Medical Billing Companies & Consultants in Livonia, MI

LTC Billing Specialists, also known as Havens LTC Billing Specialists, is a Livonia, Michigan firm that does third party billing for long-term care providers. Its main clients are skilled nursing homes and other institutional facilities. It has served facilities in Michigan and in other states since it opened in 1988. The firm focuses on the reimbursement side of nursing home operations, so facility staff can spend their time on resident care.

Billing and Claims Services

The firm runs monthly invoicing for client facilities across the major payer types found in long-term care. When claims are delayed or denied, its billers look for the root cause and work to resolve it. Its core billing work includes:

• Initial claim submission for Medicare Part A and Part B, Medicaid, HMO plans and commercial insurers
• Exhaust claims, no-pay claims, and HMO claims sent to Medicare so benefit periods are tracked
• Coinsurance, secondary and supplemental insurance billing, with ongoing follow-up
• Resolution of Medicare Secondary Payer (MSP) issues and aged outstanding claims
• Reviews of the facility aging report on a monthly, quarterly or annual basis

An in-house auditor checks claims every day and every month. Each quarter and each year, a facility contact receives a full audit of open claims so that questions and adjustments can be settled together. The company says these audit routines support a payment rate of about 99 percent. Clients also receive billing reports to review. Any problems go straight to the representative assigned to that facility. The firm also describes internal controls designed to protect facility and resident privacy.

Training, Consulting and Education

Beyond billing, the company advises nursing facilities by phone, by email or in person at the site. Help can be a quick answer about a pending admission. It can also be ongoing work, such as watching admissions and passing along changes to federal rules, state rules and payer requirements.

New employees, or staff who take on new billing duties, can get one-on-one instruction. This includes admissions, MDS and nursing personnel as well as billers. The firm also runs informal hands-on workshops and seminars, led by billers who handle claims every day.

These sessions show how each department affects receivables and help staff avoid lost revenue under Medicare, Medicaid and private insurance rules.

Background and Team

Founder Judith Havens has more than three and a half decades of experience in long-term care. She worked as an admissions coordinator, served as Medicare/Medicaid coordinator, and ran a 152-bed nursing home as its administrator. General Manager Elizabeth Mayernik once managed the office of a 120-bed nonprofit skilled nursing facility. The firm has separate teams for each area of work.

Its Medicare group has over 25 years of experience and its Medicaid group has more than 20. Its auditing and coinsurance staff have about 15 years of experience. The company points out that its staff were billing before the 1998 shift to PPS, when billing software was not yet available.

Prospective clients can request a free consultation to review their needs, goals and budget.

MedLife Medical Billing Solutions LLC, which operates as MedLife MBS, is a revenue cycle management firm that works with healthcare providers across the United States. Its office is in Livonia, Michigan, in the western suburbs of Detroit, and it has a second location in Manassas, Virginia.

The company is aimed at physician practices and other providers that want to hand off claims work. It covers the whole cycle, from checking a patient's coverage before a visit to collecting balances that have sat unpaid for a long time.

Services Offered

MedLife offers each part of the billing cycle as its own service, so a practice can hire it for the full cycle or for only the pieces it needs. Its services include:

• Claims-focused medical billing and charge entry
• Medical coding for procedures and diagnoses, including bundling and unbundling
• Medical transcription that turns dictated physician notes into written records
• Provider credentialing and help with payer contracts
• EDI enrollment for electronic claim and data exchange
• Insurance eligibility verification and prior authorization handling
• Denial management to rework and resubmit rejected claims
• Accounts receivable recovery, including balances older than 90 days
• Out-of-network billing and patient statements

Approach and Technology

The company says it stays up to date with CMS rules and individual payer policies, with the aim of cutting denials and getting payments in sooner. It handles both government and commercial payers. Clients get reporting from in-house software that tracks measures such as days in A/R, collection ratios and denial trends. MedLife says it keeps clients informed with regular account updates and offers new prospects a free audit of their practice before they sign on.

Background and Credentials

MedLife says its team has more than 15 years of hands-on billing experience and that its billing staff hold AAPC certification. It reports a first-pass claims rate of about 99 percent, which is its own figure and has not been independently checked. Its website also has billing pages for specific specialties, such as physical therapy and wound care, and it publishes educational articles on billing topics.

Considerations for Buyers

MedLife may suit practices that want one vendor for billing, coding, credentialing and front-end checks like eligibility and authorization. Its pricing is percentage-based. Practices with documentation backlogs may find the transcription service useful, since many billing firms don't offer it. Buyers should ask which practice management systems MedLife works with, confirm which office would handle their account, and ask for references from practices in the same specialty before signing.