Hello, Ideal Medical Solutions visitors. I’m Aleja from Papertrail Solutions. I am honored that my friend and BNI Collaborators colleague Chris Spero asked me to evaluate and blog about a recent 10-Minute presentation he gave at our meeting.

It is evident watching Chris speak that he is completely at ease with his subject matter. For a topic that can be confusing, and downright frustrating, he is a calm man in a storm. In addition to an impressive academic history – the University of South Florida and Fordham University, respectively – it is likely his decade of business development experience for a Fortune 500 Company that facilitated the detection and pursuit of an often overlooked market niche.

As Wall Street emptied, Chris endured the market crash in New York City while moving up the corporate ladder. He developed solid sales and training skills that allowed him, in 2009, to develop Ideal Medical Solutions as a bootstrap start-up. His determination and entrepreneurial spirit are unmistakable in his recognition of the opportunity, and his online, self-education on the subject.

Chris presented two case studies to familiarize the group with his business; both were referrals from the BNI community.

Case # 1

Billing Profile

This company employed an in-house billing agent who walked out on the job after eight months (June 2011-February 2012). Bills had not been submitted since mid-January. Chris and Ideal Medical Solutions were brought on board to evaluate the damage at end February 2012.

Primary Issues

The most significant issue was poor internal communication. Insurance verification was not handled properly; erroneous billing, bookkeeping, and pricing were commonplace; and personal insurance protection (PIP) cases were not consistently submitted in a timely manner.

Current Status

Since Chris and IMS have started working with this firm, daily bills go out more frequently, typically Tuesdays and Thursdays; receivables turn over within 19 days on average; and PIP cases go out bi-weekly. IMS has assisted in correcting errors and training staff. Through best practices and consistency, they have successfully reconciled over 4400 bills in two years.

Case # 2

Billing Profile

Chris met with a physician in August 2012 who required billing and full credentialing. As IMS did not offer credentialing services (at the time), Chris suggested the use of a credentialing third party. The physician passed on using IMS when a billing competitor offered free credentialing. The physician’s office contacted Chris just over a year later, in October 2013, when the competitor was unable to fulfill its obligations to the firm.

Primary Issues

Similar to the first case study, Chris quickly recognized the lack of communication between the billing and office staffs. Again, there was improper eligibility verification, and an egregious misunderstanding of insurance, specifically confusion between in network vs. out of network deductibles, copays, co-insurance, and out-of-pocket expenses. There also appeared to be no pricing charge master.

Current Status

Chris considers this office a work in progress, as he has aided in updating basic information (forms)/software. IMS has diligently worked to educate the staff to turn the office around and increase profitability. The office is presently on a new system, and contracted with most major insurance carriers, a significant improvement from their one carrier when IMS began working with them. Additionally, IMS has updated incorrect demographic information for all insurers, and resolved the Medicare PTAN issue.

In the spirit of customer satisfaction and as a tribute to his entrepreneurial nature, Chris now offers credentialing and contract review and negotiation services as well.

Summary

Chris’ dynamic presentation to our chapter was well received and uncomplicated, no easy feat for what the average person may consider difficult subject matter. His skills, confidence, integrity, and general sincerity for his work and his clients were marked. Chris and IMS clearly have the skills and drive to help individual providers and small practices increase their profitability. Their customized and expert approach to revenue and billing management unburdens the small business owner, allowing increased concentration on the practice. Just as important, coaching office staff to work more efficiently and knowledgeably empowers the staff, is teambuilding, and ultimately reduces overhead.

Like what you’ve read so far? IMS is always working to promote good business practices and network with like-minded professions. His contact spheres include:

  • Professional Society Board Members
  • IT
  • Financial Advisors
  • Personal Injury Attorneys
  • CPAs
  • Practice Management Consultants

 

 

About the Author

Guest Blogger Aleja Giovenco is a freelance editor/writer and owner of Papertrail Solutions.

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President Obama signed the “Protecting Access to Medicare Act of 2014″ into law on April 1.  Part of this bill includes delaying ICD-10 implementation to no sooner than October 1, 2015.  This is not the first delay since mandatory ICD-10 implementation into law in 2009.   You can view the actual bill here: http://www.gpo.gov/fdsys/pkg/BILLS-113hr4302eh/pdf/BILLS-113hr4302eh.pdf.  Title II, Sec 212 is where you will find it.

It was a long time in the making, but our website is finally up and operational! When we started working with our web developer, we knew we wanted to create a site that was easy to navigate, easy to read and understand, and that educated people on all of the unique reasons that Ideal Medical Solutions, LLC is a great partner for Medical Claims Processing, Credentialing, and Consulting services. We worked to gather the information, distilled it into bits that collectively made sense to the uninitiated and then wrapped it up in a graphic presentation that we felt was understated, soothing and attractive (much like our services!).

We plan to use this blog to update our customers (and future customers alike) on important information we learn about billing, insurance, and other relevant topics as the news is available (like impending changes to health insurance with new laws going into effect soon, and what effects they will have on your business). Be sure to check back often and let us know if you have any topics you’d like to see covered.

We’d also love to hear what you think about this site and the blog itself. After all, when you’re so close to a project for so long, it’s hard to remain totally objective. Let us know what you love, what you hate, what you wish there were less of and what you wish there were more of, and we’ll work to make the experience of visiting our site as pleasant and as pleasing as possible.

Thanks for visiting with us, and we look forward to hearing from you!