The Know-How...

What are the major problems today in the
health care industry regarding medical billing?

Outsource billing means…
  • Letting secure sensitive patient information leave your medical office.
  • Having to monitor the collection effort of the outsource billing company.   
  • Inability to access the billing system for real-time reports.
In-house billing means…
  • Not enough expertise and dedicated personnel to handle your day-to-day
    billing and collection issues with the insurance companies.
  • Hidden costs and overhead costs in running your in-house billing department.
  • Hardware and software applications need to be upgraded on a regular basis.
  • Streamlining your billing process and systems will require extensive and expensive customization.

Outsource Billing In-House: What does it mean?

1. No risk in purchasing the wrong billing software.
2. No risk in buying too much or too little hardware.
3. No risk in
 hiring hard-to-find experienced billers who may
 walk out the door when a better offer comes.

How does Shoham Consulting implement Outsource Billing In-House?
We design the system that is used for medical billing and bill collections
from the ground up to support the business model of Outsource Billing In-House.
There is a clear separation of users within the system and what they are allowed
to do while processing a bill.

The structure of Shoham Consulting Inc. -- Innovative on-site medical billing company.

Audit and technical support from headquarters
Data entry clerk
at Dr. Jones
Medical office.
Data entry clerk
at Dr. Smith
Medical office.
billing manager
responsible for
 three medical offices

Data entry clerk
at Dr. Stein
Medical office.

Two people are in charge of running the day-to-day billing at the medical facility.
They are both Shoham Consulting employees. The first is the data entry clerk,
who inputs the billing information, submits bills and posts payments and EOBs.
The second is the billing manager, who is responsible for the account and supervises
the data entry clerk. Some of the bill processing can only be done by the billing manager
such as entering checks, closing batches and resubmitting claims. Together they work
to achieve the highest collection rate. (A good analogy is the local bank,
where tellers are limited in access and are monitored by a supervisor.)

In addition, the company auditor is responsible for auditing and verifying that all
procedures and systems are in place. One of the main responsibilities of the auditor
is to approve new diagnostic codes at the medical facility in order to ensure from
the get-go that there are no mistakes with the schedule fee.

Technical support is available at all times to insure maximum productivity.

What are the benefits?
A dedicated billing system and personnel for your billing department -- with no overhead.
Coding and IT expertise when and where needed.

Security - No connection between medical offices, each has its own software and database installation.

What are the risks?  None.
We provide the hardware, software and the networking to your medical facility at
our own expense. We supply an additional computer for your medical facility office
manager, which allows access to the system for viewing all billing information.

Outsource Billing In-House -- the productivity solution.

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