of travel, based on your specific needs. We utilize a very unique and thorough collection management process that also allows you to monitor performance results on a daily basis and to track service quality. We provide you the highest level of customer communication and demonstrate our confidence in our ability to deliver “best practice” results. Interim Staffing Solutions Filling billing office positions in difficult markets coupled with the hiring processs, employee turnover or other reasons is a major challenge. These positions often require skilled professionals where “temp” resources just won’t fill the gap. We offer billing, collections and management resources on a per-diem basis to fill short-term needs available either on-site or on a remote basis. Revenue, Reimbursement & Recovery Programs (R3) In today’s complex healthcare environment, significant time and effort has been spent by hospital provider organizations in their pursuit of the best strategies for effective optimization of their revenue model. To that end, a tremendous amount of time has been spent on addressing issues related to reimbursement accuracy from the payer. Most recently, organizations have focused significant effort in this area (traditionally known as Managed Care Underpayment) based on evaluating *inbound* payments for services billed as compared to a payer’s contractual terms in order to improve cash and profitability. Significant progress has been made to date by providers in this area through the creation of internal managed care/underpayment departments, through the implementation of software systems and through the use of contracted vendor services to perform underpayment detection and recovery. While these efforts have provided benefits by improving inbound payment accuracy from the payer, they have still left an unfortunate void for providers in answering the more fundamental and difficult question –“How do I determine if the final claim I submitted was, in fact, correctly billed, charged or coded in the first place?” Attempts have been made by charge “scrubbing” vendors to match missing charges based on existing charges found on your bill. These programs are very ineffective for several reasons. First, these programs assume that the charge found on your claim and used to try to match a missing related charge is either missing as well or assumes the charge was right in the first place. Second, any issues that may be found are still left to your internal hospital team to research, validate and ultimately re-bill any corrections – leaving little benefit to you in finding your real issues or reducing your teams’ workload. Our Revenue and Reimbursement Recovery (R 3) Program is designed to do just that. We offer the first practical solution to helping providers answer these vital questions and to gain insights into your business and improve reimbursement and profitability. Our approach has forensic healthcare experts using sophisticated analysis tools to find those problems in your *outbound* data and to correct them. This remains one of the last untapped areas of opportunity for significant improvement in revenue, cash and profitability – and one that traditional internal revenue integrity and claim audit groups cannot effectively address. Ingram’s Technology & Expertise Approach Our solution embraces advanced technology combined with our team of forensic healthcare experts to tackle this complex problem. Accomplishing this task can be daunting, since the key to unlocking this opportunity is in the ability to discover the problems you don’t yet know exist. This is the dilemma of the traditional revenue integrity methodology that utilizes audits of random charts and claims to try to determine your accuracy. Unfortunately, finding these types of issues are analogous to finding the “needle in the haystack” – and reviews of even 500 claims will not adequately identify even a small percentage of the issues that most providers organization know exist – but just don’t know what they are or where to look. It is estimated that 2-4% of a hospitals’ annual revenues fall victim to this problem. Ingram starts with technology – utilizing sophisticated multi-dimensional cube analysis tools in conjunction with traditional transactional-based relational databases to provide the needed research and analysis platform essential to any true investigational effort with data. These important tools provide our analysts with the means to analyze all of your historical claims data and to identify those anomalies in your book of business – with instantaneous access to any combination of data intersections to identify and pattern claims “outliers” for further investigation. Our “Investigator Cube” provides simultaneous access to an unlimited number of data dimensions at the touch of a button to allow patterning across payer, diagnosis, CPT, procedure, date of service, length of stay, ratios for payments and charges and a host of other variables important to problem identification. In this way, our team of forensics experts can research all of your “data outlier” claims to identify and separate real issues from explainable variances that may occur in your claims. The traditional revenue integrity audit process relies on the hope that a random sample audit might uncover an issue or two. Ingram allows you the opportunity to pinpoint and research potential problem claims for real insight and broad problem identification in your outbound billing, charging and claims process.
	1720 General George Patton Drive Brentwood, TN 37027 Phone: 615.778.4500 Fax: 615.778.4510 Copyright © 2002 - 2010 Ingram & Associates. All rights reserved.