Extended Business Office Programs

Our Extended Business Office Services program provides an offsite extension of your business office to manage all, or a portion of, your active receivables.  EOS services include the provision of all appropriate billing and follow-up for any financial class (including Commercial, Self-Pay, Self-Pay Balances, Managed Care, Medicaid, Medicare, and Worker's Compensation) at any age of placement.

Customizable Options

Our Extended Office Services (EOS) solution provides a seamless extension of your business office to manage your active receivables.  You decide the amount to place with us. Our programs include all appropriate billing, re-billing, and follow-up activities for any financial class and any age of placement.

• Commercial Insurance
• Managed Care Insurance
• Medicare
• Medicaid
• Worker's Compensation
• Self-Pay and Self-Pay Residuals
• Payment Plan Arrangements

System Conversion Experience

Give us your A/R prior to, during, and after system conversions, and we can handle that too.

Work Efforts

Our work efforts are a careful balance of contact strategies and client-approved methods based on the financial class, disposition, and payer.  Advanced technology allows resolution of any portion of your  active receivables, day 1 from date of discharge. Our system automation routes account to work queues for re-billing, dispute resolution, missing payment research, medical record request, or patient contact.

Staff

Some of the brightest minds in the business are part of NCO's EOS management team, with an average of more than 15 years of experience in the healthcare industry.

Pre-Encounter

Let us take care of any pre-encounter tasks from your scheduling department.  NCO's specialists can assume the responsibility of gathering demographic and insurance information. Our staff can accurately obtain all the important information so critical for the revenue cycle process.

We offer:

• Demographic gathering and verification
• Real-time host system updates
• Insurance verification
• Service verification
• Patient education
• Appointment reminder services

Claims Resolution Services/Clinical Appeals Services

Our Claims Resolution Services help you get reimbursed even when claims are denied. Let us use our experts to obtain reimbursement for denied claims.

We know that processing and monitoring problem claims takes away valuable resources and time. Allowing NCO to assist with this task frees up your staff for core administrative and revenue-generating activities. We offer a scope of services as wide as full review of your health insurance A/R or as narrow as your most contentious claims to be referred to NCO for conclusion.

Our Clinical Appeal Services staff is composed of nurse clinicians and representatives skilled in the clinical aspects of claim disputes and denials, and their resolution with third-party payors. We expertly train our staff to successfully negotiate reimbursements.

We can also supply you with a consultant with the technical expertise and background to periodically review your A/R inventory and identify those accounts most in danger.

We’ve got the track record for situations like these:

• Timely Filing Denials
• Level Of Care Interpretation
• Reduction Of Charges To "Usual And Customary" Rates
• Per Diem/Outpatient Rate Conversion
• Pre-Existing Condition Denials
• Authorization Disputes
• Proof Of Medical Necessity
• Coordination Of Benefits Denials

Recovery Audit Contractor Review Program

The Recovery Audit Contractor Review is a government program created to identify and recover improper Medicare payments paid to healthcare providers. Improper payments may be overpayments or underpayments.  The United States Department of Health and Human Services (DHHS) is required by law to make the program permanent for all states by 2010.

During the review process, auditors review claims and medical records to identify the following errors:

• Diagnostic related groups (DRGs) and coding errors
• Noncovered service errors
• Medical necessity errors
• Duplicate claims errors

The NCO Solution

Streamlining the RAC review process so you can focus on your patients.

NCO leverages our vast experience in the healthcare industry to ensure your RAC deadlines are met, all processes are compliant, and reviews are completed in an efficient and timely manner.  NCO can respond to both types of RAC reviews:

• Automated (no medical record required)
• Complex (medical record required)

NCO has the resources to assist healthcare providers through all five levels of the appeals process:

• First Level of Appeal: Redetermination
• Second Level of Appeal: Reconsideration
• Third Level of Appeal: Administrative Law Judge Hearing
• Fourth Level of Appeal: Appeals Council Review
• Fifth Level of Appeal: Judicial Review in U.S. District Court

NCO partners with clients to ensure every aspect of the appeal is covered, from first review to final appeal.  NCO maintains a staff of nurse clinicians experienced in all medical specialties and knowledgeable in Milliman and Interqual guidelines with proven experience in RAC reviews for clients. NCO has a proven track record of appealing first round RAC reviews with success rates between 62 percent and 76 percent.

OLPayments.com

NCO's dedicated first-party web site.

NCO's EOS offices can direct patients to our online web portal (www.olpayments.com).  This easy-to-use feature is offered as part our Extended Office Services and is at no additional cost to your facility.

Patients have the ability to:

• View account balance and information
• Make a payment by check or credit card
• Download a charity application (if available)
• Request a payment plan
• Request an itemized statement
• Update their address or insurance information
• Request a call back

Please see below to view a screenshot of OLPayments.com.