FAQs

Frequently Asked Questions

Question: What are the Pros and Cons of in- House versus Outsourcing?

Answer: Utilization Review Services: Medivance’s Credentialed Utilization Review Services provides a superior service for your facility’s utilization needs. Our extensively screened staff is known throughout the industry as exceedingly experienced with in-depth knowledge in securing maximum levels of care.

Innovative State-of-the –Art technology: Medivance is proud to announce the implementation of CollaborateMD! This all-encompassing software features transparency throughout the revenue-cycle process of claims, from real-time claims submissions to exclusive claim tracking. With a 99% electronic claim acceptance rate, our clients see faster reimbursement turnaround times from payers, and can better determine revenue forecasts and projections for their practice in a more timely and efficient manner.

In-House Transition Program: Medivance understands that the time may come that a customer may see it in their best interest to take their Behavioral Health billing in-house. When you decide that you’re ready to bring your billing in-house, Medivance will assist you with training and implementation, assuring a worry-free transition.

 

Question: Should You Outsource Your Billing?

Answer: Besides costs, there are other factors that would spur a facility to consider outsourcing their billing.

Your billing process is inefficient. If you’ve been watching your collections drop while the time to collect increases, you may have issues in your in house billing department. Outsourcing to a third-party billing service typically decreases the number of rejected claims and decreases the time it takes to receive payment from a payer.

You have high staff turnover. Turnover is an issue in any industry but turnover in a provider’s billing department is especially damaging. Claim processing is the economic life blood of a facility and a new addition or replacement in the billing department will inevitably lead to slowdown in the processing of claims.

You’re not tech savvy. Keeping your billing in-house will require an investment in practice management software. Add in training for your staff and the significance of this investment becomes clearer. If you don’t want to deal with software upgrades and occasional technical issues, outsourcing is probably a good choice.

You’re a new facility. New facilities have plenty to learn and worry about aside from their billing. Outsourcing their billing right off the bat can give them much needed relief from the day-to-day stress of launching a new facility, without a trial by fire in hiring, training and managing employees.

You have different priorities. They are there to help patients and should not have to worry about the administrative/clerical side of the business. Outsourcing the billing process eliminates the hassle and frees the facility to concentrate on patients.

It’s important to note that a billing service isn’t a silver bullet for in-house billing issues. Billing services can vary widely in their efficiency and accuracy when processing claims. If a facility chooses a billing service that is lax and prone to errors, the headaches surrounding billing issues won’t get better – they’ll get worse.

 

Question: Which Approach Should I Choose?

Answer: It’s important for a facility to factor in their individual costs and preferences when deciding whether or not to outsource their billing. In an apples-to-apples comparison, we found that outsourcing had the higher net income. However, cost isn’t the only issue facilities should consider. There are plenty of other factors involved in this business decision that may be as – if not more – important than costs.

 

Question: Why should I be HIPAA compliant?

Answer: The primary objective of HIPAA is that health organizations have the infrastructure and procedures – administrative, technical and physical – that allow them to safeguard patient health information from any kind of exposure or disclosure to unauthorized parties when this information is required to be transmitted or delivered to authorized individuals.

As it has grown, however, HIPAA has evolved into a long list of strict standards and requirements which can be painful to implement. Some of these difficulties are so massive in scale that organizations struggle to see the light at the end of the tunnel, especially since HIPAA standards apply to paper-based, electronic, and oral communication of information. Yet, there are advantages to HIPAA compliance. Despite all the difficulties, organizations choosing to integrate HIPAA standards will gain a clear strategic advantage.

 

Question: What is the turnaround time for claim payment?

Answer: With a clean claim format the turnaround time for payments with major insurance carriers is 30-45 days. However if the dollar amount exceeds a certain dollar value range (usually over $10,000) the insurance company reviews the claim for a “High Dollar” review.

 

Question: Why Medivance Billing Service?

Answer: Our Mission is geared to setting the highest standards in service, reliability and cost containment in our industry. Medivance Billing Services’ vision is to become the Premium Behavioral Health medical billing company in the industry. Medivance has developed effective internal controls that promote adherence to applicable Federal and State laws, and the program requirements of Federal, State and private plans. We believe that an effective compliance program is particularly important in efforts to prevent fraud and abuse. Specifically, Medivance will meet the U.S. Health Insurance Portability and Accountability Act of 1996(HIPPA) compliance security rules by implementing a series of administrative, physical and technical safeguards to use and assure the confidentiality, integrity and availability of electronic protected health information.

Medivance’s Staff includes individuals who have over 70 combined years in the Behavioral Health Industry. Some key personnel on our staff include a Psychiatrist, Family Medical Provider, Substance Abuse Specialist, licensed Social Worker and billing specialists who implement the company’s clean claims policy. Additionally, our staff includes billing assistants, account managers and a sales and marketing manager. Each individual is thoroughly versed in the profession with expertise in claims and is capable of communicating with health care professionals to provide timely and accurate advice with regard to reimbursement matters, and overall business decision-making. Therefore, our specialists can apply forward thinking methods that are likely to make a difference in your cash flow, including benchmarking practices and exploring remittance data to uncover discrepancies from your payer contracts.

 

Question: What are the benefits of using Medivance?

Answer: Medivance’s Credentialed Utilization Review Services (CUR) provides a superior service for your facility’s utilization needs. Our extensively screened staff is known throughout the industry as exceedingly experienced with in-depth knowledge in securing maximum levels of care.

Innovative State-of-the –Art technology: Medivance uses an industry leading billing platform that is a proven and trusted practice management solution designed to simplify and streamline the way you capture revenue.

In-House Transition Program: Medivance understands that the time may come that a customer may see it in their best interest to take their Behavioral Health billing in-house. When you decide that you’re ready to bring your billing in-house, Medivance will assist you with training and implementation, assuring a worry-free transition.

Appreciation Advisory Program: Our Chief Executive Officer will conduct a minimum of two meeting a year with you to offer advice on how to continuously position your company toward maximizing revenue.