Wiki Taking back billing from 3rd Party Vendor...Advice?

n2horses

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Looking for advice from billers and practice managers. I am planning a transition to take back my billing from a 3rd party vendor, and bring it in house. We will NOT be using their software or clearinghouse, and will be starting fresh with a new software and new clearinghouse. We want to continue to clean up the old AR, they may bill a few charges, or we may take it over 100% as of a go live date and have them do nothing other than host the software until we are done with it. We are not doing a data conversion of old material into the new data base due to the amount of "garbage" in the old system.

I'm looking for advice from those who have experienced this process and what you did to make the transition smooth, especially when it comes to the revenue cycle and insurance paying claims on bulk checks/EFTs for claims in 2 different systems. How did you set up your transistion? What extra checks and balances did you put in place to account for everything in two systems? How long did you have access to your former EMR/EHR systems and how did you adapt your internal billing department to address A/R in both systems?

I have a plan, but I'm looking for the Do's/Do Not's of this process if anyone has suggestions. TIA!
 
Taking back billing...

You ask a lot of very good questions.

I have some experience in this scenario, and I would place heavy emphasis on cleaning up the A/R from the old system as soon as possible as the possibility of losing access to that system increases every day. Once the number of unpaid accounts is down to a reasonable amount, you may want to consider transferring the balances to your new system. Another option would be to transfer the patient balances as the patients are seen in your office.

As far as the 'junk' in the old system, I would try and do some sort of audit to determine what the actual dollar amount of outstanding accounts receivable is, and then try and weed out the junk. For auditing purposes for Medicare, private insurance, etc., you will need to have some backup for your charges, etc. in case you are asked to provide financial records.

You will definitely need some checks and balances to make sure payments are all accounted for. I personally would have one person responsible for balancing the payment batch for the billing company, and a separate person balance the payment batch for the new system. A third person could be responsible for making sure that the old system payments plus the new system payments add up to the total deposit each day.

Good luck with the transition!
 
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