Coding Services

Technology is the backbone of PBN’s coding procedures, but there is no substitute for experience and education when it comes to coding. At PBN, each of our certified coders specializes within a medical discipline. Our coders’ productivity and accuracy is continuously measured for quality assurance.

Clearly, there is a wrong way to code. But there are also many “acceptable” methods that fail to optimize physician payments. Nearly all automated coding software products are of the “acceptable” variety. But only by adding PBN’s experience, training, and “eyes-on” coding practices can you be assured of the kind of coding quality, accuracy, and uniformity that maximizes your income.

Call us to schedule a complimentary coding review and demonstration of how our coding practices will improve your bottom line. PBN’s coding audits routinely uncover significant lost revenue for prospective clients, who in turn become new PBN clients!

Billing

A Tale of Two Billers: What Quality Looks Like

A few years ago, PBN provided billing services for a successful radiology group. The company switched to a competing biller to save 1.5% on their billing rate compared to PBN.

Since the quality and performance of the competitor’s service wasn’t as high as PBN’s, they lost over $250,000 in revenue in the first month (based on the difference in percentage of collections achieved by PBN and its competitor) and still have not regained the level of billing performance or total net revenue they enjoyed when PBN provided their billing services.

Here’s what the numbers look like

	Last Month with PBN *	First Month with Competitor *	Difference	Difference (36 Months Later)
Total Billed Revenue**	$787,500	$700,000	($87,500)	($22,500)
Total Collected	95%	72%	(23%)	(10%)
Total Recovered	$748,125	$504,000	($244,125)	($97,875)
Billing Rate %	6%	4.5%	1.5%	1.5%
Fee for Service $$	$37,406	$22,680	$14,726	$15,626
Net Collected Revenue **	$710,719	$481,320	($229,399)	($82,249)
* Figures reflect actual amounts, but are rounded and approximate here. ** Most of the difference resulted from the difference in collections, but a significant portion was also found during an audit of competitor’s allowables compared to payer's allowables.

The moral of the story

Bottom Line: PBN’s former client paid a few thousand less each month… for the privilege of losing between $100,000 and $250,000 in revenue each month for more than three years (the term of their contract with PBN’s competitor).

Would you like to see a happier ending? Contact PBN to schedule a complimentary billing audit and find out how quality, performance-focused billing can improve your bottom line.

Billing Services

If you’re interested in understanding more about exactly how PBN’s billing practices result in faster payments and higher collection rates, this page explains some of our services—really the secrets of our success as a biller and how our quality focus results in higher returns for you.

Charge Entry

Flexible Document Control / Data Capture: You can send patient demographics in any form – including paper, scanned documents, and high-tech electronic downloads (via HL7 and PDA interfaces). Our Document Control team ensures that your records are correct to maximize clean claims so you can collect.

Fast, Accurate Batch and Payment Entry: Fast payment postings and rapid processing of electronic 835’s are primary missions of PBN’s billings team. We submit claims promptly, using electronic 837’s when possible, apply an internal claim-scrubbing process to guarantee more clean claims, and automatically review contract allowables with every submission. These extra steps mean you bill for everything you contracted for—and you get approved payments faster.

Accounts Receivable Management

PBN devotes more than 50% of its billing staff to doing just one thing: chasing down that last 10-15% of claims—the ones that normally aren’t paid on the first pass. We also appeal denials and short-pays and resubmit them in a timely manner (which can skew our receivables statistics—see the note on our Benefits page). PBN’s billing system analyzes rejected claims and builds automated and custom work queues to maximize results—so you get more of what you’ve already earned.

Customer Service for your Patients

When your patients need help with a bill, PBN’s dedicated patient customer service representatives provide courteous, prompt service, clarifying, correcting, and resolving billing issues in a fairness-focused, win/win manner.

Client Liaisons

Our Client Liaisons, certified coders with years of expertise, provide primary ongoing support and training for physicians and our other clients to better align your documentations of procedures, payer contracts, and our coding and billing practices.

Technology Support

PBN developed and continues to evolve our own proprietary collections software system. It’s a powerful tool, flexible and customizable to your information needs, including real-time, detailed reporting.

PBN Billing Benefits

This list outlines the primary competitive benefits of working with PBN as your biller.

• PBN’s ISO 9001:2008 Certification demonstrates our company commitment to quality and our constant pursuit of ways to improve our company and employee performance.
• 100% of PBN’s coders are certified. Several coders are additionally certified in a practice area or specialty discipline.
• PBN's Billing Department is made up of teams of people who work in a specialty area and become extremely knowledgeable in that field. They are able to decipher EOBs, initiate proper appeals and help catch mistakes.
• Insurance payment checks can go directly to a special bank account or lockbox we setup in your name—we can help handle both, and have relationships with banks across the country. Access to your money quicker.
• PBN’s Collections Department chases down delayed payments and challenges denials and underpayments.
• We collect billing information in several different forms: by mail, digitally, or scanned and delivered as an image. We provide software so you can view billing and collection data in real time by patient account.
• If there are ever discrepancies regarding how a procedure was coded between PBN and one of our clients, we will visit, typically over the phone, and modify as needed.
• We actively educate doctors about accurate coding and correct dictation to help ensure we code correctly. All of our coders receive Continuing Education annually to stay up to date on the latest rules and regulations.
• PBN attends legislative conferences to stay current on legal changes that may affect your practice.
• Our CEO, Jud Neal, was recently elected to the Board of Directors for the HBMA. http://www.hbma.org
• PBN is careful and strategic about the type of clients we work with, and refuses to grow faster than our current staff capacity allows.
• Collection Benchmarks—An industry rule of thumb is to aim to get paid within 45 days; our company aims for 40 days or fewer, and we don’t “reset the clock.” We begin our aging process from “date of service” not “date of billing” which is what most industry associations suggest.
• We offer both customized and standard reports that you can track online every day.
• PBN frequently appeals denials from insurance companies where other companies simply write them off to improve their A/R stats. As a result, PBN’s days in A/R sometimes looks longer than our competitors.
• PBNs proprietary billing software, developed and maintained by our own IS Specialists, allows us to constantly evolve and update our systems. We hold regular meetings to address any software issues and go over ways to improve it for our employees.
• We are 100% HIPAA compliant.
• We don’t and won’t outsource any of our services to countries outside the USA for two reasons.
  1. We believe in creating jobs in America.
  2. Foreign billers aren’t subject to US law, leading to potential problems for PBN clients and their patients.
• We meet face-to-face every month to review your numbers, answer questions, and address concerns.
• Our coders have access to the current ICD-9 and CPT coding manuals in our company library and have already prepared for the switch to IDC-10, which won’t happen for a few years.