• What is included in the Medical Billing Service?
    • The Pediatricians or Pediatric provider (Pediatric Practice) selects level of service (e.g. level III or IV sick visit), procedures completed (e.g. vaccines, strep test, vision screening) as well as the diagnosis codes associated with the visit/patient then closes their charts.
    • Account Manager (Physician Xpress, Inc.) manages the insurance and patient billing processes to optimize the collection rate for the practice.
    • Account manager follows up with the Pediatric or Pediatric provider for certain items that need provider clarification.
    • Pediatric practice and their patients to call related to questions related to medical billing.
    • Monthly reports sent to practice owners so they do not need to run multiple reports in the system.
    • Annual business review to conduct a benchmarking of practice and suggestions to fee schedule as well as other items of discussion to provide additional value to the practice owner.
    • Annual vaccine analysis that shows the total profit of the vaccine business including a breakdown of the profit per vaccine per insurance company.  This report helps a practice owner to identify problem payers and areas to enhance vaccine profitability.
    • Annual vaccine analysis that shows the total profit of the vaccine business including a breakdown of the profit per vaccine per insurance company.  This report helps a practice owner to identify problem payers and areas to enhance vaccine profitability.
  • What is included in the insurance billing?
    • Review of charges, identification and correction of issues, and submission of charges to insurance companies.
    • Follow up with Pediatrician or pediatric provider for certain items that need provider clarification.
    • Management and follow-up with initial claim denials as well as denied charges.
    • Posting of payments, resubmits denied charges, and working rejections
    • Maintain and monitor list of patients with pending AR and follow-up plan
    • Provide a local telephone number for the practice and their patients to call related to questions.
  • What is included in the patient billing?
    • After posting payments from insurance company, identify the patient responsibility.
    • Print and send patient statements to parent via mail.
    • Flag total family balance so front desk team can present to parent when they enter the office.
    • Send additional printed patient statements if initial statement is not paid.
    • Maintain and monitor list of patients with pending AR and follow-up calls as needed.
    • Provide telephone number for the practice and their patients to call related to questions about patient statements.
  • Who is the point of contact for questions related to the Medical Billing?
    • The Account manager is the point person for the medical billing for your practice.  They manage the details and work with associated billers as needed for the account.
    • The Account manager monitors and manages the medical billing per the processes established for the pediatric practice.
  • How does a practice transition to Physician Xpress, Inc.?
    • A set-up specialist from our team develops a transition plan for existing practice or a start-up plan for new practices.
    • We provide guidance/suggestions on setting up fee schedules for the practice.
    • Setup specialist provides list of common procedures, codes with suggested billed amount for the practice to establish.
    • The account manager and set-up specialist meet with practice owner/practice administrator to review details associated with the account.
  • How much effort does the practice owner need to manage billing performance?
    • Recommend reviewing the Monthly report sent each month for overall practice revenue performance and AR by insurance company.
    • Consider, if prefer to perform additional analysis, using the Tools in PediatricXpress RCM for further practice analysis.
    • If have a question or would like to discuss billing, can call and discuss an issue with the Account Manager
    • Continue to manage and coach Front Desk team members at practice on their performance including ability to register patients consistently and collection of copays.
    • Attend Annual Business Review discussion  that provides a 45 minute to one hour custom practice revenue cycle review, benchmark and suggestions.
  • Do I need to hire a biller for our office?
    • No – our service is inclusive of insurance and patient billing
    • PhysicianXpress has the highest average collection rate and most consistent Pediatric RCM Service available for Pediatric Practices
    • Pediatric practices need to select the diagnosis code, procedure and level of service (ex: level 3, 4, or 5 sick visit)
    • Our team will review the coding, modifiers needed, submit to insurance company.
    • We identify issues with rejected claims, correct and resubmit
    • We review and enter payments from ERA and EOBs
    • We send out patient statements with local phone (area code of your practice) and answer calls questions from patients on billing
    • We make outbound calls to families for payment and send follow-up patient statements
    • We can collect payments for patient statements via phone and fax a completed form to your office for processing
    • We list the actions on all patient responsibility and insurance responsibility that is aged more than 120 days
    • For patients/families that do not pay after multiple calls, patient statements, we review with the practice owner and they have decision on action (such as them sending to a collection or locking charts)

Get in Touch

We would like to be of service to your organization. Please contact us for additional information.

PHONE

(877) 366-7331

EMAIL

sales@physicianxpress.com

ADDRESS

Physician Xpress, Inc.
409 2nd Avenue Suite 201,
Collegeville, PA 19426.

We are a cloud based, Electronics Health Records and Revenue Management Company. Call or contact us today to discuss how we can increase your bottom line.