Michael T. Crowley, CPA
Personalized Professional Service Specializing in Small to Medium Businesses

Medical Practice Management

We provide expert medical practice management services in the following areas:


  1. Medical Billing and Cash Flow Services


  2. Collections

Billing for Medical Providers


  1. Provider Applications and Set up

    We prepare basic Medicare and Medicaid applications as well as certain other major insurance or Managed Care applications. We also prepare re-credentialing applications with all payers and hospitals. We maintain and update the provider CV and include it as necessary with these applications. We advocate for our clients under "any willing provider" legislation where appropriate. We provide the basic registration, assignment of benefits, release of information, and waiver of liability forms as well as HIPAA-compliant procedures.

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  2. Patient Registration

    Our registration database has capability for a virtually limitless history of insurance carriers as well as different primary insurers for members of the same family. Our attention to detail and persistent follow up effort during the registration process insures timely, accurate claim adjudication. This translates to quick cash turnaround for our clients. We also verify authorization for outpatient treatment and maintain this information in our unique referral authorization tracking checklist. We share this tracking information with our clients to insure that all services rendered are paid. Our electronic communication capabilities minimize client effort and claims adjudication time.

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  3. Charge Entry and Claims Processing

    • Charges are entered into our software from encounter sheets completed by the provider.
    • Claims are prepared daily and transmitted electronically.
    My staff is experienced in their specific client's attributes of procedural and diagnosis coding as well as Medicare's correct coding initiative with respect to ICD/CPT agreement. Our software and procedures can be customized to identify specific instances of compliance or denial risk.

    For example, if a fourth or fifth digit level of specificity is required on a diagnosis code (such as with ICD code 250.13 -- diabetes with ketoacidosis type I insulin dependent, uncontrolled), and the physician has provided only three digits, then our staff will notify the physician of the need for a more specific code before the claim is submitted for reimbursement. Additionally, we will review your fee schedule to minimize your risk of underpayment (e.g. Medicare or Medicaid paying the lower of cost or charges).

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  4. Receipt Posting and Secondary Processing

    All payments are remitted to a Post Office box in our locale. Deposits are prepared daily and reconciled to your monthly bank statement. All checks are restrictively endorsed and deposited into your bank account (where authorized signers are limited to your designees). This provides sound internal control while allowing maximum productivity on our part. As part of our compliance program, we do not maintain escrow accounts or become authorized check signers on our clients' accounts. Additionally, as part of a solid internal control structure, our deposit preparation staff do not have access to receipt or adjustment posting processes on the software.

    Secondary claims and patient statements go out immediately after cash is posted. We generally do not wait until month-end to process these bills. We additionally provide guidance to your practice staff on collecting co-pays and deductibles at time of service. To this end we provide assistance to the practice to obtain credit card capability, if desired. We include this credit card information on your customized patient statements. For mail received that denies payment, we follow up immediately to resolve. Our clients generally enjoy better than 96% cash receipt as compared to net charges.

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  5. Month-End Closing

    Productivity and aging reports, as well as trend analyses are available to the practice monthly (generally, via e-mail). Deposits are reconciled to client bank statements where requested and review of the aging for follow up also occurs at this time. Accounts that have no payment activity for 45 days are reviewed and adjudicated.

    Telephone inquiries concerning payment are directed to our toll-free number in Glenville, New York. Any questions we receive related to patient care will be directed back to the practice.

    Our fees range from 5% to 10% of cash receipts, depending on volume and complexity, and are in compliance with the office of inspector general's guidance for medical billing companies.

    Cash Flow Management, Compliance, and Collection Services are also provided on both per engagement and contingency bases.

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Collections

  • We specialize in the recovery of outstanding dollars due to medical providers. Our Specific successes in overturning medical necessity, lack of timely filing, pre-existing condition, and coverage termination denials as well as our low fees makes us a logical choice for small to medium size hospitals and medical practices of almost any size.

    We specialize in cash flow enhancement within compliance through the management of our clients' accounts receivable. Techniques utilized in performing this management function include medical record review, billing, follow-up, CPT coding review, collection, compliance assessment, write-off analysis and staffing/procedural review.

    My expertise in the recovery of "dead" monies has created a demand for services as trainer of new and existing billing and collection staff at hospitals and group practices.

    Our area of specific expertise is in behavioral health. We have also performed the collection and billing function for a variety of other providers (Oncologists, Internists, Gerontologists, etc.).

    Our fees are dependent on volume. Many of our arrangements are in the 15% - 18% range.

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