In-House Third Party Billing – Is it Really Working? Beth,

In-House Third Party Billing – Is it Really Working? Beth, Eagles, Dept. Head, Billing & Reception University of Arkansas Libby Greaney, Director of UHS Western Kentucky University Ethel “Willi” Haskins-Cotton, Insurance Program Manager UMBC Jennifer K. Lepus, Director of UHS UMBC

In One Word . YES!

Objectives of Today’s Session Describe ways in which to participate in third party billing Compare successes of UMBC, WKU, and U of Ark Describe administrative functions relative to managing a health center that performs third party billing

Why do billing? State revenue decreasing Keeping records in house More control in revenue and purchasing Able to expand other programs within UHS

Topics to be Discussed Today Participating? Do you want to be a participating provider? Credentialing - Signing up as a provider Setting up your pricing - How much will you need to charge? Insurance file setup What type of billing will you do? Paper vs. electronic Payments and Denials

Getting started Somebody Who Knows Personnel Join the Party? – Participating With Insurances What it means to participate – The Contract The Good The Bad The Ugly Who to participate with The Big Five Big Fish in a Small Pond – Local Plans The Biggest Fish – Medicare/Medicaid

Show Me What You’re Working With Credentialing Becoming a provider CAQH Provider Credentialing Database https://caqh.geoaccess.com/oas/ NPI numbers Applying http://www.cms.hhs.gov/NationalProvIdentStand/ 03 apply.asp# TopOfPage

Show Me the Money - Setting up your pricing Ready, Set, Go - Insurance file setup How Many is to many Paper or plastic - How to file claims Medicare Pricing Where to find The Cost Where will the payments go Payments and Denials Understanding the EOB How many billers does it take to post payments

Questions? Contact Us. Beth Eagles, Dept. Head Billing & Reception, U of Ark [email protected]; 479-575-4075 Libby Greaney, Director of UHS, Western Kentucky University [email protected]; 270-745-3830 Willi Haskins-Cotton, Insurance Specialist, UMBC [email protected]; 410-455-1556 Jennifer K. Lepus, Director of UHS, UMBC [email protected]; 410-455-3751