Insurance Companies Don’t Make Money When They Pay Claims
It isn’t a conspiracy but the simple truth is that insurance companies make it increasingly difficult to get claims paid. When a claim has an error or requires an appeal the estimated cost is $25 in administrative cost to correct it. Medical claim denial rates are steadily increasing, distorting healthcare providers’ revenue cycle and, in turn, impacting their operational effectiveness. The net-effect is that health care costs continue to rise and FQHCs don’t have the money to serve the patients in their community.
The Trusted Partner to FQHCs
Working exclusively for FQHCs, Synergy Billing meets their needs comprehensively through their turnkey billing solution, which includes front desk training, compliance monitoring, and a white glove credentialing service. “The uniqueness of FQHC billing lies in the fact that it requires a partnership.
Synergy Billing: Revenue Cycle Management Exclusively for FQHCs
The company starts by mapping out all the workflows of the health center to understand their operational processes. Working in partnership helps refine the processes to reduce errors and ensure that the claims get paid the first time. In more than 15 years of its operation, Synergy Billing has a phenomenal track record of more than 90 percent of claims getting paid within 30 days and an average increase of 10% to net revenue.
One of the foremost challenges faced by health centers is the lack of skilled personnel at the front desk, which results in errors leading to denials and barriers to reimbursement. Synergy works with the front desk staff and sees to it that that they have proper training. The company has developed its training and certification program that teaches mastery of billing and revenue cycle management.
The uniqueness of FQHC billing lies in the fact that it requires a partnership.You could be the best revenue cycle manager in the world but if you don’t have the right combination of people, process, and technology then you can’t achieve results,” says Jayson Meyer, CEO, Synergy Billing.
The second concern revolves around provider credentialing. Often, a provider may begin providing patient care before she/he is enrolled in all of the health plans in which the center participates. Synergy undertakes the credentialing for them, making sure that they are enrolled and the center is paid appropriately for their services.
Another area in which healthcare providers struggle is medical coding, as the staff seldom has relevant training. Using incorrect codes produces errors, causing denials. Synergy reviews all of the provider’s claims and coding before the claim is submitted for billing, thus helping prevent errors. Through its denial prevention service, it conducts a thorough examination of the claim before submitting it to insurance. In addition to leveraging technology, Synergy also provides rewards and incentives to its clientele. Clients providing clean data or clean claims are provided with a 2 percent rebate for every claim that is ‘error free’.
A testament to the efficacy of Synergy’s services is the way its bundled services have helped its clients make meaningful changes and maximize revenue. “What appealed to us about Synergy Billing is that they are proactive about anticipating our needs. We have a dedicated Revenue Cycle Manager at Synergy who hosts a weekly Zoom meeting and reviews our financials. With Synergy’s help, we now have well over 12 months cash on hand,” says Scott Rosenthal, CEO of Northeast Oklahoma Health Services in Hulbert, Oklahoma.
Moving ahead, Synergy Billing plans to expand its reach. Operating from a 25-acre campus in Holly Hill, Florida, the company has capacity and is prepared to be the trusted partner for all of America’s Health Centers.