• For full-service billing, this fee generally ranges from 5% to 10%, depending on the specialty, payer mix, and practice revenue. Larger specialty groups may pay even less.
• For past account receivables (Old AR) that need to be collected, this fee generally ranges from 25% – 35%, depending on the age of the claims. 

Q. Are you HIPAA-compliant?
A. Absolutely, Synergy Healthcare Resources is fully compliant with all HIPAA requirements and standards.

Q. Where do the insurance checks go?
A. Payments are always sent directly to your practice or to a designated lock box account—never to us. Be wary of billing companies that demand that the payments come to them. All we need is a front/back copy (or original, if you prefer) of the EOB to properly credit the account.

Q. What kind of service will you give me?
A. We’ll give you excellent service—we take pride in our outstanding customer service, extreme attention to detail, lightening fast response, and personal follow-up.  Each practice is assigned to a specific billing specialist who knows your practice, your staff, and is familiar with your needs.  When you have a question you will talk to the specialist responsible for your billing, not “someone from our billing pool.”  You talk to someone you know and get the information you want when you want it… all to optimize your financial success.   

Q. I’m not located in your area… How would I submit my information to you?
A. With over 2,000 clients nationwide, this is something we manage on a daily basis.  In most cases, Synergy Healthcare Resources will integrate technology between your practice and our facility to transfer/receive your billing information on a daily basis. If this doesn't work out for your practice, we will set up a courier account for your practice and your information is automatically picked up either on a weekly or bi-weekly basis, depending on the size of your practice.

Q. What kind of information do you need from my practice?
A. To make thing easier and more accurate, we’ll design an easy-to-use superbill for you, or work from your existing one. In less than 30 seconds per encounter, you’ll be able to get us the information we need to properly submit your claims. (For new patients, or patients whose demographic and insurance information has changed, we ask that you give us a copy of their registration sheet and copies of insurance cards).

Q. I’ve seen medical billing software for sale. Why shouldn’t I do my own billing?
A. The answer to this question depends on the specific needs of your practice. In some cases, it does make more sense to do some or all of the billing in-house and in that situation we can easily get you onto our software program, Practice Manager X3.  That’s why we carefully evaluate your needs and advise you accordingly. We will not try to sell you something you don’t need.

Q. I already have an Internet-ready computer and would like to be able to access my practice data. Can I have secure access to the data on-line?
A. Yes—and that’s not all. We are also a software developer and our practice management system, Practice Manager X3, allows you to look up information and even run reports and patient ledgers.

Q. Whom does the patient call with a billing question?
A. Our toll-free number is printed on your patients’ statements, and a Synergy Billing Specialist will handle all billing questions.

Q. How do we make sure Managed Care plans pay us according to the contracted rates?
A. This question is a critical part of any Accounts Receivable follow-up, and we understand why you’re concerned about constant underpayments or payments at non-contracted rates affecting your patients’ balances and your revenues.

To address it, we request copies of your practice’s contracts and related fee schedules when we’re setting up your account, and we update our system’s profiles for each of those contracts. Then at time of payment posting, we monitor expected reimbursement and appeal any underpayments and/or denials. When necessary, we directly contact your Managed Care representative to resolve any problems, and we keep you aware of these problems and their resolution every step of the way.

Q. What kind of reports will I get?
A. There are a variety of reports available.

• The standard report package includes comprehensive monthly closing reports that confirm productivity such as the amount of charges, insurance payments, patient payments, and aged receivables.
• Practice-specific reports are usually available on request, as well, and can greatly enhance your ability to make fiscally responsible business decisions.

Q. Are you a collection agency?
A. No. Synergy Healthcare Resources focuses strictly on billing and follow-up. However, we pursue delinquent insurance claims and continue to work on them until payment is received. Our procedure is to send three statements to patients. If after the third statement there is no response, we send a 10-day notification letter. At that point, it’s up to you to decide how to pursue collecting the balance due (e.g., outside collection agency, bad debt write-off).\

Q. What if the patient is on a payment plan?
A. We’ll send as many statements as it takes to get the balance paid as long as there is patient activity on the account.

Q. What’s included in your services?
A. Our services include the following.

• Help with transition to new billing service:
  • Implement/integrate Practice Manager X3                                                                          As a current software developer supporting over 2,000 medical professionals nationwide since 1980, we’re equipped with a Synergy Technical Team to help you with any technical issues that you experience during this transition.  Help train your data-entry and front-desk staff in appointment scheduling, obtaining demographic data, and charge entry).
  • Assist with documentation necessary to sign up new providers to various carriers.
• Review demographic and insurance data and encounters/superbills received from you to ensure accuracy (e.g., CPT coding, modifiers, diagnoses linkage), and enter them within 2 business days.
• Report and request any missing billing documentation to you. We expect a reasonable turnaround time (usually 48 hours).
• Assist with CPT, ICD-9, and HCPCS coding to maximize reimbursement and minimize denials.
• Electronically bill all payers.
• Handle third-party billing.
• Resubmit claims for review when initial payment is not in line with typical doctor profile (we will maintain Medical Manager’s Managed Care contract profiles to assure proper reimbursement, as we recognize this to be a critical factor in maximizing collections).
• Post payments received to patient accounts (line item application allowing tracking of CPT reimbursement history).
• Post Adjustments according to provider’s Managed Care contract profiles, monitoring the profiles for reimbursement accuracy as outlined above.
• Send monthly statements to patients and follow-up non-payment by phone and mail.
• Review all claims within a 30–45-day period and resolve denials or resubmit claims as necessary.
• Submit and review the provider’s monthly reports (a wide range of already-developed custom reports is available). Some of the standard reports include:
  • Practice financial summary by doctor/location with charges, payments, adjustments (detail categories) with collection ratios and A/R totals,
  • Summary/detail/analysis aging reports by insurance and patient due,
  • Detail/summary procedure and diagnoses productivity reports,
  • New-patient-visit count by doctor/location, with financial detail,
  • True collection history reports by doctor/location/CPT/ICD-9 and other selection criteria,
  • Additional payer-specific productivity reports to analyze Managed Care contracts’ profitability and utilization.
• Review past-due accounts with the physicians or their designee for further action (reports can be provided by doctor and patient name, with collection history, to facilitate the doctor’s or practice manager’s decision-making process).
• Advise physicians on any changes in HCFA requirements, CPT, and ICD-9 coding to maximize their reimbursement, and
• Assist in fee schedule review/updates annually (automated fee/profile schedule updates).