Frequently Asked Questions

Q. We already use a billing company. Why should we consider a partnership with MedOptima?
Q. Why should we consider outsourcing our billing?
Q. My billing staff has been with the practice for many years. Does MedOptima have opportunities for them?
Q. Is the transition to MedOptima difficult?
Q. What kinds of improvements will we be able to employ in our practice?
Q. What are "clean claims," and why are they important?
Q. How does MedOptima achieve a high percentage of clean claims?
Q. Our practice has trouble keeping up with changing reimbursement rules. Can MedOptima help?
Q. How can MedOptima help us find new profit centers?
Q. How does MedOptima help with patients' billing inquiries?

Q. We already use a billing company. Why should we consider a partnership with MedOptima?
A. MedOptima is not a traditional billing company. We hire the best people through a multi-level screening process designed to identify "A Players." We also employ best practices from other industries like Six Sigma and Lean Manufacturing to help our clients' practices run efficiently and therefore more profitably. In addition, we offer consulting services to help with other practice issues such as negotiating hospital contracts, streamlining operations and implementing new profit centers. We also will help identify ways to generate new revenue. Our objective is to optimize practice performance so you enjoy more revenue, faster payment times, no payment hassles or "surprises," enhanced compliance, and ultimately a more satisfying professional life.

Q. Why should we consider outsourcing our billing?
A.  Due to the complexities of claims filing and the growing difficulties of collections, it is not uncommon for internal billing departments to become overwhelmed. If a high level of performance is not maintained, collections and the practice's overall profitability will suffer. Inefficient internal billing operations can generate excess costs that many medical practices can no longer afford.

When you partner with MedOptima, you will enjoy a number of benefits:

• Clients typically experience a 10 percent increase in revenue from their previous biller.*
• MedOptima employs an experienced team of billing experts to manage your billing. The expertise we provide far exceeds what most groups are able to provide on their own.
• MedOptima serves as an extension of your practice. It will feel like you have your own billing department; we just don’t take up your office space.
• MedOptima mirrors its billing practices after the sound business principles developed by world leaders in manufacturing. Our proprietary methods will help you optimize billing and overall financial performance. Accuracy, speed, and compliance: these are the hallmarks of our billing experts!
• Third-party payers are extremely adept at denying, delaying, and partially paying for physician services. This can result in significant revenue loss and increased billing costs. MedOptima specializes in providing diligent follow-up services, making sure you collect every dollar you are owed in a timely fashion.
• Recruiting and retaining an experienced billing staff is challenging. If a key employee leaves, the cost to the practice can be extremely high. MedOptima makes this is a non-issue for our clients.
• MedOptima has a proven track record of generating more revenue for medical practices for a similar or lower cost than their internal billing operation.

Q. My billing staff has been with the practice for many years. Does MedOptima have opportunities for them?
A.  MedOptima is always looking for talented people to join our team. A passion for excellence, a desire to be part of a growing organization, a willingness to learn, and a good work ethic are attributes we look for in our employees. It is not unusual for us to hire individuals who were previously employed by a client. With training in the latest technology, tight operating processes and support, they become valuable assets to the MedOptima team and a greater asset to their former physician practices. 

Q. Is the transition to MedOptima difficult?
A   The transition from one's old billing system to MedOptima takes an average of 90 days. The process is often transparent to physicians. From day one, we begin the process of expediting the billing process, maximizing compliance, boosting revenue yield, and decreasing the rate of denials. We do everything we can to ensure moving to the new system goes as smoothly as possible.

Q. What kinds of improvements will we be able to employ in our practice?
A. One of the true values of MedOptima is our ability to provide an objective assessment of your practice's strengths and weaknesses. These in-depth consulting services help you identify opportunities and strategies to retain more of your income or create new revenue streams. Each practice is different; various levels of consulting engagements are available.

Q. What are "clean claims," and why are they important?
A. A “clean claim” is a billing claim that is free of errors and omissions. Incomplete claims and claims riddled with errors can cause a significant loss of cash flow and revenue. Payers will send claims with errors back to a practice, adding weeks or months to the reimbursement cycle. MedOptima provides a greater than 98 percent first-time clean claim yield. This is compared to the industry average of just 90 to 92 percent.

Q. How does MedOptima achieve a high percentage of clean claims?
A. Simple—we make accuracy our top priority and work at it every day. First, we track the percentage of clean claims generated by your practice at various stages during the billing cycle. This makes it possible to identify recurring errors and implement corrective and preventive actions. Second, MedOptima’s advanced billing software identifies common errors and omissions that can be corrected before a claim is submitted. Finally, we employ specialized billing policies and procedures that minimize errors and other breakdowns.

Q. Our practice has trouble keeping up with changing reimbursement rules. Can MedOptima help?
A. Absolutely! MedOptima keeps its fingers on the pulse of what's happening in Washington DC with changes in Medicare and Medicaid reimbursements as well as changes on the state level and with insurance companies and third party payers. MedOptima's proactive approach to regulatory changes and reimbursement rates is just one more very important benefit to our clients that assures optimal financial performance.

Q. How can MedOptima help us find new profit centers?
A. New profit centers are typically specialty-specific and can include ancillary services such as labs and imaging, direct-to-consumer sales and new services. We are continually looking for new profit centers, thanks to an extensive network of industry experts and business advisors. We can implement a variety of cutting-edge strategies that have been successful for other physician practices.

Q. How does MedOptima help with patients' billing inquiries?
A. Your patients are your customers so their satisfaction is important to MedOptima. That's why we have a dedicated Patient Services Center staffed by knowledgeable, friendly professionals who respond to inquiries about the patient's accounts or services received in physicians' offices. Should patients have questions about their bills, we resolve them as quickly as possible.

* This is not a guarantee. Increases in revenue depend on multiple factors including patient retention, adoption of MedOptima's best practices, and no adverse changes in issues beyond MedOptima's control.