Why should I use Cosmos Medical Management (CMM) for medical billing and management services?

Our collection from insurance companies is 100% and A/R denial is >1%. By outsourcing billing and management services to CMM, you do not have to worry about billing staff as we are responsible for hiring, training, and supervising of employees. Our services will allow you to free up your office space and eliminate the need for billing software, thus alleviating stress, and giving your staff more time to devote to patient care and day-to-day activities. Our 20 years of experience allow us to improve your collections, no matter the size or specialty of your practice. Aside from billing services, CMM also provides complete credentialing and recredentialing services with a variety of insurance companies. We can help set up new practices and obtain NPI numbers and tax IDs if needed etc. Cosmos Medical Management is your end-to-end virtual medical billing, coding, credentialing, and management solution.

How do I make billing information available to CMM?

There are several ways to do this. We can download the patient’s demographics and superbills from your office if you give CMM remote access. Alternatively, you can email or fax the information to CMM via our secure eFax service.

How are primary and secondary insurance claims filed?

All claims are initially filed electronically or on paper if the carrier does not accept electronic claims. Claims that require medical documentation are faxed, emailed, mailed, or uploaded to the insurance website. Claims billed to secondary carriers are faxed, mailed, or billed electronically with primary insurance EOB.

How do you ensure that all claims are processed and paid by the insurance company?

We run reports regularly and use several steps to make sure all claims are paid in a timely manner. We work on each claim until it has been paid or a reasonable denial for nonpayment has been given. If a claim is not paid in a timely manner, our professional staff either calls or checks its status online and follows up rigorously until its settled. If a claim is denied and we are not satisfied, then we appeal the decision and work that claim until a satisfactory decision is rendered.

How does your company get access to EOBs and payments?

Most insurance companies make EOBs available electronically, which can be downloaded in our software through our clearing house or from the insurance carrier’s website. If your office receives EOBs and checks from insurance companies and patients, the payment will be deposited by your office staff, and EOBs and copies of the payment will be faxed to CMM.

Where do payments from insurance carriers and patients go?

All payments from insurance carriers and patients are sent directly to you by mail or through Electronic Funds Transfer (EFT). You can choose whether payments and EOBs are remitted to your post office box, bank lockbox, or physical address. If you choose to use a lockbox, EOBs are mailed to your bank where all the checks are scanned and deposited and made available through the online banking system. If you use a PO box or physical address, EOBs and checks are mailed to the payment mailing address.

How does CMM handle delinquent accounts?

CMM pursues delinquent health insurance claims and patient accounts professionally and courteously. Our procedure is to send three statements to patients with follow-up phone calls. We offer several payment plans until the account is paid in full. We also provide mutually agreed upon discounts if the patient agrees to send a full payment. Payment through credit card is offered to the patient. If the patient does not respond after three statements and phone calls, then the account is sent to a collection agency upon your approval.

How can I stay in touch with CMM to make sure my billing is done to my satisfaction?

We can meet with local physicians and selected staff upon request. For long distance clients, we can arrange a phone call or Zoom meeting to discuss any questions. We provide extensive, self-explanatory reports at the beginning of every month and can create customized reports upon request. We also provide annual comparative reports for up to the past three years of charges, collections, and outstanding balances to show the trend of your practice.

How do I make sure that patient information and data is secure?

CMM is a HIPAA-compliant billing and management company. We follow secure data protection policies, and our data is securely backed up multiple times every day.

Who answers medical billing service questions that patients might have?

The staff at CMM answers all billing-related phone calls and questions. A toll-free number will be provided on all claims and patient statements.

How do you charge for your billing and management services?

CMM does not get paid unless you get paid. Our fees are percentage-based and proportional to your receipts. The percentage charged is based on many factors, including specialty, practice size, and customized services offered. There is a one-time, nonrefundable setup fee for new and established practices. Credentialing services can be provided on an hourly basis or per project. Please contact CMM for more information.

Can I revoke or cancel my agreement with you?

Your contract with CMM is nonbinding and can be cancelled with 90 days’ prior notice and a written agreement from each party.

How do I get started?

We will send you a service contract to review and sign. We can start entering your data as soon as the agreement is signed, and the appropriate information is available. For more information please submit through our contact form or schedule a free consultation.

Revenue Cycle Management

Optimizing Your Practice’s Financial Health with Simplified Billing and Strengthened integrity

In 2014 the revenue cycle management market was valued at $18.3 billion (Ref.: 25 things to know in Revenue Cycle Management, Murphy Brook) and at $260 billion in 2020 (Ref.: Revenue Cycle Management Market Share Report) We will streamline your financial process, reduce overhead administrative costs, no more hiring and training staff, reduction in denied claims, increase in cash-flow, and improved quality patient care.

Managing the revenue cycle in healthcare is complex, involving multiple steps from patient intake to payment collection. At Cosmos Medical Management, we specialize in Revenue Cycle Management (RCM) services designed to streamline your financial operations, improve cash flow, and reduce administrative burdens. Our comprehensive RCM solutions ensure that your practice remains financially healthy, compliant, and efficient.

