NVLPC Mini Expo

URS Billing Services is heading to the Hilton Garden Inn in Fairfax, VA on Friday, November 7th for the NVLPC (Northern Virginia Licensed Professional Counselors) Mini Expo! We will be going as a vendor so be sure to stop by our booth and enter to win a Starbucks gift card!

Those attending the expo will be listening in on an Ethics Workshop. If you are involved in this aspect of the healthcare field, be sure to attend. More information is listed above.


Common Misconceptions: Loss of Control

Many of us are in need of control, in some cases desperate. There is a common misconception with using a medical billing service that you need to give up control. Not only is this not the case, but you are actually in more control.

First off, URS Billing Services doesn’t touch any money. This can be your first order of business to cross off your check list. 

Second, because we are professionals in the medical billing field (just like you are professionals in the healthcare field) we are aware of every modifier, diagnosis, chief complaint needed in order to get your claims not only paid but paid at their maximum allowable. 

Last but not least, you are in even more control by using URS Billing Services. How? 

  1. You’re paying for what you get. Let’s look at this from an employee of your office: They are going to get their paycheck regardless if they get a claim paid or not. Sure, they may get a bonus if they get it paid but they can still rely on that weekly paycheck. 
    1. You are not only paying their salary but you’re also paying for their computer, their software, their software updates, their training, their time off, their sick days, their maternity leave...
  2. By using our service you are getting more bang for your buck. By increasing your monthly revenues you have the option to take off time with your family, or maybe use that extra money to open an extra office, what will it be? 
  3. You have full access to your billing representative, no automation system to dial in to, you pick up the phone and ask your representative any question you have about your account. How often do you go to your employee’s desk to ask a question and you find out they’ve called in sick? 
Go ahead and give our office a call today, receive a free A/R Analysis to see how we can help you.


What Is Your Time Worth?

Have you thought about what your time is worth? Have you considered by freeing up billable time you have more slots for patients equaling more income? This in turn can mean more vacations with family, a new office, a bigger staff...the possibilities are endless by just freeing up a couple hours to URS. We can help make the difference between a couple days with family and a couple weeks with family. 

Not only does URS offer medical billing services we also offer:

Call our office today and ask for a free A/R analysis, so we can show you how we can help you TODAY!


Relative Value Units (RVUs) to Measure Success in Your Medical Field

RVU’s is a copyrighted scale and resource-based methodology which has been in
wide use throughout the industry since 1988. The relative value units (RVUs) for
professional and technical component splits are the same as the global service RVU.
Medical Procedure Charges (MPCs) are created for the component splits by changing
the conversion factor, not by splitting the RVUs by a percentage. The conversion factor
used is more accurate because it takes into account all CPT codes performed by the
physician, along with the frequency (count) of each service.

URS Billing Services has developed fee schedules using Relative Values, Conversion
Factors and zip code specific criteria. The Relative Values (RVs) are used to develop
fees specific to the medical practice’s geographical area. RVs weigh medical
procedures relative to one another on a scale linked to difficulty, work, risk and the
material cost of the procedure. The second factor can be characterized as simple
statistical profiling of charges in the geographical areas.

Percentiles are frequently misunderstood and inaccurately utilized. URS Billing Services
bases its findings, methodology and current databases, on fees in the 75th percentile,
not necessarily 75% of the highest range. If the fee for a given service is at the 75 th
percentile, then it means that 75% of the submitted charges for that fee is higher than
your fee.

In calculating fees, we used two percentiles (75.0% & 80.0%) because of current fee
structures and patient demographics. URS Billing Services does not advise using the
95th percentile because of the current political atmosphere of cost containment.

Moreover, consistent high-level billing could be harmful to the financial well-being
of the medical practice. As managed care networks become more prevalent, high
priced physicians may find themselves without an invitation to be involved with some
healthcare organizations. Equally painful, physicians may find themselves losing
patients who are increasingly unable or unwilling to tolerate high out-of–pocket medical

Also, keep in mind, Insurance Adjustments indicated on the ‘explanation of benefits’
show what your practice agreed to accept in your contractual agreement with that
provider. Adjustments are based upon a variety of reasons, including such factors as
who was the primary physician, location of service, equipment ownership and the role of
the physician in the overall treatment of the patient. In cases where adjustments appear
unusually high compared to reimbursement amounts, it generally reflects any one or
combination of the above reasons. It does not necessarily mean that charges should be
lowered or raised.


