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Chapter 5 - How it Works

Highlight Moment

One of our behavioral health clients suspected revenue loss due to underbilling and asked us to investigate the problem. We immediately found that they had a new person who recently started billing for them.  This person billed 96 people during a one-week period for UAs (Urine Analysis).  But he billed one panel at $100 (They do a 13-panel screen). So, he billed a total of 9,600 dollars (100*96 = 9600).  The collection department never caught any discrepancies because the Center got paid on what they billed. But the biller missed billing for the other 12 panels. 12 panels x 96 people x 100$/panel means they underbilled by 115,200$.

 

That’s how it works.  That’s what we do.  We find the money.

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“Mr. Selix came into our center and found $115,200.00 in twenty minutes! Nine-month-old missed invoicing. It’s a great story.” ~ KG

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The Process

Our process is extremely fluid.  We’re not off the rack because one size fits none.   Every center is incredibly unique.  It’s your center, we get that. You worked hard to make that happen and we just want to see if we can help.  We’d like to meet your decision team.  Here are the questions you need to ask:

  • Can you be sure that whomsoever collects information to send to the biller (Inhouse or Not) is sending correct and accurate information for every single service performed?  You sure?

  • How do you really know?

  • And are you sure that no one in this chain did anything that wasn’t in the best interest of your center on purpose or by error? Our discovery model is based on Game Theory which states that people always act in their own best self-interest which is often diametrically opposed with the financial interest of your center, of your financial interests.

  • Do you trust that all those people never once made a decision based on their own self-interest? Or ever made a mistake?  Can you be sure?

  • Did they match services against AUTH’s? And are you sure that the price was correct on the tens of thousands of invoices?  Are you sure?

  • And how sure are you that the person (who makes 15$/hour) sent the list of services to be billed, billed correctly? Scale of 1-10?  How sure?

  • Can we check?

​We’ve never not found money.  Ever.  The money is always there. The question is whether Health Care Collections and your center can work together to find your money.  That is step one in the process.

As a rule of thumb, if we decide it would be mutually beneficial to move forward, it generally takes us a month to sort through three months of past billing.  We would see what three-month recent period seems most vulnerable.  Billing is a very dynamic process in the behavioral health industry.  We’d travel to your facility and fine comb through thousands of services.  If you outsource billing, we’d have to have to also go there.  Counter-intuitively, outsourced Billing Services they are often very receptive.  Recall, they get 10% of money collected.

Pricing

It’s 75$/an hour.  Figure a week to see if there is gold.  Plus travel within reason.  Something we can meet and discuss.  After the FREE initial consultation, if it looks like a go at the end of week one, we move forward; at the end of the week, we’ll reexamine.  I don’t want to waste either of our time if there isn’t a reason to move forward.  And if we make it a week, and I can’t find any money, it’s a refund and we part ways.