Our RCM service optimizes each stage of the revenue cycle to ensure timely reimbursements, reduce claim denials, and improve overall financial performance.

Our Comprehensive RCM Services Includes:

1. Eligibility Verification

Gather Patient Information : Collect basic details such as name, date of birth, insurance provider, and policy number.

Verify personal identification : We verify personal identification through driver’s license and/or insurance card.

Check Insurance Coverage : Use an eligibility verification system or contact the insurance provider to confirm active coverage, policy details, and exclusions.

Review Requirements : Determine if the patient meets program eligibility (e.g., Medicaid, Medicare, commercial insurance). Check if pre-authorizations or referrals are needed.

Verify Benefits and Limitations : Confirm the services are covered under the patient’s insurance plan. Identify deductibles, co-pays, and out-of-pocket expenses.

Confirm Provider Enrollment : Ensure that the healthcare provider is within the patient’s network.

Notify the patient : Notify the patient of coverage details, co-pays, deductible, and any required steps.

2. Charge Capture and Coding

Accurate Charge Capture : We ensure that every service provided is captured accurately to prevent revenue leakage. Our charge capture processes are integrated with your clinical workflow to ensure no charges are missed.

Medical Coding : Our experienced and certified coders use the latest coding systems (ICD-10, CPT, and HCPCS) to ensure accurate and compliant coding, reducing claim denials and optimizing reimbursements.

3. Claims Submission and Follow-Up

Timely Claims Submission : We submit claims promptly to insurance providers and follow up to ensure that claims are processed correctly the first time.

Claims Management : We track and monitor claims to resolve any issues quickly, addressing underpayments, denials, or delays, and ensuring the fastest reimbursement possible.

4. Denial Management and Resolution

Denial Analysis : Our team identifies the root cause of denied claims and implements strategies to reduce future denials. We appeal against denied claims efficiently, reducing the time spent on outstanding balances.

Denial Prevention : By analyzing trends in claim denials, we implement preventive measures to improve the accuracy and efficiency of future submissions.

5. Payment Posting

Accurate Payment Posting : We ensure that all payments received, whether from patients or insurers, are accurately posted to the corresponding accounts, providing a clear picture of your practice’s financial health.

Account Reconciliation : We perform regular account reconciliations to identify discrepancies, resolve billing issues, and ensure that your practice’s financial records are always accurate.

6. Patient Billing and Collections

Clear Billing Statements : We generate easy-to-understand patient statements, ensuring transparency and reducing confusion regarding payment expectations.

Payment Plans and Collections : We work with patients to offer payment plans and ensure timely collections, helping you maintain consistent cash flow while accommodating patient needs.

7. Reporting and Analytics

Comprehensive Financial Reports : We provide detailed, actionable financial reports, including accounts receivable aging, revenue trends, and payer performance. These insights help you make informed decisions for better practice management.

RCM Performance Tracking : We continuously track key performance indicators (KPIs) to identify opportunities for improvement and ensure the efficiency of your revenue cycle.

Benefits of Revenue Cycle Management with Cosmos Medical Management

Improved Cash Flow : We ensure that your practice gets paid quickly and accurately for the services you provide.

Reduced Administrative Burden : Let our expert team handle the complexities of billing, coding, and reimbursement so you can focus on patient care.

Increased Efficiency : Streamline your operations with end-to-end RCM solutions that eliminate redundancies and improve workflow.

Better Financial Insights : Access detailed reports and analytics that help you make informed financial decisions and improve overall practice performance.

Minimized Risk of Denials and Audits : With our comprehensive approach to coding, claims management, and compliance, we reduce the risk of denials and audits, ensuring that you’re paid fairly for your services.

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Why Choose Cosmos Medical Management for Revenue Cycle Management?

Comprehensive and End-to-End Solutions : Our RCM services cover every aspect of the revenue cycle, from eligibility verification to payment collection, giving you a fully integrated solution to manage and optimize your practice’s financial health.

Experienced Team of Experts : With years of experience in healthcare billing, coding, and financial management, our team has the expertise to handle complex billing and coding challenges, reduce denials, and improve revenue cycle efficiency.

Maximized Reimbursements : We work diligently to ensure your claims are processed accurately and promptly, maximizing reimbursements for your practice and reducing the time it takes to get paid.

Improved Cash Flow : Through our proactive claims follow-up and payment posting services, we help you maintain a healthy cash flow by reducing delayed or denied payments and ensuring timely reimbursements.

Compliance and Risk Reduction : We ensure that your practice remains compliant with ever-changing healthcare regulations and payer policies. Our solutions reduce the risk of audits, penalties, and other compliance issues, keeping your practice secure.

Customized Solutions for Your Practice : We understand that every practice has unique needs. Our RCM services are tailored to meet the specific requirements of your specialty and patient demographic, ensuring maximum efficiency and results.

Get in Touch

Contact Us, if you’re ready to optimize your practice’s revenue cycle, reduce claim denials, and improve your financial performance, let Cosmos Medical Management help. Our expert team is here to streamline your RCM process and maximize the financial success of your practice.