5 Way to Improve Profitability

1. Increase patient volume - The first step to improving profitability, in most practices, is attracting more patients. Many patients select or are referred either from referrals, by specialty, relatives, word of mouth or friends. There are many ways of attracting new patients to medical practices. First – asking current patients to refer friends, relatives and establishing an effective referral system or using a marketing service.

2. Contract a physician liaison - Once a practice has established its operating philosophy, communicate with other geographically located physicians, regardless of specialty, which services are available. This process can be effectively conducted by contracting with a marketing service of hiring a physician liaison or sales/marketing manager.

3. Communicate with both primary care and specialists - Communicating and establishing relationships with physicians in your practice’s geographical area, including those who currently refer patients, is an important key and ensures many physicians will likely refer to your facility, says Richard Tamburello, Managing Director of URS Billing Services, L.LC. "Maintaining open communications and providing follow-up reports and updates to the referring practice is important and should not be overlooked. Open communications with all physicians is important, especially to referring physicians and primary caregivers. There will be at some point in time in the patient’s history that insight, support and treatment might require exchange of thoughts and possible treatment", says Richard Tamburello, Managing Director of URS Billing Services, LLC

4. Provide referring physicians with the clinical results and services they expect - This is where many practices have fallen short because of time, shortage of personnel or neglect. The number one key information piece some treating physicians fail to disclose to referring physicians is the open line of communications. It is not only a professional courtesy, but providing results of the treatment to the referring practice helps the practice by receiving insight of the results. Plus, instituting open lines of increases the prospects of receiving more patient referrals.

5. Maximize each physician’s case load - Once the practice establishes a comfortable patient load level, including referrals, physicians should at levels that sustain quality level of care and maintaining good bedside manner. One method is offering bonuses or other incentives based upon meeting and exceeding established patient treatment goals. For example, front desk personnel should take patients from the waiting room to the procedure room. Once the patient is settled, set a time frame in which the patient is seen by the doctor (5 minutes, 7 minutes or maximum of 10 minutes), then track the time and possibly incorporate a `special recognition’ award to the physician and front desk personnel. Although there is some resistance to this procedure, increasing case load is not about rushing procedures but accelerating other aspects of the visit - registration, insurance verification, setting a patient up in a room and discharge.

In conclusion, these are just a few ways to improving efficiencies and the profitability of the medical practice. Today’s medical practices need to `re-exam’ and re-evaluate ALL internal operations and fine ways to optimize revenues and better manage production, labour and benefit costs. If current operations are not changed or effective innovative marketing concepts not implemented, there will be fewer dollars left at the bottom-line the end of each month and at the end of the year.


How well does tort reform work?

