Increase your Medicare billing staff by using Liberty's Medicare Billing and Follow-Up team. This specialized group of employees consists of Seasoned Hospital Medicare Billers, each with an average of 10 years hospital experience.
Hospitals throughout New Jersey call upon Liberty's Medicare Billing and Follow-Up team as a resource with the answers. The staff has extensive knowledge in all aspects of Medicare billing, specializing in:
- Complex Inpatient Cost Outliers;
- Intricate Inpatient Part B Ancillary Calculation and Billing;
- Partial Hospitalization Services;
- MSP, Dialysis and MICU Billing;
- RTP Analysis and Correction; and
- Voucher Assessment for Administrative and LMRP Appeals.
Liberty's discerning Medicare staff is accustomed to high value inpatient billing and a high volume of outpatient billing. Our unique team of employees monitors an array of websites and subscriptions on a daily basis to keep informed of the changes in Riverbend procedures and edits, as well as Medicare's regulatory statutes. Liberty maintains a complete library of Local Medical Review Policies, National Coverage Issues, Medical Review Quarterly Reports, Drug Fee Schedule updates, Riverbend Medi-Letters and more.
Liberty's accomplished and highly trained Medicare billing staff provides quality billing and follow-up services and is supported by dedicated computers for direct access to the Riverbend Direct Data Entry (DDE) system. This billing process allows Liberty to track the claim to final disposition and make any necessary corrections immediately, without the worry of third-party billing software rejections and complications.
Liberty's senior management team meets with hospital management each month to review progress, provide operational improvement ideas and ensure that our outcomes exceed hospital expectations.
Quick Links
www.CMS.gov
www.riverbendgba.com
Increase the effectiveness of your Medicaid Billing staff by using Liberty's Medicaid Billing and Follow-Up team. This specialized group of employees consists of Seasoned Hospital Medicaid Billers, each with an average of 10 years hospital experience. Our dedicated and insightful Medicaid staff routinely handles high value inpatient billing and high volume outpatient billing.
Medicaid claims are billed electronically from Liberty's Wayne, New Jersey office. Eligibility and status assessments are conducted online and through direct contact with Medicaid. Our online billing systems provide Liberty's clients with the most efficient and effective road to Medicaid payment.
Liberty's follow-up protocols track the progress of all claims to final payment. Required corrections and adjustments effect accurate final disposition of each claim.
Liberty's Medicaid Billing and Follow-Up team is proficient in all aspects of Medicaid billing, including:
- WebMD Billing and Follow-Up;
- ePACES Billing and Follow-Up;
- Out of State Enrollment, Billing and Follow-Up;
- Attachment Required Primary and Secondary Billing;
- Seven-Day Readmissions;
- Adjustments and Voids;
- Fair Hearing;
- Medicaid HMO Billing and Conflicts; and
- Eligibility and Status Inquiries.
Liberty's Medicaid staff keeps abreast of the continuous changes, trends and regulatory statutes for all Medicaid payers and programs through Internet access, billing seminars and State contacts.
Liberty's senior management team meets with hospital management each month to review progress, provide operational improvement ideas and ensure that our outcomes data exceed hospital expectations.
Quick Links
www.CMS.gov
www.njmmis.com
www.emedny.org
www.health.state.ny.us/nysdoh/Medicaid/Medicaid.htm
Liberty's Seasoned Hospital Blue Cross Billers create an alternative for hospitals to collect stagnant Blue Cross receivables. Electronic billing and follow-up, and directed management intervention guarantee our superior team of talent and persistence which resolves aged Blue Cross receivables.
Liberty's dedicated and insightful Blue Cross staff is accustomed to high value inpatient billing and high volume outpatient billing. Unpaid referred claims are promptly followed up and incorrectly paid claims are adjusted as required. Liberty has an unrivaled team of employees who are trained to assess complex contract language in order to ensure accurate reimbursement.
