CodeOne provides consulting services in areas including practice analysis, coding review, audit reconciliation, managed care contracting, practice compliance, and business coaching. Our team of consultants comes from a diverse background of medical billing, practice management, managed care leadership, and payer organizations. Gain clarity regarding all facets of your operation; contact CodeOne today to help you achieve your goals of a more effective, prosperous practice.
Management and Operations
- Practice operations assessment
- Staff training
- Scheduling and patient flow
- Organizational structure
- Staffing and Human Resource issues
- Business model development
- Billing and Coding Assistance
- Comprehensive revenue cycle improvement
- Billing and collections performance improvement
- Accounts receivable analysis
- Charge master analysis
- Overhead analysis
- Feasibility studies
Professional Contract Negotiation
- Development of current contract matrix
- Analysis of current contracts
- Payer negotiations
- Payer mix analysis
- New physician mid-level set-up
- Market analysis
- Facilitation of planning process
- Contract model development
- Pro forma assistance
- Policy and procedure development
- Recruiting assistance
Billing Services Overview
CodeOne is committed to putting you in financial control of your practice. In order to have a pulse on your finances, we provide timely, inclusive, relevant information to allow you to make the best possible decisions for your patients and practice. We provide the tools for you to understand the clinical and financial components of your practice, enabling the financial health of your practice to prosper and thrive.
Upon forming a billing partnership with a practice, CodeOne’s initial mission is to understand the goals and priorities of the practice being served. Forms, including and not limited to: Superbills, patient registration forms, and Fee Schedules are created and/or updated. Present processes at the practice are reviewed and contracts are assessed to ensure the practice is appropriately tied to all payers contractually. CodeOne installs the necessary equipment in the practice’s office (device and scanners), and the billing service process commences.
Claims are regularly examined for accuracy of coding, proper sequencing, and modifier use. Diagnosis codes, CPT codes, and fee schedules are updated annually or as needed.
Patient demographic and encounter information is received, sorted, and packaged into virtual folders. CodeOne’s highly skilled employees utilize proprietary, state-of-the-art technology to track every line of every claim, for every patient, every day.
CodeOne’s main objective is to ensure clients receive timely reimbursement for their efforts. CodeOne promptly submits clean claims and carefully monitors the reimbursement timeline.
CodeOne’s audit and appeals departments analyze the adjudication of every claim. Variances in payment amounts are researched and professionally appealed. Our extensive, multi-specialty knowledge base allows us to anticipate trends and problems with certain codes and particular payers.
CodeOne generates all patient statements and makes any necessary follow-up phone calls. All client and patient questions concerning benefits, payments, and patient portions are referred directly to CodeOne. CodeOne communicates with each client about aging patient balances, refunds, write-offs, and when to utilize an outside collection agency.
CodeOne’s Physicians Insight Report includes detailed and specific information about each procedure, provider, and payer. It is immediately accessible through CodeOne’s color-coded software product, allowing company/client transparency 24/7.
Negotiated rates are equally as critical as the contract performance on promised rates. CodeOne continually monitors performance against contract promise to ensure accurate reimbursement with one goal in mind: your prosperity.
CodeOne works with clients to develop a Superbill and Fee Schedule unique to their practice. Annual and necessary changes are made promptly.
Monitor our performance and the health of your practice daily; CodeOne provides the automated tools you need for the most up-to-date information regarding your practice.
Rest assured knowing your practice meets HIPAA and government requirements; CodeOne’s billing, adjudication, and provider/group enrollment are compliant with all local, state, and federal governing authorities.
Secure your hard earned dollars; CodeOne protects against embezzlement through reconciliation of posted receipts, deposits, and bank statements.
Gain immediate online access to daily detailed reports; CodeOne provides daily online reports regarding the financial and clinical activity within your practice.
Achieve your financial potential; CodeOne monitors payers and analyzes industry trends to provide measurable benchmarks and set viable financial goals.