In Ohio, it works very well indeed
The spring of 2002 was not a happy one for many of Ohio’s physicians. Professional liability insurance rates had skyrocketed, making coverage unaffordable and sometimes unobtainable, especially for those in high-risk specialties like obstetrics, neurosurgery, and orthopaedics. Many physicians were considering retiring early, moving, or eliminating high-risk procedures. The American Medical Association had placed Ohio on a list of states considered “in crisis.”
As a result, the Ohio State Medical Association (OSMA) took action at the state government level to reform Ohio’s tort system, so that physicians could stay in practice and continue caring for Ohioans. From 2002 to 2004, OSMA and its members helped enact 20 sweeping medical liability reforms that provided relief from the liability crisis.
A “supreme” effort
Like many states, Ohio had seen the state legislature pass tort reform measures, only to have the laws overturned by the state supreme court.
To help ensure that these reforms “stuck,” OSMA, Ohio physicians, and other interested parties undertook the task of changing the philosophical make-up of the Ohio Supreme Court. This was accomplished by supporting candidates who held a “judicial restraint” philosophy. Prior to 2002, the Ohio Supreme Court was considered an “activist” court, one that “legislated from the bench.” At that time, four of the seven justices fit that label.
Today, 6 years and three election cycles later, the Court is considered to have a 6-to-1 “judicial restraint” majority, one that defers public policy matters to the legislative branch. With this new philosophical majority and a new law that addressed prior Court decision reasoning, tort reform measures have a much better chance of being upheld if challenged.
The benefits of reform
As a result of the tort reform efforts, the total number of medical liability suits has declined, insurance rates have stabilized, and the liability insurance market is more robust.
In 2005, the first year that the Ohio Department of Insurance collected data on medical liability claims, 5,051 medical liability claims were closed. Of these, 21 percent (1,046) resulted in a payment to the claimant. One year later, 4,004 claims were closed and only 794 resulted in a payment to the claimant.
In other words, there was a 20 percent reduction in overall claims from 2005 to 2006 and a 24 percent reduction in claims resulting in a payment.
Additionally, the 2005 data revealed that claims subject to the new tort reform law had indemnity payments nearly $100,000 less than claims not subject to the new law.
Starting in 2001, medical liability insurance premiums began to increase significantly—22 percent in 2001, 30 percent in both 2002 and 2003, and 20 percent in 2004. Once the tort reform proposals had time to work, rate increases began to moderate; rates increased just 6.7 percent in 2005 and actually declined by 1.7 percent in 2006 and by 10.9 percent in 2007. The 2007 rate reduction translates to an average savings of at least $1,000 per Ohio physician.
In 2000, Ohio had nearly 30 medical liability carriers who provided professional liability insurance for physicians. At the height of the liability crisis in 2003, the state had only five carriers, three of which were showing increasing financial difficulty. Today, however, Ohio has 15 companies competing for business in a more robust and predictable medical liability marketplace.
Holding trial lawyers accountable
In addition to its efforts for tort reform, OSMA also created a Frivolous Lawsuit Committee to fight back against trial attorneys who file frivolous claims. The committee, made up of physicians and lawyers, reviews possible cases of alleged frivolous conduct by a plaintiff’s lawyer. Then, if warranted, the committee will assist defense counsel with seeking sanctions against that lawyer for filing the frivolous claim.
In three separate cases, the court sanctioned trial attorneys and the physician defendants were awarded recovery of defense costs totaling more than $35,000. Most importantly, these cases have provided a legal precedent in Ohio for holding trial attorneys legally and financially responsible if they file a frivolous lawsuit.
A positive outcome
The medical liability changes that have occurred in Ohio since 2004 have had positive effects: the medical liability insurance market has stabilized, insurance rates have declined, court case filings are down and physicians no longer have to worry that a liability insurance crisis will drive them out of practice.
In response to the critics of tort reform, we can say that all of the changes still permit those with legitimate liability claims to have access to the courts and access to reasonable and fair compensation.
Does tort reform work? One only needs to look to the Ohio experience as proof that it works very well indeed.
Tim Maglione, Esq., is senior director of government relations for the Ohio State Medical Association.
                                                                                                              Continue Reading>>>

Increasing Revenues, Minimizing Overhead Costs and Improving Patient Data Collection Accuracy

Medical practices seeking greater operating efficiency and improving bottom lines are implementing more stringent registration, billing and data collection policies. Practices failing to implement and take charge are likely to lose literally hundreds of thousands of dollars annually.

Some common and frequent problems directly related and often overlooked or ignored start at registration. Patient registration is the key to ensuring near perfect practice efficiency. Patient registration forms must ask and include ALL pertinent demographic information and must be carefully reviewed for accuracy and completeness by front desk personnel prior to patients seeing doctors.

Medical practices seeing new patients should schedule appointments 48 hours in advance allowing sufficient time for staff to validate insurance eligibility, obtaining authorizations, granting or obtaining referrals and patient demographics. When questions arise or incomplete information is discovered, practice staffs need to immediately contact patient and/or guarantor to make necessary corrections.

One important step to further streamlining the practice and these critical areas is informing both new and returning patients which credit cards are accepted, co-pay amounts, credit policies for patients with deductibles and those without insurance.

In conclusion, although these `efficiency’ components sound reasonable and logical, many practices do adhere to such policies however, many do not resulting in significant amounts of unearned revenues.

The professional medical billing team at URS Billing Services is keenly aware of the financial benefits these policies generate and highly recommends they become integral to all medical practices.