Products and Results
Liberty is uniquely qualified to bill and follow up Medicare claims in accordance with the Centers for Medicare and Medicaid Services regulations and established Hospital procedure.
Hospitals call upon Liberty’s Medicare Billing and Follow-Up team for its’ high collection rate. Our staff has extensive knowledge in all aspects of Medicare billing, and we specialize in:
- Complex Inpatient Cost Outliers;
- ePREMIS services and products for electronic billing;
- Intricate Inpatient Part B Ancillary Calculation and Billing;
- Partial Hospitalization Services;
- MSP, Dialysis and MICU Billing;
- RTP Analysis and Correction; and
- Voucher Assessment for Administrative and LCD Reconsiderations.
- Call Center
- Small Balance and Credit Balance Projects
Liberty’s Medicare staff is accustomed to high value inpatient billing and a high volume of outpatient billing. Our unique team of employees monitors an array of websites and subscriptions on a daily basis to keep informed of the changes in Novitas procedures and edits, as well as Medicare’s regulatory statutes. Liberty maintains a complete library of Local Medical Review Policies, National Coverage Issues, CMS Quarterly Updates, CMS Medicare Learning Network Newsletter articles, and more. Our staff is readily available, as consultants, to respond to any questions from our hospitals.
Liberty’s accomplished and highly trained Medicare billing staff provides quality billing and follow-up services for direct access to Novitas via the ECC Technology platform. This billing process allows Liberty to track the claim to final disposition and make the necessary corrections immediately, without the worry of third-party billing software rejections and complications.
Liberty’s senior management team meets with hospital management each month to review progress, provide operational improvement ideas and ensure that our outcomes exceed hospital expectations.
Out Of State Medicaid
Liberty’s Medicaid staff is uniquely qualified to bill and follow up Out of State Medicaid claims for all states. This specialized group of employees consists of experienced Hospital Medicaid Billers, each with an average of 10 years hospital experience. Our Medicaid staff routinely handles high value inpatient billing and a high volume of outpatient billing. We average an 85% collection rate for enrolled Out of State Medicaid claims.
Each claim is billed in accordance with the respective state’s procedure. Eligibility and status assessments are conducted online and through direct contact with Medicaid. Our online billing systems provide Liberty’s clients with the most efficient and effective road to Medicaid payment.
Liberty’s follow-up protocols track the progress of all claims to final payment. Required corrections and adjustments effect accurate final disposition of each claim.
Liberty’s Medicaid Billing and Follow-Up team is proficient in all aspects of Medicaid billing, including:
- ePREMIS Billing and Follow-Up;
- Out of State Enrollment, Billing and Follow-Up;
- Attachment Required Primary and Secondary Billing;
- Seven-Day Readmissions;
- Adjustments and Voids;
- Fair Hearing;
- Medicaid HMO Billing and Conflicts; and
- Eligibility and Status Inquiries
- DRG Reviews
Liberty’s Medicaid staff keeps abreast of the continuous changes, trends and regulatory statutes for all Medicaid payers and programs throughout the United States.
Liberty’s senior management team meets with hospital management each month to review progress, provide operational improvement ideas and ensure that our outcome exceed hospital expectations.
Liberty’s experienced Hospital Blue Cross Billers create an alternative for hospitals to collect stagnant Blue Cross receivables. Electronic billing and follow-up, and directed management intervention with a superior team of talent and persistence which resolves aged Blue Cross receivables.
Liberty’s commercial billing staff is accustomed to high value inpatient billing and a high volume of outpatient billing. Unpaid referred claims are promptly followed up and incorrectly paid claims are adjusted as required. Liberty has a team of employees who are trained to assess complex contract language in order to ensure accurate reimbursement.
Liberty’s commercial insurance team dedicates persistent effort to resolve unpaid claims and process adjustments. Follow-up on Blue Cross claims entails online follow up and, when needed, lengthy telephone effort. Blue Cross provider representatives can be ineffectual, requiring more than one follow-up inquiry. Liberty makes numerous follow-ups, as many as it takes, to bring referred claims to contracted resolution.
