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Summary of Services

The FIRM provides professional claims billing services for individual providers, clinics and facilities. We service all disciplines of practice, i.e., medical, dental, diagnostic testing, chiropractic, physical therapy, optometry/ophthalmology, mental health, chemical dependency, and durable medical equipment.

We offer specialty services such as consultation, collections and appeals, contracting and credentialing, verification and preauthorization and personal injury settlement negotiating. We offer form development and revision services, office reorganization and personnel training.

We have extensive experience in all areas of commercial insurance, Workers Compensation, personal injury, Third Party Administrators, Medicare, Medicaid, and other state and federally funded programs. We offer personalized services designed specifically to meet your needs.

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What’s left to do in the week before ICD-10 coding goes live?

The Firm Services can help your office get ready for ICD-10 by CARL NATALE  SEP 23, 2015 - 12:00 AM There's only a week left before you have to start using ICD-10 codes. That's not a lot of time to do much. Earlier this month, we published an ABC checklist with last minute ICD-10 implementation tips for procrastinating physicians from the Centers for Medicare and Medicaid Services (CMS). It focused on: Assess systems Be sure everything is ready Contact vendors For medical practices that started preparations sooner than this month, there are still some last minute steps. Nelly Leon Chisen writing for Hospitals & Health Networks offers some ideas to add to healthcare providers' ICD-10 check lists: Create a communication plan to report problems. Who gets contacted? How to update everyone. Who to contact at health plans, clearinghouses and vendors for information and help Review contingency plans What is the status of ICD-9 coding backlogs? What will it take to clear them? Test medical coders' skills Plan quick refreshers Assess ICD-10 coding accuracy If you're billing software isn't going to cut it, CMS has these suggestions for patching Medicare billing problems: Free billing software that can be downloaded at any time from every Medicare Administrative Contractor (MAC); In about half of the MAC jurisdictions, Part B claims submission functionality on the MAC’s provider internet portal; Submitting paper claims, if the Administrative Simplification Compliance Act waiver provisions are met. Those ideas should be considered temporary until medical practices get things ironed out with healthcare vendors.[ICD10Watch Poll: Are your vendors ready for Oct. 1?]Even with good plans in place, things could get tense next week. Rebecca Fox, MD, has some ideas for helping medical practices work through the stress [...]

ICD-10 hops Congressional hurdle

The Firm Services can help your office get ready for ICD-10 Congress will have just 17 week days to pass legislation killing the conversion. Is ICD-10 finally in the clear? Tom Sullivan, Editor-in-Chief, Healthcare IT News- August 10, 2015 Health IT professionals and policy wonks sleeping with one eye open while watching Capitol Hill for clues about ICD-10's fate can rest easy – at least for now. Congress kicked off its vacation on Monday and, in so doing, effectively hit a pause button of sorts: Before the U.S. Senate and House of Representatives return on September 8 there will not be any legislative action to delay or kill ICD-10. None. Just don't mistake the midsummer truce that the Centers for Medicare & Medicaid Services made with the American Medical Association as any type of guarantee. That was not an act of Congress and insofar as public knowledge goes, CMS was operating under its own recognizance when it agreed to that treaty. What's more, critics say the concessions – CMS won't deny erroneous claims so long as they are submitted in ICD-10 for the first year – are nice but not enough. It doesn't help, either, that the seminal readiness survey conducted by WEDI (Workgroup for Data Interchange) and published just last week found that 10 percent of providers and approximately half of medical practices are unsure whether they'll be ready on time. Yes, the other 90 and 50 percent, respectively, indicated they would meet the mandate, but those who might not triggered enough concern for WEDI to caution that claims disruptions might accompany the transition. The thing about Congressional timing, though, is that Senators and Representatives will have just 17 week days in [...]

Are you prepared for the ICD-10 deadline?

ICD-10 is coming October 1st. Are you ready? By Julie Henry | September 11, 2015 The October 1 deadline for converting from ICD-9 to ICD-10 is fast approaching. As of October 1, ICD-9 codes will no longer be accepted. “At the end of the day, claims for services delivered on or after Oct. 1, must be coded using ICD-10 codes in order for the provider or organization to be paid,” says Pam Jodock, senior director of Health Business Solutions at Healthcare Information & Management Systems Society (HIMSS). “There is no grace period.” So are hospitals and other healthcare providers prepared for the switch? Robin Settle, partner at global management consulting firm Kurt Salmon, says that most, if not all hospitals and large physician groups are ready for ICD-10 and have been ready for well over a year. “Most have made the transition to EHRs to take advantage of the meaningful use incentives and to avoid meaningful use penalties,” she says. “ICD-10 compliant versions of software have been implemented as part of routine maintenance. Many hospitals also provided some ICD-10 training to their employed and community physicians.” Jodock says indications are that the majority of providers will be ready for the conversion on Oct. 1. “However, we do anticipate there will be small pockets of providers – primarily solo or small group practitioners – who may not be fully prepared,” she says. Is your organization prepared for the switch? Dr. Reid Conant, a board-certified emergency physician and CMIO at Tri-City Emergency Medical Group in Oceanside, CA, says he feels like his practice is prepared, but they are not taking the transition lightly. “We have prepared on both an educational level as well as a [...]

White House Takes Aim At Medicare And Medicaid Billing Errors

Physicians Credentialing Doctors for Medicare SEPTEMBER 03, 2015 5:03 AM ET -NPR White House budget director Shaun Donovan called for a "more aggressive strategy" to thwart improper government payments to doctors, hospitals and insurance companies in a previously undisclosed letter to Health and Human Services Secretary Sylvia Mathews Burwell earlier this year. Government health care programs covering millions of Americans waste billions of tax dollars every year through these improper payments, Donovan said in the Feb. 26, 2015 letter. "While some progress has been made on this front," Donovan wrote, "we believe a more aggressive strategy can be implemented to reduce the level of improper payments we are currently seeing." Donovan, director of the Office of Management and Budget, went to say that "we must continue to explore new and innovative ways to address the problem and attack this challenge with every tool at our disposal ... ." Donovan cited problems with traditional Medicare, which pays doctors and hospitals on a fee-for-service basis, as well as Medicare Advantage, its fast-growing, privately run alternative. The private insurance plans are paid a set fee each month for each patient using a billing tool called a risk score. The White House budget chief also noted in his letter that payment errors rose by $3.1 billion last year in Medicaid, the government health care plan for lower income people, which is jointly funded with the states. In addition, he directed HHS to draw up a plan for getting payments right under the Affordable Care Act. The health law has added millions of people to insurance rolls and is slated to undergo payment-accuracy audits for the first time starting this fiscal year. A copy of Donovan's letter, which also directs [...]