Artificially Intelligent Chiropractic Billing Service

Accuracy – Are all of the claims being submitted timely and accurately
In the traditional model, claims are submitted by the third party service. This is error prone and in many cases delayed. Delays happen in the transfer of visit information to the third party and because, in some cases, the third parties’ policy is to submit claims in batches throughout the week and/or month.

Secondary submission is also affected by delays and errors. In turn, follow up on underpaid and denied claims is inadequate. This leads to lower collections and your money sitting in the payer’s bank account, collecting interest, rather than your account.

Lastly, when claims are not submitted accurately and on time it affects patient balances. One hidden reason patients stop care is when they ask their doctor for an accurate balance. With traditional outsourcing this number can be very difficult to obtain. The patient’s perception of the practice’s competence is decreased, and the patient is never seen again.

Accountability – Teamwork
When something goes wrong, it is hard to see who was responsible for fixing the issue in a timely manner. Without this it becomes impossible to identify recurring issues, a breakdown in an established process, a broken process, or keep any one person accountable.

Outsourcing should be a team effort. Insurance companies have the game rigged in their favor. They are already trying to pit doctors against patients and in the case of outsourcing, they are trying to pit your office against the third party billing service.

Without transparency and accountability it is easy to start pointing fingers when there is an issue rather than approach problems as a united front against payer.

Delays, inaccuracies, and a lack of simplified teamwork through transparency and accountability have a snowball effect. Simply put, your money slips through the cracks as it becomes more and more difficult to keep insurance companies accountable to paying you what you deserve.

Remember, insurance companies make most of their profit on the interest collected on monies owed to you. The more we fight amongst each other the more they collect, they win!

How do we provide higher quality and better results??

The new reality with Genesis

Technology
The solution to the pitfalls seen with traditional third party billing services is built on a foundation of state of the art technology. With the advent of the internet, practices can now access enterprise level technology for a fraction of the cost. Genesis pioneered the use of AI in the cloud starting in 2004.

The Network Effect
Doctors who work with Genesis are not alone any longer. Their claim data is constantly being compiled, but not shared, with other practices data. Millions of claims now flow through one centralized database. Big Data analysis by AI and certified billing expert, our SWAT team, helps us all keep an eye on payers and the changes in their tactics. One change by a payer affects thousands of claims for thousands of users, rather than just a claim or two for one practice.

With traditional billing services, and a single account manager, these issues are easy to miss and can continue for months affecting thousands of dollars in collections, if they are ever recognized at all.

With the Network Effect, providers are given real time warnings about what is changing allowing them to stay nimble and counteract the payer’s changes.

Accuracy
Armed with the benefits of the Network Effect, doctors can be nimble and be sure that their coding is the most accurate and up to date. No wasted time, claims are created and submitted in real time by the provider’s office. No delays, or errors. Any mistake made that would prevent payment is immediately re-routed to the providers office for correction and resubmission.

With AI built into the documentation system, claims are generated based on what is documented ensuring the highest possible level of compliance and the best chance at avoiding post payment chargebacks and penalties.

Transparency and accountability
Using a real time system, in the cloud, means both the provider and the billing service are accessing the same data and reports. Real time accounts receivable dashboards mean you know where every penny is in the process. With a simple click providers can “drill down” as far as the claim level and see every action taken, every conversation had with payers. A full audit trail of every action taken by any party, the office staff, the AI, or the Genesis team, is time and date stamped means unprecedented transparency and accountability.

Action items made simple
With AI and automated workflow, Genesis takes the guesswork out of actionable items that are needed to get you paid. Genesis does not wait for a person, either on our side or on the provider’s side, to find a claim that needs attention. The AI finds the claims in real time.

When a claim needs the attention of the practice it sends the claim to the practice’s claim workbench.

When a claim needs the attention of our team, the AI finds the claim and sends it to the followup workbench.

AI and automated workflow saves a practice and our team dozens of hours a month by eliminating the time it takes to find the work that needs to be completed. It eliminates the need for phone calls, emails, and faxes. Everything is contained in one place.

For the practice manager or owner, this means they can see what claims need to be addressed by the end of day, each and every day, in order for the practice to collect every penny it is owed as fast as possible with unprecedented transparency, control, and accountability.

These two numbers, number claims that need attention from the practice, number of claims that need attention from the Genesis team, are accessible in real time as soon as you log into Genesis. Click on the number and drill down as far as you’d like! You’re in total control!

Even more time and money savings
Genesis automates every step in the claim lifecycle. With traditional billing services, and disparate technologies this is impossible. These processes include:

1. Claim submission
2. Claim submission error identification
3. Secondary submission
4. EOB/ERA posting
5. Unpaid/underpaid claim identification
6. Patient balance calculation
7. Recurring patient payments
8. Patient payment/credit allocation toward patient balances
9. Patient statements (specific to the patients the practice chooses)

Eliminating the “busy work of billing” means accuracy and focus on what matters most in terms of collecting every penny. Your practice is freed up to focus on patient experience and practice growth, our team is free to focus on following up on every claim as fast as possible. Who’s on that team?

You’ve got an army behind you
With focus comes scalability and quality.

Our team of billers is made of certified coders. Over 200 followup resources and growing.

Our billing SWAT team is a separate team that looks at the data, discussed earlier, and improves the Genesis process. The SWAT team, our seasoned veterans, are also there to drill into more difficult issues, should they arise, whether they be on an individual practice level, payer level, or overall system level.

Quality Control
Our follow up team gets paid when you get paid, they are not paid on salary. Highest performing followup resources are always given the next new Genesis client.

Our technology randomly samples the claims that have been completely processed. Our independent quality control team is paid when they find mistakes. Mistakes are routed to the SWAT team for process, technology or resource improvement.

Help and Support
Problems will always arise even with all of the above taken into account. Why is Genesis continuously rated highest in customer support?

With transparency accountability and control we provide, our clients bring issues to us with a spirit of teamwork.

Here are some more examples of how we support our clients.

1. Support is baked in. As soon as there is an issue with a claim there is a build in mechanism to rate the claim. A low rating alerts the entire Genesis company and you can be sure we will be reaching out to make things right.
2. Accountable support. Have a question about the system, a specific patient account? Built into Genesis is a support task system. Open a support task and attach the patient account. This ensures HIPAA compliance that can be lost with phone calls, emails, and faxes. The task is accountable, trackable, and transparent, just like everything else in Genesis. No more waiting for returned emails and phone calls to come back from the black hole. Not satisfied with the solution we provide? Simply click a link in the support task to schedule screen-share time with a SWAT or support team member.
3. Socialize with other Genesis clients in our private Facebook group. See announcements from Genesis, ask best practices questions, or share the love!
4. Contextual help. Within the Genesis system you’ll notice little question marks”?”. These are scattered throughout different parts of the system like the patient schedule, the claims workbench, and the documentation system for example. One click brings you to all of the help documentation and videos for that part of the system for your reference.
5. New user training. Every new Genesis client and their staff is trained on an individual basis. Training progress is tracked by our onboarding team. Our team will verify that each and every person on your team knows how to use the Genesis system before you “go live”.

After going live, during the transition phase, our onboarding team stays with you and your team to ensure you are getting the most out of Genesis.

Have a new team member joining your practice? We’ve got your back. We track new users and make sure they are brought up to speed just as though they were there from the beginning.