Revenue cycle management (RCM)
+ Medical Necessity Verification

Background

Too often, laboratories are finding that insurance companies are severely underpaying and even denying claims completely. This leads to an exponential increase in accounts receivable, complications with payer contracts, and costly errors in the coding and billing process. This means your laboratory is losing out on your hard-earned money. 

 ScriptsIT helps you level the playing field with your insurance payers by providing a unique legal perspective for your business operation. Co-created by attorneys with extensive healthcare experience and enhanced by CPAs, entrepreneurial innovators, and medical billing experts, ScriptsIT’s goal is to ensure you get fair, timely, and more consistent payments helping your laboratory achieve a more sustainable operation.

With the merging of legal experience, technology solutions, and finance management, ScriptsIT will provide your organization with the most comprehensive, up-to-date approach to billing and collecting. We are uniquely situated to provide valuable recommendations to streamline the revenue cycle process, which begins at patient intake where most problems begin.

In fact, ScriptsIT is the ONLY revenue cycle management (RCM) organization that uses Medical Necessity Verification for diagnostic laboratory billing and collection. ScriptsIT handles the RCM for both Medicare and private commercial payer out-of-network and/or in-network laboratory claims.  ScriptsIT also provides insurance payer negotiations, contract review and contract management.  Many organizations have contractual relationships with payers, but have failed to provide a system to ensure appropriate payment. ScriptsIT has solved these problems for other providers and can solve this problem for your organization as well.

Through patented and patent pending proprietary processes in the area of medical necessity verification and RCM, ScriptsIT will utilize a multi-step process of evaluation to identify the areas that are causing delays in the payment of claims or possibly even the non-payment of claims.  

We are confident that we will be able to deliver a cost-effective option to ensure that your business is securing full and proper reimbursement for current claims and effective account receivable management.

a two part approach

 

Step 1    Audit/Evaluation

We will conduct an audit/evaluation of your current RCM processes.  As part of this audit, you will sign a Business Associate Agreement that allows ScriptsIT to access your patient’s medical records, in accordance with all HIPAA and HITECH rules and regulations.

The audit will focus on overall billing and collection management.  Medical Bills submitted to Medicare will be reviewed for compliance and coding.  Associated EOB’s will be reviewed to identify specific trends in denials, payments, and other issues associated with payments.  This process will also usually identify deficiencies with the quality of the medical reports and records being produced by the medical providers.  This is NOT a full and complete audit of each and every file.  This is merely a sampling of claims.  This audit will take one week to complete.
 

 

Step 2    Formal Offer of Services

Once the audit is completed, ScriptsIT will make a formal offer of services to be provided and fees to be charged.  ScriptsIT has the ability to:

  • Provide software to manage medical necessity of services
  • Code laboratory claims
  • Provide electronic submission of claims daily
  • Provide revenue recovery of old accounts receivable
  • Negotiate in-network and cost containment contracts with private commercial payers.

The pricing structure for these services will vary based on the services that are being sought by the client to be performed by ScriptsIT.

Current billing and collection fees typically range from 5 to 10 percent of the amount collected, and account receivable collection fees range from 30 to 50 percent.  The exact fee will be determined after the evaluation process is completed.

Based upon past experience, ScriptsIT is confident that our services will deliver significant increases in revenue, which typically results in direct bottom line dollars.  Understandably, these statements are not a guarantee and are not intended to be a guarantee, nor does the hiring of ScriptsIT constitute an attorney client relationship.
 

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