InHouse Third Party Billing Is it Really Working

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 n 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? n n 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 n Participating? Do you want to be a participating provider? n Credentialing - Signing up as a provider n Setting up your pricing - How much will you need to charge? n Insurance file setup n What type of billing will you do? Paper vs. electronic n Payments and Denials

Getting started… n Somebody Who Knows n n Personnel Join the Party? – Participating With Insurances n n What it means to participate – The Contract n The Good n The Bad n The Ugly Who to participate with n The Big Five n Big Fish in a Small Pond – Local Plans n The Biggest Fish – Medicare/Medicaid

n Show Me What You’re Working With n n n Credentialing Becoming a provider CAQH Provider Credentialing Database n https: //caqh. geoaccess. com/oas/ n n NPI numbers n Applying n http: //www. cms. hhs. gov/National. Prov. Ident. Stan d/03_apply. asp# Top. Of. Page

n Show Me the Money - Setting up your pricing n n n Ready, Set, Go - Insurance file setup n n How Many is to many Paper or plastic - How to file claims n n n Medicare Pricing Where to find The Cost Where will the payments go Payments and Denials n n Understanding the EOB How many billers does it take to post payments

Questions? Contact Us. n Beth Eagles, Dept. Head Billing & Reception, U of Ark beagles@uark. edu; 479 -575 -4075 n Libby Greaney, Director of UHS, Western Kentucky University Libby. greaney@wku. edu; 270 -745 -3830 n Willi Haskins-Cotton, Insurance Specialist, UMBC Ehaskins@umbc. edu; 410 -455 -1556 n Jennifer K. Lepus, Director of UHS, UMBC Jlepus@umbc. edu; 410 -455 -3751 n n