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All claims will go via electronic submission, unless they are forced to paper by the payor and/or claim specific submission requirements. Claims are filed daily.

Automated front-end validation tools enable MedSynergies to identify and extract claims which are likely to be denied by the payor. Identifying rejects prior to submission to the payor enables claim corrections and resubmission within days resulting in reduced payor denials and faster reimbursement.

MedSynergies employs its own software edits to reduce clearinghouse costs, assure claims are presented in proper formats, and enable the fastest payment possible. Our clients benefit daily from the intelligence we’ve gained through our years of experience.

As you do business with new payors, we ensure that all new formats and filing rules are set up properly to make the transition fast and easy.

View the MSI Imaging Demonstration

All payment correspondence, Explanation of Benefits (EOBs) and checks are imaged from the payor and scanned or received through the bank and loaded at our corporate operations center using lockbox technology. MedSynergies works with our clients to establish dedicated lockboxes that facilitate fast and efficient payment posting. As part of that service we provide regular reconciliation of payments posted in the Practice Management System.

Unlike many organizations, MedSynergies posts payments on a line item basis, including $0 payments. This level of detail allows us the ability to more easily identify the collection opportunities that maximize payments and provide complete reconciliation reporting. Every EOB has a separate and distinct digital image indexed to the proper patient account and charge which amplifies the visibility of the data. MedSynergies currently has 14 index fields which may vary by application.

All payments are reconciled and posted to the A/R system on a daily basis from imaged data. This includes MedSynergies’ Operations Portal which tracks all payment information received from the client/bank that is then tracked all the way through the Practice Management System in order to post, reconcile and audit back to the credit detail.

Secondary claims on paper are auto-matched using appropriate criteria in order to marry documentation needed for payment such as the primary EOB and are mailed to the secondary payor.

Patient billing services exists to help our clients’ patients manage their statements. Frequently additional information is required from the patient in order to properly process insurance billing. Patient Services helps gather that information from patients and puts it in the hands of our A/R Resolution team to get the statements paid by the insurance company. The Patient Services team also works with self-pay patients and on pass-through balances to process payments, establish payment plans and help patients understand activity in their accounts.

Our patient billing services are based on our advanced approach to managing pass-through revenue. Pass-through revenue consists of dollars billed to the insurance company that should have been collected from the patient. Pass-through reporting identifies self-pay accounts that are 30 days from date-of-service.

Our self-pay revenue cycle is an automated, scheduled, and comprehensive process consisting of patient statements, letters and telephone contact. Supplemented with client reporting, progressive levels of communication are used to intensify qualified patient contact as balances age. Driven by highly efficient process automation, these tools serve to optimize and accelerate patient payments while minimizing the cost of patient contact.

Patient statements are laser printed, folded, presorted, stuffed into window envelopes with a return envelop, and mailed to patients. Our statements are customizable for each of our clients and can include their company logo.

Collection letters are printed and folded in a presorted window envelope.

This process is flexible, allowing individual physicians or practices to determine which accounts to refer for collection. At the discretion of the client, uncollected charges are transferred to a collection agency.

MedSynergies’ philosophy on A/R is one touch resolution. We review, correct and resolve all demographics and charge issues in one sweep. To be successful, we go back to the logical basics of using automation and innovation paired with basic coding, payor and compliance rules.

MedSynergies’ proprietary Claims Intelligence System (CIS™) is an advanced rules-based engine for billing that enables medical groups to identify specific problems and trends in denied claims, and then correct the issues causing the problems on many accounts at once versus going into each individual account to correct, thus making A/R scalable.

Real-time reporting captures payments or denials enabling scalable A/R work. The results: an average of $800,000 collected per A/R analyst.