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Verimed Services, Inc. - Medical Billing, AR Management, Practice Management Services
About Verimed Services, Inc.
Verimed Services, Inc. is a company dedicated to assisting medical providers to become more efficient and experience a
stronger bottom line by allowing them to outsource their claims processing and accounts receivable management functions and
obtain the advantage of having experienced, professional personnel assist with the review and management of the practice.
Outsourcing has become a key tool in maximizing a company's profitability.
Verimed's implementation of internet-enabled technology accompanied with
current technology in software, hardware and communication systems merged
with a labor pool capable of exploiting this technology, provides more
efficient, as well as cost beneficial services in the Healthcare market.
Through the utilization of a Virtual Private Network (VPN), Verimed creates
a seamless interface allowing its clients to maintain real-time access to
its data and reports via a secure Internet connection.
Verimed maintains a competitive edge by providing the following benefits:
-
Extensive experience of senior management in both the healthcare field and management. The management of Verimed combines
strong backgrounds in Healthcare, finance, technology, marketing and operations. This strong background allows Verimed to
review and analyze a practice and provide practical and cost efficient solutions to improve the bottom line.
- Understanding and utilization of multiple systems, which allows Verimed
the flexibility to utilize its own systems, as well as that of clients,
who prefer to maintain their existing system.
- Experience in contract negotiations and negotiating out of network
reimbursement.
- Concentration on follow-up and collection services focused on knowledge
of reimbursement rules and contractual requirements.
- Experienced in compliance programs and Corporate Integrity Agreements.
- An encrypted virtual private network ensuring compliance with HIPAA regulations.
- Customized reporting as part of the basic service.
Rising costs have pressured the profit margins of carriers that provide
healthcare coverage, as well as the demands on the publicly funded programs
of Medicare and Medicaid. The reaction is not surprising, a constant effort
on the part of the payors to limit or even reduce the amount paid to Medical
Providers, who themselves are faced with ever increasing costs of labor,
facilities, supplies and equipment.
Medical Providers, therefore, are increasingly focusing on ways to increase
and/or maintain their revenue levels, as well as reducing and/or limiting
the increases in their own cost base. Revenue increases may come from
expansion of service base (i.e. more patients), but also from closer
scrutiny of internal systems to insure that compensation is being received
for all services rendered and at the proper amounts. Methods to control or
reduce costs are of ever-increased interest.
While many companies rely on software technology, the review and reporting
by service companies are generally inadequate. The industry increasingly
requires skilled personnel to monitor the constantly changing rules and
regulations and apply these changes efficiently. Inevitably, errors are
going to occur, which require personal intervention in corresponding with
Verimed. Due to the cost/benefit ratio of following up on denials and
rejections and the constant pressure to maintain cash flow, it is very
difficult for an individual Healthcare Provider to afford the cost of
follow-up. Verimed, however, is able to provide the follow-up services and
appeal denied claims as an integral piece of its standard services,
improving the profitability of its clients.
Copyright ©2000-2006 Verimed Services, Inc.
1631 South Atherton Street, State College, Pennsylvania 16801
Verimed Services, Inc. - Medical Billing, AR Management, Practice Management Services
Medical Billing and Accounts Receivable Management
What Verimed Services Does:
Verimed provides to its clients a full range of Medical Billing and Accounts Receivable Management services, including:
- Complete patient record setup, including demographic and insurance information.
- Electronic and manual claim submission.
- Patient billing for self-pay and patient portion of claims, including co-pay and deductible.
- Claims posting and patient records updating relating to collections and contractual adjustments.
- Follow-up and collection of rejected and denied claims.
- Credentialing of client with insurance carriers and other payors.
- Contract negotiation with carriers and payors to ensure maximum reimbursement rates.
- Fee Schedule Analysis
Verimed's standard monthly reporting package includes:
- Aged Accounts Receivable Report.
- Total Accounts Receivable Outstanding Report.
- Collections Applied.
- Adjustments/Writeoffs Applied.
- Charge Submissions Report.
- Collection Ratio Statistics and Trend.
- Days Outstanding and Trend.
- Payor Mix Statistics.
- Monthly Commentary on Activity.
In addition, Verimed has the capability to deliver customized reports on both a recurring and one-time basis, affording
clients the opportunity to receive information critical to the effective management of their practice.
Our clients, Healthcare Providers, are faced with an environment of increased pressure on income due to sharply rising costs
of operations and downward pressure on reimbursement.
Follow-up with insurance carriers of rejected, denied, unpaid, and underpaid claims is emphasized by Verimed. We have
found that the complex sets of rules and regulations imposed by such carriers often afford them the opportunity to avoid
payment or to remit only a portion of what they are actually obligated to pay, using the myriad of rules to conceal such
underpayments. It is the pursuit of this hard money that distinguishes Verimed from many other Medical Billing
Services.
Verimed is firm in its belief that our clients are entitled to receive 100% of the reimbursement due them for services
provided, and that such reimbursement be remitted in a timely manner, and we are aggressive in this pursuit.
At the same time, Verimed is conscious that compliance with reimbursement rules is critical to both accelerating collections
by maximizing the number of initial "clean claim" submissions and avoiding potentially serious problems as a result of
submission of claims in a manner determined to be in violation of rules established for governmentally funded insurance
programs. In fact, Verimed has been engaged by several clients to assist in maintaining their compliance with Corporate
Integrity Agreements (CIAs) to which these clients are subject.
