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Pharmacy Claims & Pharmacy Billing

Pharmacists

Revenue Acceleration & Management Solutions

Juggling cash flow, software implementation, technology and staffing/payroll is a challenge for any business owner. At USMF, we know that successful management of these areas can make or break your business—and we want to help you succeed through our proven Revenue Accelerator Program.

USMF’s comprehensive Revenue Accelerator Program includes:

  • Practice finance, cash flow and billing management services
  • Collections service and management
  • Electronic Health Records (EHR/EMR) implementation and management
  • Rules identification and claim remedies
  • Technology implementation and management
  • Training and continuing education

Finance

Over the next decade, practice owners will face a variety of challenges as the healthcare industry shifts and the federal government introduces new initiatives and practice regulations. Businesses embracing these changes with viable technology and superior service will become profitable, while their competition will struggle to stay afloat. At USMF, we’re experts in healthcare finance, and we’re committed to easing the burden of finance management—so you can focus on patient care. Here’s how we can help:

  • Managing receivables and cash flow problems so you can focus on patient care
  • Assisting you with short-term cash flow concerns
  • Locating funding for practice expansion when you’ve been turned down by major banks
  • Helping your practice numbers look better day-to-day, not just on paper
  • Lowering the number of rejected/denied claims
  • Determining whether you’d would benefit from hiring a billing and collections expert
  • Assisting with the implementation of growth & acquisition plans
  • Creating a comprehensive system to manage expenses, billing and cash flow

For nearly two decades, USMF has helped healthcare practices obtain the rates and capital they require to operate efficiently, profitably and transparently. Our Revenue Acceleration & Management Program provides you with reliable working capital and immediate access to cash—so you can serve existing clients while planning for future growth.

Technology

USMF’s Revenue Acceleration and Management Program is a progressive service that helps your practice embrace the latest in software and technology systems, which are critical to any practice’s growth. This exciting USMF program provides you with the technology required to (1) reduce financial shortfalls caused by denied healthcare claims and unpaid invoices, and (2) reduce staff time required for claims submission and invoice collection.

Claim Lifecycle Manager

The truth is, over ¼ of all first-time insurance claims are denied—and nearly half of those are never resubmitted to the insurance company. When coupled with constantly changing insurance requirements, these claim problems eat into your staff’s time—and your practice’s revenue. Using our web-based Claim Lifecycle Manager, USMF will help you avoid revenue and cash flow bottlenecks through intuitive user interfaces that process your insurance transactions simply and efficiently.

Claim Lifecycle Manager benefits include:

  • No-hassle access to payer eligibility and benefit information
  • Scrubbing/editing features that reduce your chances of a denied insurance claim
  • Claim tracking systems that allow you to manage claims by exception
  • Analytical tools and reports to simplify and organize the claims submission process

In addition to offering our Claims Lifecycle Manager, USMF’s Revenue Accelerator Program provides the following solutions:

  • Practice finance, cash flow and billing management services
  • Collections service and management
  • Electronic Health Records (EHR/EMR) implementation and management
  • Rules identification and claim remedies
  • Technology implementation and management
  • Training and continuing education
  • Revenue reconciliation and bank deposit services
  • Best-practice management of your practice’s revenue cycle

USMF’s exhaustive claim management services include:

  • Data management/organization of 835 ERA files
  • Real-time, web-based insurance claim submission
  • Real-time, web-based editing and claims reprocessing
  • Claim assignment, history and status
  • Payer response and benchmark analysis/reporting
  • Claims generation (paper to 837)
  • Claims remittance processing (paper to 835)
  • Payer payment posting and A/R aging reporting

USMF’s electronic eligibility services include:

  • Automated processing of patient eligibility and coverage verification
  • Online editing and scrubbing
  • Management of denied claims (and those with exceptions)
  • Documented, updated audit trails and claims history
  • Analytics, reports and messaging options

At USMF, our experienced team of consultants specializes in recommending the guidance and profit-building technology your practice requires to sustain growth, expand and increase profitability. And each software product is designed for healthcare professionals and tested for efficiency, usability and cost-effectiveness.

Service

At USMF, we understand that quality care is your #1 concern, and we’re committed to helping you serve and satisfy patients while maximizing profitability. Through our Revenue Acceleration Program, we’ll help you assess practice efficiency, identify and eliminate practice problems and streamline existing processes. Our comprehensive program provides solutions to a variety of practice challenges. Solutions include:

  • Real-time eligibility and claims management reporting (works to reduce rejected claims)
  • Speedy data flow for expedited patient check-in and scheduling
  • Real-time pre-certifications and referral authorizations
  • System-generated, printable encounter forms
  • Automated patient appointment reminders
  • Customized billing solutions and software systems

Each USMF service solution is designed to: (1) reduce administrative hours, (2) accelerate staff efficiency and (3) improve the viability of your practice. Saving you time and money as you develop your business, our team of consulting professionals listens carefully to your needs—and recommend solutions that fit your business requirements and your budget.

USMF’s Revenue Accelerator Program also includes the following proven billing, education and training solutions:

  • Remote medical coding and audit capabilities
  • EMR implementation and records management systems
  • Medical coder training and testing
  • Improved charge capture
  • Claims generation and remittance services
  • Staff hiring and management services/training
  • Regular insurance and coding updates
  • Continuing education for physicians and staff
  • Practice audit and compliance assistance (meets OIG requirements)
  • Technology training

Relying upon our comprehensive understanding of the latest industry software, USMF professionals use industry-best technology and software to manage revenue flow, prevent claim errors before they arise—and maximize overall practice collections. In addition, we provide the systems training required to get your staff up to speed on each solution—and make it work for your practice.

USMF’s Revenue Accelerator Program may also be customized to include the following revenue reconciliation and reporting solutions:

  • Bank deposits
  • AR aging and distributions
  • Payer mixes, charges and payments
  • Referral sources and contact specifics
  • Current procedural terminology (CPTs) for procedures and collections
  • Relative value units (RVUs) for provider productivity

Call our qualified professionals today to learn more about our Revenue Accelerator Program, or to inquire about USMF’s claims management, collections assistance and practice technology solutions.



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