Wisconsin Radiology Specialists (WRS) formed when four distinct radiology practices merged together in 2000. After the merger, the newly created WRS sought out a medical billing and coding company to handle the increased workload as well as help them establish best practices.
After WRS signed on to work with SVA – Healthcare a few issues were immediately identified that needed attention. The most evident being four hospitals WRS provided services for had not previously worked with SVA. Immediately a new process was established to electronically send patient demographics to SVA for coding and billing purposes. The second obstacle – ensuring all services performed by WRS were billed.
Wisconsin Radiology Specialists (WRS) reduced their denied claims by 50% with SVA – Healthcare* (SVA) by taking a proactive approach to their billing.
In order to overcome this second obstacle and guarantee all WRS services were received and being billed, SVA, together with WRS’s Business Manager, Al Jensen, strategized to create an audit process. This process was developed to ensure all electronic patient data was successfully received from each hospital and subsequently billed by SVA.
Recognizing there can be a variety of issues associated with the electronic transfer of data from the hospitals, the audit process has become a key best practice. “SVA was completely receptive to developing an audit process and we’ve come to rely on this process to ensure they’ve received everything from the hospitals,” stated Jensen.
The auditing process has been in effect for over 7 years. “It provides piece of mind knowing we are not missing hundreds of claims each month. We rely on the audit process to see what has not been billed. And, it also helps with payor compliance,” added. Jensen.
With SVA staying on top of the ever-changing policies of insurance companies, Al relies on his SVA team to inform him of those billing and coding changes. In turn, he relays the information and educates the 37 radiologists at WRS.
“Staying abreast of compliance rules helps reduce the amount of denied claims for WRS. If our codes are in compliance with payor rules and regulations our denied claims are minimized,” stated Jensen.
SVA and WRS have developed a proactive process to reduce denied claims. SVA alerts WRS if they see an issue with a patient file not being compliant with the payor policies. According to Jensen, “With SVA taking a proactive approach, WRS’s denied claims have been reduced by 50%.”
“Communication is key,” continued Jensen. “Without the type of communication I have with SVA, there is too much room for billing issues. I speak to at least one of my SVA team members multiple times per week, and sit down with my Account Manager on a monthly basis.” “It is important to me to have a core group of individuals on my account with little turnover. I have that and more with SVA,” concluded Jensen.
*SVA Healthcare is a GetixHealth Company