Home Forums Discussions Coding and Billing Total MD? Caretracker?

Im going to start off by saying - please excuse my ignorance.

What is the most seamless cloud based billing option of we were going to hire a coder/biller. I just need an easy platform for her to use.

My current practice that I work with is paying an obscene amount of money for billing. Obscene.

I’d like to work towards having a coder/biller and I’d like whatever we use to be cloud based if possible and very integrated (ie so Front Desk staff can see balances and inquire about them).

Please define "obscene". We had in-house billing for years, but switched over a decade ago to a billing company. That still requires some work by support staff to get the information to them, but it works well for us. Cost is about 7%.
What have you been paying?

9-10%, and they don’t code, scrub, and are really quite terrible at handling customer service issues with our patients.

Athena is about 8%(of everything in the billing system including copays) includes ehr, billing service, labelled imports. Seems ranked kinda high. Anyone know docs on it?

I use TotalMD. I don't know if it's the most seamless but it has worked fine for us for 10+ years. We bought the desktop version of TotalMD at the beginning and have done several upgrades thru the years. I send the e-claims to the paid Availity clearninghouse. I pay for the extra Advanced Claims Editing feature which I CANNOT live without. (Can explain more if you're interested but basically you create your own claim scrubs). The Avality part has been $213 per month for the whole time I've used them.

I was hoping you’d respond ;-)

I am going to work with a coder/biller that I trust, do you think the advanced feature would still be beneficial? Do you also use BillFlash? Have you ever used their collections if you have?

To be clear, I walked into a complete nightmare in terms of providers who are paying 10% for bills that do not get reviewed or scrubbed, that they are coding themselves with an old fashioned perspective on coding, and with some charts not entered from over 9 months ago. It’s going to take time to unravel the mess. Their wrote offs are high…..like really high.

Can you speak to how billing integrates from TotalMD to AC? Do your front desk staff just ignore billing stuff in AC and use TotalMD for that part of things?

Well I think it is. I think I'm a pretty good biller but you're always going to make mistakes. The Advanced Claims Edit catches everything that you ask it to catch. I'm attaching a screenshot of one of the many edits I created. (You have to be able to work with If/Then statements. Availity does not make these for you.)

I don't use their collections. I use a collections company called SCS that take about 28%. But they've never been successful. We just try our hardest to collect everything up front. I hope everyone knows about the real-time claim estimators that most payer portals now have.

The TMD integration:
Charts created in AC show up in TMD. When an encounter is signed off and the doctor selects the CPT code, those show up in TMD as a new bill. We still use a paper superbill. The biller takes the stack of paper superbills and opens TMD. Then they go to each chart in TMD and sees the new billing with the E/M code already in there. Then they complete the claim by adding any vaccines and procedures. (The doctor selects only the E/M code when they sign off. The doctor COULD select all the vaccine and procedure codes during signoff but we don't do this for our workflow.) Then once a day I batch send the completed TMD claims to Availity.

The TMD-AC connection is a bit finnicky. You have to have a program running on the server computer and this program sometimes closes down. I check it every Monday morning and sometimes I have to restart it. If I'm on vacation on Monday and the program is down, then nothing will get transferred to TMD.

Also you have to pay AC yearly for this connection.

Oh the irony!

Correct me if I am wrong, but I think that the goal of developing an integrated billing program for AC was a major thorn in Jon B's side, and perhaps even influenced his departure.
Then there was such a program, pushed heavily by subsequent owners of AC.

Here we are, years later, and clearly... there is no robust integrated option to do billing through AC. It can be done, in various ways, and Harris has an option, but....

We brought billing in-house years ago due to problems with an outside biller. We started using Kareo which was not integrated to AC in any way. We changed to Caretracker (Harris Product) and it is interfaced with AC. I like having the person in the office to do the billing because if there are issues she is available to talk to the pt and myself and get things resolved locally. A name with a face that the patients can relate to not just a voice on a phone. Patients seem to appreciate this personal interaction. If want you can PM me and I'll have my biller talk to you or your staff. She has her complaints and problems but does tell me that the Caretracker program is much better that the separate AC/Kareo combo. Caretracker recently added an advanced scrubber (extra charge) but she feels it has helped. I spend about $800 per month for monthly billing including invoices generated by Caretracker. I do feel we send out too many bills and am trying to figure out how to decrease this number to decrease my monthly costs.