Revenue Cycle Management
Improve Profitability, Maximize Reimbursement
MPS takes a holistic approach to manage an organization's Revenue Cycle process, with expertise in providing revenue cycle management (RCM) services on a variety of platforms including, e-Clinical Works, Practice Velocity, Docutap, and Epic to name a few.
Our Revenue Optimization Program (ROP) is the reason you choose MPS. ROP provides the insight organizations need to drive incremental revenue increases, improve overall profitability, and maximize reimbursement. While some organizations are mostly concerned with the cost of outsourcing their Revenue Cycle as a main deciding factor, at MPS we believe that the organization should change their optics to the real goal, which is to increase medical group revenue.
Medical groups can experience 5% to 10% growth in their revenue by utilizing our RCM services, which has a direct impact on physician income. MPS has developed multiple automation processes that allow for the continuous work of the accounts receivable.
In addition to a reliable workforce, our ROP process works continuously in the background, automating critical functions in account follow-up around the clock.
Underpayment Examples
$33K Worth of Workers Compensation Claims Appealed
In one case, MPS identified where a Workers Compensation payor was erroneously denying first visit claims by a mid-level provider in the State of Georgia even though the State of Georgia has guidelines that allow a mid-level provider to provide an initial treatment of injury. We successfully identified the pattern of denials and successfully appeal over $33K in claims on our clients behalf.
3 Years Worth Of 99213 Visits Appealed
MPS took on a new client and identified where United Health Care was paying $12.75 less per 99213 visit than what their negotiated agreement stated. This issue dated back three years and was due to an error on United Health Care’s credentialing department. MPS appealed the reimbursement rates of the claims, had the credentialing issue resolved, and recouped the clients income in addition to forcing UHC to pay interest payments on the different as per the state law on prompt payment of claims.
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