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

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.

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

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  1. 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

  2. In One Word…. YES!

  3. 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

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

  5. 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

  6. 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

  7. 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

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

  9. Questions? Contact Us. • Beth Eagles, Dept. Head Billing & Reception, U of Ark • beagles@uark.edu; 479-575-4075 • Libby Greaney, Director of UHS, Western Kentucky University • Libby.greaney@wku.edu; 270-745-3830 • Willi Haskins-Cotton, Insurance Specialist, UMBC • Ehaskins@umbc.edu; 410-455-1556 • Jennifer K. Lepus, Director of UHS, UMBC • Jlepus@umbc.edu; 410-455-3751

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