Denied accounts are referred to our denial management team, headed by registered nurses who review each denied claim for appeal for clinical and technical appropriateness.
Liberty’s senior management team meets with hospital management each month to review progress, provide project findings, operational improvement ideas and industry trends.
Liberty’s experienced Commercial/Managed Care Claim Representatives are dedicated to resolving third-party commercial payor issues. Liberty’s specialized team brings years of payor-specific knowledge to the table. Their effectiveness is measured in real cash payments made directly to hospital clients. They are accustomed to high value inpatient billing and a high volume of outpatient billing.
Any account aged at day 60 is a problem account. The reasons are many:
- Complex Inpatient Claims
- High Volume of Outpatient Claims
- Appeal Required
- Lack of Pre-certification
- Lack of Authorization
- Lack of Medical Necessity
- Inappropriate Denial
- Allowance Entry Required
- Carve Outs overlooked in Managed Care Contracts
- Electronically Rejected Claims
- Reduced Hospital Staffing
- IT Conversion
Upon referral, accounts are analyzed within 24 hours.
Liberty’s Commercial/Managed Care team will assess any complex contract language to ensure accurate reimbursement. Our unique customized matrix system includes all contracted payors and refines payment verification. Client-specific data are strictly confidential.
Denied accounts are referred to our denial management team, headed by talented registered nurses who review each denied claim for appeal appropriateness.
Liberty’s senior management team meets with hospital management each month to review progress, provide project findings, operational improvement ideas and industry trends. Liberty wants to ensure that our outcomes exceed hospital expectations.
Appeals and Denials
Liberty’s Denial Management Registered Nurses pursue technical and clinical denials. This denial management team is directed by a registered nurse with more than 20 years experience in clinical care and health-care administration. Advanced degrees in finance and certification in medical record coding strengthen the team’s extensive experience.
Liberty has a documented success rate of 60% in overturning medical necessity denials and a success rate of 38% for no authorization/timely filing denials for commercial and managed care payors. The outcome of our efforts is increased cash flow, or “found money” for the hospital on accounts previously deemed uncollectible.
Liberty’s denial management personnel coordinate information from the hospital’s registration, managed care, utilization management, patient accounting and medical records departments. Appeals are based on a fine-tuned assessment of the denied service.
If appeals are submitted at all, many hospitals submit generic, pre-formatted appeal letters. Liberty appeal letters are patient-specific, and are personally signed by the registered nurse who wrote the appeal. Where necessary, letters are sent to the patients for their information and/or action.
Prior to appeal generation, a nurse reviews demographic and online or hard copy medical information to ensure there is support for action. Assessed support data are presented in a logical and concise format to ensure the utmost consideration.
Extensive follow-up is performed to ensure appeal receipt, payor review by the correct department and ultimate accurate reimbursement on denial reversal.
Liberty maintains a database of all submitted appeals. Appeal reasons and payor-specific denial data (including additional dollars paid) are presented to hospitals at monthly client status meetings.
Liberty’s senior management team meets with hospital management each month to review progress, provide operational improvement ideas and ensure that our performance exceeds hospital expectations.
Eligibility Enrollment Advocacy Services
Because of our unparalleled expertise in Medicaid, Charity
Care and other government-based eligibility, Liberty can secure
As part of our process we:
- Treat each patient with dignity and compassion
- Provide on-site eligibility and disability advocates
- Utilize proprietary bedside eligibility screening and face-to-face interaction with patients and their families
- Assist patients by advocating with payers on their behalf
- Identify payer sources for uninsured or underinsured patients
- Verify eligibility for government and other financial assistance programs, including Supplemental Security Income (SSI),
- Victim of Crime or liability-related injuries
- Provide state-by-state expertise on Medicaid and Disability qualification requirements