Transcript Third Party Billing in University Health Centers

In-House Third Party Billing –
Is it Really Working?
Beth, Eagles, Dept. Head, Billing & Reception
University of Arkansas
Libby Greaney, Director of UHS
Western Kentucky University
Ethel “Willi” Haskins-Cotton, Insurance Program Manager
UMBC
Jennifer K. Lepus, Director of UHS
UMBC
In One Word….
YES!
Objectives of Today’s Session
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Describe ways in which to participate in
third party billing
Compare successes of UMBC, WKU, and
U of Ark
Describe administrative functions relative
to managing a health center that performs
third party billing
Why do billing?
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State revenue decreasing
Keeping records in house
More control in revenue and purchasing
Able to expand other programs within UHS
Topics to be Discussed Today
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Participating? Do you want to be a participating provider?
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Credentialing - Signing up as a provider
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Setting up your pricing - How much will you need to charge?
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Insurance file setup
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What type of billing will you do? Paper vs. electronic
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Payments and Denials
Getting started…
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Somebody Who Knows
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Personnel
Join the Party? – Participating With
Insurances
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What it means to participate – The Contract
 The Good
 The Bad
 The Ugly
Who to participate with
 The Big Five
 Big Fish in a Small Pond – Local Plans
 The Biggest Fish – Medicare/Medicaid
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Show Me What You’re Working With
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Credentialing
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Becoming a provider
CAQH
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Provider Credentialing Database
 https://caqh.geoaccess.com/oas/
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NPI numbers
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Applying
 http://www.cms.hhs.gov/NationalProvIdentStan
d/03_apply.asp# TopOfPage
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Show Me the Money - Setting up your
pricing
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Ready, Set, Go - Insurance file setup
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How Many is to many
Paper or plastic - How to file claims
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Medicare Pricing
Where to find
The Cost
Where will the payments go
Payments and Denials
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Understanding the EOB
How many billers does it take to post payments
Questions? Contact Us.
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Beth Eagles, Dept. Head Billing & Reception, U of Ark
[email protected]; 479-575-4075
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Libby Greaney, Director of UHS, Western Kentucky University
[email protected]; 270-745-3830
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Willi Haskins-Cotton, Insurance Specialist, UMBC
[email protected]; 410-455-1556
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Jennifer K. Lepus, Director of UHS, UMBC
[email protected]; 410-455-3751
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