CREDENTIALING

HighPoint Medical strives to maximize payer reimbursement for each and every one of our clients. To do so, HighPoint will contract with all major government and commercial insurance carriers. Provider applications will be completed in a timely and accurate manner to ensure prompt reimbursement. HighPoint will negotiate all fee schedules to secure maximum reimbursement; contracts will also be reviewed periodically and on an ongoing basis. HighPoint will keep all contracts current by re-credentialing providers as required. Other credentialing services offered by HighPoint Medical include, but are not limited to, EFT/ERA setup, CE tracking and license expiration notification.

FEE SCHEDULE ANALYSIS

HighPoint Medical will provide an annual Fee Schedule Analysis and submit to our client for approval prior to setting or changing any practice fees.

FEE TICKET REVIEW

We will review fee tickets to ensure all kept appointments have a linked charge, diagnosis codes are appropriate for services rendered, and current billing concepts/rules are applied.

PATIENT DEMOGRAPHICS

HighPoint Medical will finalize all patient demographics and insurance information. Our client will enter basic patient information that is required to create an appointment.

CHARGE ENTRY

HighPoint Medical will review and enter all charge data based on information provided by our client. All charges will be keyed within one business day after receipt.

COLLECTIONS

HighPoint Medical will actively pursue patient balances within guidelines approved by our client. As normal protocol,HighPoint Medical will prepare and mail graduated collection letters & statements beginning at 30 days and continuing for the 60, 90 and 120 day past due cycles. HighPoint Medical will attempt to make contact with the patient by phone to establish a payment schedule for the satisfaction of past-due accounts. It is understood by HPM that our client retains the final authority as to whether an outstanding bill is sent to an attorney or outside collection agency. HighPoint Medical will give input but it is ultimately our client’s decision to make.

DEPOSITS

HighPoint Medical will make daily bank deposits into our client’s solely owned bank account. HPM will transfer these funds to client’s business bank account as instructed.

PAYMENT POSTING

All payments and adjustments are posted within three business days after receipt. This data will be reconciled to the daily deposits made on behalf of our client.

CLAIM TRACKING & FOLLOW UP

Each claim is tracked to ensure payer receipt within seven days. HighPoint Medical will also follow up to ensure each claim is processed within 30 days. Upon receipt of payment all Explanation of Benefits (EOBs) will be reviewed and posted. All rejections and denials will be corrected and documented at the time of posting. Payers will be contacted when inappropriate amounts are received. HighPoint Medical will not write-off any amount, other than contractual adjustments, without the prior written consent from our client. Claims settlement may also be reached by a compromise between our client and the insurance company, patient or attorney. HighPoint Medical will comply with all federal and state regulations regarding billing and confidentiality requirements.

REFUNDS

HighPoint Medical will research and process insurance and patient refunds. All supporting documentation regarding the credit will be provided to our client’s accountant to process refund checks.

MONTH END REPORTS

HighPoint Medical will provide monthly account review and month-end reports on a regular basis for our client. Month-end reports will be generated the 1st business day of each month and sent to our client via mail or email depending on preference. HPM will review these reports with our client to ensure data is understood.
The following reports are provided:

- Monthly Changes in A/R
- Year to Date Changes in A/R
- Monthly Production by CPT
- Year to Date Production by CPT
- Aging by Financial Class