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February 28, 2007
New PhyLogic System Increases Cash Flow
Springfield, MA - PhyLogic Reimbursement Specialists recently received a powerful new weapon in their battle with insurance payers for reimbursement. Called “Collector”, it is a recently-implemented module in PhyLogic’s AdvancedMD billing and Accounts Receivable Management System which helps automate follow-up activities on outstanding insurance claims.
According to Peggy Camerlin, CPC, PhyLogic’s Manager of Technical Operations, “The Collector system is powered by an insurance-specific, rules-based engine which allows a reimbursement specialist to follow-up in a more efficient, effective and aggressive manner than with the industry norm of paper reports”.
How it works
Traditionally, insurance follow-up is a manual process relying heavily on aging reports or stagnant worklists. The process is very tedious and cumbersome, often requiring billing personnel to sift through paper reports while simultaneously accessing previous system claim history.
In contrast, the Collector module provides for a much more robust and efficient system for follow up through the use of dynamic on-line worklists. These worklists are specific to each insurance payer and are populated with accounts which match predefined criteria on a daily basis.
For example, if experience demonstrates that a specific insurance payer usually provides payment for a practice within 25 days, the system can be automatically set to place any outstanding claims past the 25 day period in the appropriate collector worklist. This action then automatically prompts a PhyLogic Reimbursement Specialist to contact the payer for payment at the correct time.
The system then requires the user to enter notes from the interaction with the payer and then sets the next follow-up action and date (ie. the claim was found to be in process for payment, call payer again in 12 days if not received). If the claim is paid by this next date, it is automatically removed from the Collector module. However, if the claim is not paid within the designated time, the Reimbursement Specialist will again be alerted by the system and the next appropriate actions can be taken.
The Collector system is also being used as a “pre-collections” mechanism for patient balances, orchestrating pre-collection actions such as letters and/or phone calls.
The result
Use of the Collector system has already provided excellent results including lowering average days in Accounts Receivable, improved collections, and fewer outstanding dollars in older aging buckets.
Ultimately, the system allows PhyLogic to contact payers regarding outstanding claims much closer to the date of service, and much more accurately than ever before. Furthermore, follow-up activities subsequent to the initial contact occur in a more automated and aggressive manner.
Implementation
PhyLogic began core implementation of the new Collector system module with a sampling of practices in mid-2006. Once the system was validated, it has been added to more practice databases every month since. All PhyLogic clients will have the new module implemented by second quarter of 2007.
Along with implementation of the actual system, PhyLogic has allocated a great deal of human resources specifically for the usage of the new system and insurance follow-up activities. In fact, nearly one half of all PhyLogic Reimbursement Specialists are solely dedicated to payer follow-up and now use the new collector module as their primary system. Collector has been very welcome addition to their PhyLogic AdvancedMD system.
Michael Broer is a Reimbursement Specialist at PhyLogic specializing in the resolution of overdue claims who states, “PhyLogic’s collector system gives me exactly the information I need, when I need it in order to most efficiently battle insurance payers for reimbursement. The system also has outstanding reporting and accountability features, which are important to me.”
As a sixteen-year veteran in the physician reimbursement field, who recently left a competitor to come to PhyLogic, Broer has used a number of different systems and follow-up methods in his career. He added, “It is simply the most powerful and flexible system I have ever used.”
Should you have any questions regarding PhyLogic’s new Collector module, please do not hesitate to contact Kim Paradis, Manager of Billing Operations at (877) 273-3100 or email her at KimP@phylogic.com.