Liberty's Blue Cross team dedicates persistent effort to resolve unpaid claims and process adjustments. Follow-up on Blue Cross claims entails costly, lengthy telephone effort as Blue Cross provider representatives can be ineffectual, requiring more than one follow-up inquiry. Liberty makes numerous follow-ups; as many as it takes; to bring referred claims to contracted resolution.
Denied accounts are referred to our denial management team, headed by talented registered nurses who review each denied claim for appeal appropriateness.
Liberty's senior management team meets with hospital management each month to review progress, provide operational improvement ideas and ensure that our outcomes exceed hospital expectations.
Quick Links
www.horizonbcbsnj.com
www.empireblue.com
Liberty's Seasoned Commercial/Managed Care Billers are recognized as New Jersey's premier focus group dedicated to resolving third-party payor issues. Liberty's specialized team brings years of payor-specific knowledge to the table. Their effectiveness is viewed in real cash payments made directly to hospital clients. They are accustomed to high value inpatient billing and high volume outpatient billing.
Any account aged at day 60 is a problem account. The reasons are many:
- Complex Inpatient Claims
- High Volume of Outpatient Claims
- Appeal Required
- Lack of Pre-certification
- Lack of Authorization
- Lack of Medical Necessity
- Denial is Inappropriate
- Allowance Entry Required
- Carve Outs overlooked in Managed Care Contracts
- Electronically Rejected Claims
- Reduced Hospital Staffing
- IT Conversion
Upon referral, accounts are analyzed for immediate action.
Liberty's Commercial/Managed Care team is trained to assess complex contract language to ensure accurate reimbursement. Our unique customized matrix system includes all contracted payors and refines payment verification. Client-specific data are strictly confidential.
Denied accounts are referred to our denial management team, headed by talented registered nurses who review each denied claim for appeal appropriateness.
Liberty's senior management team meets with hospital management each month to review progress, provide operational improvement ideas and ensure that our outcomes exceed hospital expectations.
Quick Links
www.aetna.com
www.cigna.com
www.oxhp.com
www.uhc.com
Liberty's Denial Management Registered Nurses boost hospital efforts to effectively pursue administrative and clinical denials. This denial management team is directed by a registered nurse with more than 20 years experience in clinical care and health-care administration. Advanced degrees in finance and certification in medical record coding strengthen the team's extensive experience.
Liberty has a documented success rate of 70% in overturning Riverbend medical necessity denials and a success rate of 55% for no authorization/timely filing denials for commercial and managed care payors. The outcome of our efforts is increased cash flow, or "found money" for the hospital on accounts previously deemed uncollectible.
Liberty's denial management personnel coordinate information from the hospital's registration, managed care, utilization management, patient accounting and medical records departments. Appeals are based on a fine-tuned assessment of the denied service.
If appeals are submitted at all, many hospitals submit generic, pre-formatted appeal letters. Liberty appeal letters are patient-specific, printed on original hospital letterhead, and are personally signed by the registered nurse who wrote the appeal.
Prior to appeal generation, a nurse reviews demographic and medical information to ensure that there is support for action. Assessed support data are presented in a logical and concise format to ensure the utmost consideration.
Extensive follow-up is performed to ensure appeal receipt, payor review by the correct department and ultimate accurate reimbursement on denial reversal.
Liberty maintains a database of all submitted appeals. Appeal reasons and payor-specific denial data (including additional dollars paid) are presented to hospitals at monthly client status meetings.
Liberty's senior management team meets with hospital management each month to review progress, provide operational improvement ideas and ensure that our performance data exceed hospital expectations.
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Liberty is an accounts receivable firm that specializes in the collection of insurance accounts receivables. After all insurance obligations have been met, payments received and posted, there are often balances due from the patient.
Once that is determined, Liberty staff updates the payor on the hospital computer system to self pay, establishes a hospital-specific dunning cycle and enters a comprehensive note into the hospital system. We document all attempts to contact patients and guarantors and strictly adhere to HIPAA regulations. Our notes detail the reason for transfer to self pay, and the background history that brought the account to the self pay disposition.
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