Specialties
STI does credentialing, billing and collections for most medical specialties.
Why Revenue Cycle Management with RCM-STI?
You really don’t think of RCM until you lose a billing person and have a problem finding qualified billers with experience in your specialty. Or your current staff just falls behind with billing and collections due to an increased workload and insurance regulations.
RCM-STI can replace your current billing staff or you can use our RCM Flex Program to assist your current billing staff to catch up with billing and collections rather than hire additional and hard to find experienced billing staff members.
What services do you offer with the basic RCM package?
Billing and Collections:
We provide assistance in billing and collecting of charges and other billing services that include:
- Insurance claim filing for primary and secondary claims
- Sending Electronic Patient bills
- Insurance collection procedure for unpaid charges
- Practice analysis and management reports
- Data retrieval via provided scanner (set-up & support included)
- Submission & verification of electronic insurance claims.
- Editing of electronic insurance claim denials for resubmission.
- Production & mailing of paper claims w/ necessary attachments
- Processing of appeals to facilitate claim denials.
- Production & mailing of secondary claims with EOBs attached
- Production & review of electronic patient statements.
- Coordination of patient account collection agency activity & phone hearings.
- Posting and balancing of insurance payments.
- Processing of patient & insurance refunds.
- Processing of returned patients checks.
- Working the aged accounts receivable report to follow up on past due claims.
- Processing of end-of-month functions in software.
- Production of monthly financial reports for managerial review.
- Production of specialty requested reports as needed.
- Assistance with credentialing issues & fee schedule renegotiations.
- Coding & pricing assistance (CPC’s on staff).
Can you use our current billing software?
In most cases yes, we can and we prefer that the billing data remains in your facility office and under your NPI number. If you do not have a current billing software system we can provide a cloud based version that we can share with your staff.
What type of personal assistance do you provide to the practice?
An RCM-STI Account Services Manager (ASM) will be assigned to each practice, as well as your own dedicated biller(s). The ASM is responsible for conducting reviews with you to discuss improvement in your monthly billing process. This includes relevant topics of concern to the practice such as A.R Management, Meaningful Use, electronic prescribing, CPT Coding changes, Value added modifiers, new practice personnel and training requirements to keep current with medical billing and information technology issues from the federal government.
Procedure Fee Review:
We will review your current billing fees and make recommendations on how you have these fees set based upon your geographic location, participating insurance carriers and other standard fees.
Code validation:
If we discover that your practice is not billing appropriately based upon standard code validation information we will review your coding for accuracy. We will personally notify you of ways to improve your coding based upon our code validation results. We also have the ability to compare your coding patterns against other comparable practices.
Free Access to STI University:
We provide webinars and videos on how to use STI products and services as well as information webinars about new federal billing and IT requirements. Your account manager will discuss these resources with you and suggest which sessions you should attend based upon your staff’s background.
Billing & Collection Liaison:
You will have a personal STI liaison assigned to your practice who can answer day to day questions about the status of you billing and collections.
What other services are available from STI besides RCM at an additional fee?
Collection Services:
We provide a collection agency to recover patient payments that they will not voluntarily pay. These accounts are discussed with the practice before being turned over to our collection company.
Credentialing Services
- Registration in our extensive database used to track applications and expirable (license, DEA, liability policy, etc
- Completion of new CAQH application or updating and thoroughly reviewing previously completed CAQH application to ensure accurate and current information
- Obtaining/updating Type 1/2 NPI as necessary
- Customized reporting of the application tracking process, tailored to meet your needs
- First year of Credentialing Maintenance included (see description under “Optional”)
- Choose as many insurance plans available to your provider type
- Enroll with new plans or update demographics of existing status with carriers
- Submission of applications/updates with specified insurance plans
- Tracking requests & applications from start to finish via routine status checks with carriers
- Communicating provider numbers and effective dates to billing company and office staff
Annual Maintenance Fee Option
Let us take over as your “credentialing contact”, allowing you and your staff to focus on more important tasks. We are then responsible for:
- Maintaining active in-network status as a participating provider with your selected insurances
- Re-attestation of CAQH applications every 120 days, upon provider approval
- Completion of re-credentialing applications for unlimited number of carriers throughout the year, via phone, fax, mail and email requests. Medicare/Medicaid revalidations included.
- Working with your billing staff on credentialing-related claims issues
- Expirables management reporting – notifying you of the approaching expiration dates of licenses, DEA’s and malpractice insurance policies
Credentialing Problem-Resolution:
Do you have a specific credentialing issue with one carrier and don’t envision requiring further assistance? We will research and complete any application deemed necessary to resolve.
- Enroll your organization as a group or revalidate your group info with Medicare or Medicaid. Fee is per application/revalidation.
Our focused division permits our clients to leverage a team to provide answers and assistance on ALL specialties in medicine.
The RCM team at STI will increase your net earnings AND direct you in the safe navigation of Compliance and Regulatory matters.
Our focused division permits our clients to leverage a team to provide answers and assistance on ALL specialties in medicine.
The RCM team at STI will increase your net earnings AND direct you in the safe navigation of Compliance and Regulatory matters.
Revenue Cycle Management requires aggregated knowledge of general billing principles from the insurance industry and overall health-care administration as well as the unique attributes incorporated into Specialty Billing. STI’s expertise’s range from managing complex reimbursement models of health systems, to processing claims for single practitioner practices. This diversity has allowed us to concentrate and dedicate teams to focus on unique specialties to optimize reimbursements for clients while at the same time take advantage of collaboration with experts within our organization when universal issues become present.
