Medical Billing Companies & Consultants in Idaho Falls, ID

Overview

United Medical Solutions, LLC (UMS) is a medical billing and revenue cycle management company located in Idaho Falls, Idaho. It belongs to a corporate group known as The Business Side, Inc.

UMS works with solo providers and with group practices, and it presents itself as a partner that operates alongside the practice instead of a vendor that handles one narrow task. Its stated focus is the complete path of a claim, starting when a charge is captured and ending when the account is settled.

According to the company, its staff combine hands-on experience running practices with detailed knowledge of coding rules and industry regulation. Certified coders are part of the team. UMS says it tailors its work to every client, adapting processes to the practice's requirements and to the way that practice wants its patients handled. It also points out that many providers believe their billing is in good shape, yet a careful review of accounts receivable indicators frequently shows results outside healthy ranges.

Specialties Served

UMS states that it understands the payment complexities found in some of medicine's more unusual specialties. The areas it lists include:

• Anesthesia
• Ambulance services
• Ambulatory surgical centers
• Family practice and primary care
• General surgery and orthopaedic surgery
• Interventional and diagnostic radiology
• Laboratory services
• OB/GYN

Building and Sending Claims

The company aims to head off denials and delays before a claim is submitted. Its approach involves matching daily charges against provider schedules, checking that codes are supported by the record, and capturing patient registration details correctly so no revenue slips away. Insurance and demographic data is collected from the practice and placed in a secure database, which UMS says helps cut the number of days accounts stay in receivables.

Coding work includes several tasks:

• reviewing documentation and either fixing or flagging inconsistencies
• assigning or confirming CPT, ICD-9, ICD-10, modifier and PQRS codes
• alerting providers to documentation gaps
• offering coding education to a client's staff
• integrating with major software and coding platforms

Whenever feasible, claims are sent electronically using HIPAA standard transactions, which UMS says brings faster responses from payors and steadier cash flow. Paper submission is also supported. Claims are directed to Medicare, Medicaid and participating commercial insurers, and then to secondary and tertiary coverage. The firm also coordinates liability claims with attorneys and other third parties.

Payments, Follow-Up and Reporting

Funds come in through electronic transfers and online patient portals. Contracted allowable amounts are stored in the company's billing software so staff can verify that insurers remit the right amounts and spot reimbursement errors linked to particular carriers. Payments sent by mail go to the practice or to a post office box the client keeps.

UMS posts what is received, records contractual adjustments, balances each day's work, prepares bank deposits and tells the client what was received. Credit balance work includes researching overpayments, mailing verification letters to insurers and reconciling unclaimed property.

When insurance claims go unpaid, staff look into denials and processing mistakes, chase pending claims, correspond with insurers, resubmit as needed and track the habits of individual payors. For patient accounts, the team responds to questions, sends statements on flexible cycles, manages payment plans and assigns uncollectible balances to the client's collection agency.

At the close of a period, UMS finalizes the books, moves bad-debt accounts to collections, issues credit balance refunds and can build custom month-end and year-to-date reports that help providers gauge practice performance. The company contends that handing off these duties allows clinicians to concentrate on patients rather than paperwork.