How Verimed Does It:
Verimed has combined an educated, highly trained work force, under the direction of experienced mangement, with a
state-of-the-art communication and networking infrastructure to provide a superior service to its clients. Through
utilization of a Virtual Private Network (VPN) Verimed creates a seamless interface, allowing our clients to maintain
real-time access to its data and reports via a secure Internet connection.
Verimed's work force is career-oriented in this field, with most members holding college degrees. This foundation is built
upon through Verimed's in-house training program through which staff members gain extensive knowledge of Medical Billing and
Accounts Receivable Management. Upon completion of training, staff members gain knowledge of the specific reimbursement rules
and contracts affecting the individual clients they are assigned to service. We believe that it is only through attainment of
this level of knowledge for success to be achieved in attaining full reimbursement. Our clients benefit from the fact that the
Verimed staff knows the rules and knows what the proper level of reimbursement is to be, and that pursuit of reimbursement on
their behalf will be conducted on a more level playing field of knowledge.
Superior performance for our clients is the product of this combination of mangement, technology, and a professional,
knowledgable staff.
A few examples of Verimed's Success on behalf of its clients:
CASE 1:
Client began to utilize a new treatment protocol expected to significantly
improve patient results but which is both more labor and more capital
intensive, requiring higher reimbursement. One large carrier denied claims
based on their position that the procedure was experimental. VERIMED
challenged these denials and after a four month negotiation was successful
in having the carrier concede that the procedure was in fact NOT
experimental and therefore should be reimbursed. This resulted in nearly
$20,000 of denied claims to be reimbursed which would have been written off
if the carriers initial position was accepted. More importantly, the client
is now confident that utilization of this procedure in the future will be
reimbursed.
CASE 2:
Client, prior to engagement of VERIMED, had invested heavily in an in-house
Billing System but found themselves significantly behind (over sixty days)
in claim submissions, resulting in virtually no collections to support
operations. VERIMED was successful in developing and executing a plan to
eliminate the backlog while simultaneously transitioning the client,
generating cash flow within 30 days of engagement.
CASE 3:
Client operates a free standing facility to provide the technical services related to this specialty's patient care and had
contracted with a physician to provide the professional component of service for which the physician billed separately. Major
insurance carriers in the State resisted recognizing such a "facility only" for reimbursement purposes which would have
resulted in the closure of the facility due to inability to receive reimbursement, thereby eliminating a source of treatment
for patients in the service area. VERIMED was engaged and was successful in having the facility recognized as a free standing
facility for reimbursement purposes, the first such facility to be so recognized in the State for this specialty.
CASE 4:
Client was a party subject to a Corporate Integrity Agreement (CIA) which required a periodic audit of claim submissions.
The initial audit alleged a high level of claim submission errors which had the potential for imposition of sanctions under
the terms of the CIA. VERIMED was successful in challenging a number of the audit conclusions.
Copyright ©2000-2006 Verimed Services, Inc.
1631 South Atherton Street, State College, Pennsylvania 16801
Verimed Services, Inc. - Medical Billing, AR Management, Practice Management Services
Practice Management and Accounting
Practice Management
Utilizing experienced, certified staff, Verimed's Practice Management maximizes the efficiency of administrative
operations, which will enable Healthcare Providers to focus on their core competency, Patient Care. Verimed's Practice
Management's full range of services to assist administratively include:
- Evaluation and assessment of practice operations
- Develop compensation programs
- Human Resources, providing staffing models, personnel management, benefits administration and payroll services
- Development of policies and procedures, training, program implementation, quality assurance and auditing in connection
with Corporate Integrity Agreements
- Develop Compliance Plans
- Assist in program and facility accreditation (i.e., JCAHO, AAAHC, ACR, ACRO and various State and Federal DOH
programs)
- Monitor safety and regulatory issues (i.e., OSHA, Fire Safety, CLIA, HIPAA, NRC, FDA, EPA and ADA)
Through the review of financial information of Healthcare Providers, Verimed's Practice Management group identifies
the keys to financial shortfalls for physicians and clinical services. We have found that Healthcare Providers survive from
what is known as the "Easy Money." "Easy Money" relates to reimbursement for claims filed without errors. However, due to time
and manpower limitations, many Healthcare Providers do not obtain the total reimbursement to which they are entitled. We have
found that Healthcare Providers could improve their reimbursement by ten to twenty five percent, if they took the time to
follow-up on rejections and denials from payors. Verimed concentrates its efforts in this segment of revenue cycle management,
to improve the Healthcare Providers' profitability.
In conjunction with its Practice Management Services, Verimed provides Accounting services, which include:
- Processing accounts payable
- Maintain accounts receivable and fixed asset sub-ledgers
- Preparation and maintenance of detailed general ledger and trial balances
- Provide standard and customized financial reports including both financial and statistical information
- Assist in the preparation of tax returns
- Provide audit support
Verimed is dedicated to assisting Providers to become more efficient and experience a stronger bottom line by allowing them
to outsource their administrative functions and obtain the advantage of having experienced, professional personnel assist with
the management of their practice.
Copyright ©2000-2006 Verimed Services, Inc.
1631 South Atherton Street, State College, Pennsylvania 16801
Verimed Services, Inc. - Medical Billing, AR Management, Practice Management Services
Contact Us
You may contact Verimed in the following ways:
Postal Mail/Express Service
Verimed Services, Inc.
1631 South Atherton Street, Suite 300
State College, Pennsylvania 16801
Telephone
Toll-free: (866) 706-4520
Direct: (814) 689-3000
Facsimile
(814) 689-2011
Electronic Mail
Contact us by email (verimed@verimedservices.com)
Copyright ©2000-2006 Verimed Services, Inc.
1631 South Atherton Street, State College, Pennsylvania 16801