Medical Billing Companies & Consultants in Ewa Beach, HI

Medical Billing of Hawaii, LLC handles the entire receivables workload for medical offices from its home in the islands. Its clients are mostly independent physicians and other providers who prefer to hand off claims, collections and patient balances. The firm sees itself as the manager of a practice's complete revenue cycle, a job that begins with enrolling new patients and clinicians and ends only when payment arrives on each completed claim.

Background and team

Owner Judy Brown leads the company, and clients frequently refer to her by name when they share their experiences. An earlier version of the firm's site gave 2006 as its founding year. Combined, its billing staff claim over 65 years of work in medical coding and billing. Among the clients who have offered reviews are a psychologist and a geriatrician.

They describe hands-on support such as obtaining hospital face sheets, gathering insurer forms when a physician opens an additional office, and pointing out coding discrepancies. They also say the staff identifies second and third layers of insurance coverage and pursues claims that remain unpaid.

Services

The firm presents its outsourced model as a substitute for building an internal billing department. It notes that practices can skip the expense of hiring, onboarding, employee benefits and payroll taxes. It adds that clients are spared the revenue disruptions that tend to follow when billing employees leave. The services it provides are:

• Enrolling providers with insurance companies (credentialing)
• Entering patient demographic details and claims
• Checking charges for accuracy prior to filing
• Filing claims electronically
• Recording payments and remittance advice
• Contesting claim denials through appeals
• Mailing patient statements and responding to patients' billing questions
• Detailed reporting on practice performance, plus annual fee schedule revisions
• Connecting a practice's electronic medical records with the firm's in-house billing platform
• Submitting MIPS data through a registry approved by CMS for quality reporting

Software and technology

For an added monthly fee, the company will load its own office management program onto a desktop or laptop at the practice. The program features a scheduling calendar capable of placing automatic reminder calls to patients before visits.

It also connects to a number of insurance eligibility databases, HMSA and Medicare among them, which means office staff need not verify coverage over the phone or through a website. Practices using the program can review and edit patient demographic records, see what guarantors owe, browse account activity and generate revenue reports.

Compliance

Regulatory adherence and the protection of patient data are priorities for the firm. Every year, an independent specialist conducts a Security Risk Assessment on its behalf, and the results can help a practice attest under the MIPS quality payment program. Messages carrying protected health information or other confidential material are sent with encryption.

Billing specialists must also finish and pass annual training on HIPAA, confidentiality and security risks in order to keep their certification.

Practices weighing billing vendors may find the key distinctions to be its local presence in Hawaii, its working knowledge of both HMSA and Medicare, a staff with many years of experience, and an owner who deals personally with the physicians it serves.