Fee Schedule Evaluations

Fee schedule evaluations and other profit enhancement services

Change seems to be the only constant in healthcare today! The forms you are required to complete this month may be obsolete next month. HMO's and PPO's may dramatically affect your practice's earning potential. Does it seem the harder you work, the less you make? MGSI can't change healthcare regulations, but we can help steer your practice so you receive every dollar to which you are entitled. Do you review and update your fee schedule annually? As your revenue cycle management partner we review each of our client’s fee schedules by payor. All government, managed care, commercial payors-etc.

Fee schedule reimbursement rates are loaded into our practice management software at the CPT code level to insure you are being paid based on your contracted rates. In addition for each payor the provider participates with MGSI a leading medical billing company identifies: the time filing limit and time allotted to appeal a claim. This analysis is handled annually. How does your practice know if you are being paid accurately? How do you track the health payors claim edits which do not reimburse for certain services/procedures when billed with other services rendered? Is your practice up to date insurance company payment rules? Are you being kept in the know when your payors reduce your reimbursement rates? Together, we can increase your revenue and maximize your profit.

The following are some of the ways in which we can help you with fee schedule evaluations:

Develop fees for new procedures

Using Relative Value Studies, we can help physicians objectively create and adjust fee schedules for new procedures.

Coding Assistance

MGSI has medical coding specialists who are accessible on an "as-needed" basis. We will teach you and your staff to code accurately. As part of our ongoing service, our consultants are available to answer difficult coding questions and advise on the correct codes for primary diagnoses. They will review documentation to ensure accuracy and to determine that appropriate levels of care are reported. Possibly nothing done in your business office is as important as coding accurately. Our goal is to help you bill the maximum allowable amount under governmental and third party regulations. Your practice will be more efficient and therefore, you will increase your financial success.

The staff at MGSI stays abreast of changes in the healthcare environment so that we can help you maximize your profit potential.