Billing is the lifeblood of all medical practices. When done correctly the business can develop and grow, if done poorly they struggle or discontinue operations. At Medigistics our single focus is medical billing and making sure every possible collectable service is pursued for payment. We accomplish this with our experienced and motivated staff using the most up to date hardware and software. We are constantly comparing our statistical benchmarks to those produced by the MGMA, RBMA and others to make sure we are achieving levels of service to our clients that meet or exceed these standards.

Data Capture :

The billing process starts with the collection of patient, guarantor and insurance holder information. This is the demographic information needed for billing.

The second set of information pertains to services provided to the patient. This includes the date of service, location of service, CPT, ICD-9 code, as well as other information.

This information is then screened and audited before being entered into the system.

Many data elements must be entered and audit for a complete and accurate claim to be generated.

Daily Billing :

To speed up the collection of medical accounts receivable daily billing of new charges and balance forward amounts are a must.
   Charges that are entered into the system create a statement or claimform within 24 hours.

Insurance payments with deductible or co-pay amount cause the system to produce a statement to the guarantor within 24 hours.
   We print all of our statements and claimforms in-house on a high speed Xerox 4850 color laser printer.

Patient Services :

All practices are assigned a specific group of billing specialists to assist their patients with any problems they may have.
   Patients can reach us by toll free numbers, email or fax.

Billing Specialists at Medigistics are the employees with the longest tenure with the company to ensure patients have someone knowledgeable to speak to.

Electronic Claims :

We file claims electronically to all third party payers.
   Approximately 85% of all claims we file are filed electronically.

Compliance :

Over the years compliance in medical billing has become one of the major issues of importance for both our clients and us. This is for good reason because a legal misstep can have dire consequences for both businesses. Medigistics adopted our compliance plan during the 3^rd quarter of 2000.

The six elements of the compliance plan are:

Standards and Procedures - includes written standards of conduct for employees, the development and distribution of written policies that reinforce Medigistics's commitment to compliance and address specific areas of potential fraud, such as billing and claims processing.  

 Oversight Responsibilities - designates a chief compliance officer or other appropriate high-level corporate official who is charged with the responsibility of operating the compliance program.  

Employee Training - offers education and training programs to employees.

Monitoring and Auditing - uses audits and other evaluation techniques to monitor compliance and ensure a reduction in identified problem areas.

Enforcement and Discipline - contains a code of improper/illegal activities and employs disciplinary action against employees who have violated internal compliance policies or applicable laws or who have engaged in wrongdoing.

Response and Prevention - investigates and remedies identified systemic and personnel problems; promotes adherence to compliance as an element in evaluating supervisors and managers; promotes the development of policies addressing the non-employment or retention of sanctioned individuals; provides for the adoption of procedures to protect the anonymity of complainant; and sets forth a procedure for record creation and retention.

Our compliance program is a dynamic program and, therefore, one that may be modified or expanded as information and knowledge is gathered about the best practices and procedures for the organization.  In our compliance program, we attempt to provide guidance and structure to assist all of our employees in the early detection of misconduct, prevention of future wrongdoing, and promotion of corporate citizenship.