Our onboarding Plan for New Partners
Here's how OHS guides its partners to success from day one
1
Assemble Credentials Portfolio
It's time to get all documents and information in one place!
Before OHS can effectively manage your billing operations and potential payer enrollments, we'll need to assure that we have all essential information for the practice entity, its locations, and each performing provider. After building this portfolio together, you'll have an administrative burden lifted and OHS will be in an organized state to move forward productively.
2
Trending Denial Review
As we review your past billing, knowing what denials are recurring and why will be vital to preventing them from happening again. As we address your unpaid, underpaid, and denied claims, we'll determine what general actions, corrections, or appeals are needed to clean up your past billing. Avoiding prior errors will also give your billing a fresh start.
3
Billing Cycle Analysis
Each step in the RCM cycle is fundamental to the success of your practice's revenue. This is an ongoing process as we continually seek to optimize your billing operations in every way.
4
Coding Evaluation
There are many factors involved when considering what CPT, HCPCS, and ICD-10-CM Codes to use for an encounter. At OHS, our priority is to balance profitability with compliance. That means that we help doctors to focus on procedures that are covered under the pertinent diagnosis. We take into account fee schedules and local coverage determination (LCD) standards. We want providers to be paid for the highest allowed dollar and unit amounts on the market, thus Relative Value Units (RVUs) and Medically Unlikely Edits (MUEs) come into consideration as well. These factors are especially important when dealing with claims that involve surgery or injections. Some providers aren't very familiar with all of these most recent updates to be juggled today. We understand that this educating material can take time, which is why we're happy to assist doctors, by providing certified coders to interpret the medical notes and records.
5
Software Integration
The best performance requires the best tools. We want to ensure that all of our partners are using the best software for EMR and Practice Management purposes. If you're currently using a reliable platform, then we'll recommend that you stay with it. On occasion we do advise our partners to make a switch to a new software platform if absolutely necessary. Unfortunately, this is because there are some platforms that just don't carry the essential features to meet the standard of productivity that's needed to be successful in healthcare today.
Whether a change is needed or not, OHS will walk you through everything and verify that everything is setup properly. It's still common for us to evaluate new partners who are using great software and still discover that they have operational errors in play. Thus doing a thorough software evaluation is of great importance in our onboarding process.
6
EDI + ERA Clearinghouse Enrollment
Sending claims and receiving EOBs electronically are the norms of the future. Medicare no longer accepts mailed paper claims and other insurance payers are following. Having a reliable clearinghouse is extremely important for your billing operations. The electronic capabilities available today make claims processing faster and improves tracking. Having a clearinghouse with effective scrubbing features is also a great asset that prevents claim errors from becoming denials. OHS manages the Electronic Data Interface (EDI) and Electronic Remittance Advice (ERA) contracts for all partners, so they have this option with all capable insurance payers. You'll soon see just how convenient it is to receive remittance (reimbursement data) directly in the software's reports, rather than dealing with the hassle of constant paper EOBs that need to be forwarded. We also offer the unique capability of implementing clearinghouse benefits in auto insurance and workers compensation billing.
You won't find another billing company that assists in EDI and ERA enrollment for your clearinghouse.
7
EFT Setup
OHS helps every partner in setting up their Electronic Funds Transfer (EFT) with each of their insurance payers that offer direct deposit. This removes the hassle of tracking and depositing paper checks. Medicare and other payers no longer offer paper checks, making EFT a trending requirement, as more payers set this standard each year.
8
Compliance Survey
Your Compliance is Your Reputation. If your operations go out of line, your license, board enrollment and name are under fire for alleged fraud and/or malpractice. OHS checks for risk factors in all of its partners' operations. We routinely verify that our partners perform their administrative work within the lawful parameters of healthcare. The increasing legalities can be difficult to navigate. That's why we help you to maintain the peace of mind that your operations are secured with compliant measures
9
Quality Reporting Check
The Quality Payment Program (QPP) has called for a new caliber of expertise in Quality Reporting. If you render services for patients with Medicare Part B, you may be required to participate in QPP and will need to consider your reporting options. OHS guides its clients in achieving high payouts through Merit-based Incentive Payment System (MIPS).
Click here to find out if your practice should be participating in QPP.
10
Maximize Reimbursement
Now that your operations are organized and each key process is thriving, your OHS billing reps will continue to be relentless with your denials and underpayments. OHS will hold your insurance payers accountable to the reimbursements that you have earned.
Billing | RCM Services
Claim review & submission
Correct Clearinghouse Rejected Claims
Accounts Receivable
Payment Posting
Claim Follow-up
Denial Management & Prevention
Appeals
Itemized Reporting
Patient Invoicing (optional)
Complimentary Services that are All-Inclusive
with our Billing | RCM Services
Coding Review
Eligibility Verification
Prior Authorization
Compliance Consulting
Software Implementation
Credentialing:
Insurance Panel Enrollment
Provider Demographic Updates
Routine Attestations
Re-credentialing
Hospital / ASC Appointments & Re-appointments
EFT / ACH Enrollment
Contract Re-Negotiation
Clearinghouse Management:
EDI / 837 & ERA / 835 Transaction Enrollments
Accreditation Guidance for Group Level licensing, Certification, or Accreditation.
Supervisory Protocol Implementation for or Non-Licensed Practitioners, Interns, or Newly Licensed Practitioners that are undergoing payer enrollment.
Why OHS?
Team Members receive incentive pay, thus their work is results oriented.
Our teams have a diverse background in AR, when handling different specialties.
Consistent Communication with the same team of individuals.
Did you see our All-Inclusive Services and No-Cost Digital Tools?
Seriously, It's time to upgrade!
No Risk!
OHS offers a
30-day cancellation policy.
In case you decide that we aren't the best fit for you,
There are no long term contracts.
Our results speak through our partners
I've had a great experience so far with OHS and have confidence that it will continue so. They have attention to detail, are prompt to respond to our questions, are very organized, and provide timely feedback that will help our business be more profitable.
- Dr. Arlene Johnston DNP | Health & Vitality
OHS is awesome and incredibly easy to work with - they always respond in a timely manner and their attention to detail is impressive. They are currently helping me navigate out of a sticky situation and get my billing back on track. We are so excited to have them in our corner! Highly recommend!
- Dr. Christina Bui DPM | Howard County Foot & Ankle
