Introduction

FMS’ wide selection of services allows us to provide you with the flexibility and versatility to create customized solutions to fit the particular needs of your operation. Our clients are afforded the personalized attention they need. It is FMS’ commitment to provide our clients with the services they require with the value they expect.

We build great business relationships as a result of efficient and clear communications, dependability and exceptional results. When you become a client of FMS, you gain an associate that has become an extension of your operation.

On this page you will find links to detailed descriptions for each of our services. You may navigate through them by clicking on the links provided on the left-hand side of the screen.

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Hospitals

FMS provides billing and collections services for some of the largest and most prestigious hospitals and healthcare systems on the East coast. We have a wealth of experience in all payor classes in both day-one and aged claims processing.

Our proprietary system automates, simplifies and streamlines the entire claim submission process for you. Enhanced by electronic front-end edits and strictly programmed by Correct Coding Initiative protocols, our billing system ensures clean and accurate claim submissions.

Through a dedicated team approach to each of our clients, FMS becomes an extension of your business office. By incorporating thorough follow-up techniques and establishing long term relationships with third party payors, our staff reduces your days in A/R and turns potentially lost revenue into cash. We will enable you to achieve excellent adjudication rates.

FMS excels in all aspects of hospital billing, including:

Our approach to hospital billing incorporates reliable reporting and meticulous denial management, supported by reason codes, and efficient claim submission at proper fee schedules.

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Physicians

FMS’ physician billing department currently performs billing and follow-up activities for over 1,000 hospital-based physicians and independent practitioners. Our staff has the experience to expertly and efficiently handle your claims, regardless of provider specialty. This list represents some of the specialties we are presently billing for:

Each client has a dedicated account Executive who is responsible for the supervision of all account activity and productivity. He or she is directly responsible for your progress and will build a relationship with your staff. Your account executive will meet with your staff on an ongoing basis to review reports and discuss issues, trends and potential revenue enhancements. Each account executive is supported by a senior staff member with extensive experience in healthcare receivables management.

It is FMS’ priority to reduce your company’s claim days in A/R. On the front end, all claims are “scrubbed” by CCI edits before submission; and, on the back end, a denial management team, empowered by a unique ‘reason code report,' performs follow-up on outstanding claims. In addition, through our versatile reporting capabilities, including work relative value units (WRVU) calculations, FMS gives you the management tools to monitor and grow your practice with confidence.

FMS ensures that our billing staff follow proper procedures concerning patient health information (PHI) as prescribed by HIPAA guidelines.

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Workers’ Compensation and No-Fault/Auto-Accident Billing

FMS bills Workers’ Compensation and No-Fault/Auto-Accident claims for a large number of hospitals and physicians on the East coast.

FMS emphasizes thorough and persistent follow-up on all client receivables. Claims are generated timely and at the proper fee schedule, ensuring prompt claim adjudication. FMS excels at performing strict follow-up demands required of Workers’ Compensation claims and Auto Accident claims.

At the time of service, FMS provides your patient with an information request letter (available in multiple languages) requesting all necessary data needed to process his or her claim. We also offer on-site training to your staff so that the correct information is obtained at the time of registration. Our advanced tracking tools enable us to monitor your reimbursements for accuracy and timeliness. This approach allows us to adjudicate improperly paid or denied claims on your behalf. Our staff has developed a relationship with most Auto Accident (No Fault) and Workers’ Compensation carriers, which significantly aids in the claim adjudication process.

Our in-depth understanding of and experience with Worker's Compensation and No-Fault/Auto-Accident claims ensures that your organization will have a timely and correct resolution.

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Credentialing

FMS offers credentialing solutions tailored to your specific needs. We utilize advanced technology to streamline the entire accreditation process. In addition, a designated credentialing team works hand-in-hand with you to gather all required documentation to submit applications. This team oversees expiring credentials and maintains up-to-date status information on all applications. Our staff’s familiarity and comprehensive understanding, along with the technical tools available, provides us with the precision and organization required to handle the credentialing process demands. We also utilize the Universal Credentialing DataSource, a software application provided by the Council for Affordable Quality Healthcare (CAQH). We have developed a system that integrates the features of these software applications to make the credentialing process efficient and timely.

The FMS credentialing team follows the industry standards closely so that your operation is always kept abreast of new developments in the credentialing world. We maintain standardized forms, which are immediately updated, when applicable, for the following carriers:

All NPI applications are submitted directly through the Centers for Medicare and Medicaid Services.

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Coding

Healthcare professionals recognize and value the importance of correct coding. It is the most essential component in the billing of medical claims. Correct coding is vital to the analysis of provider productivity; i.e., the tabulation of work relative value units (WRVUs). Certified and experienced coders who have expertise with both diagnostic and procedural coding are a fundamental necessity for any healthcare-based operation.

Our coders stay current in the ever-changing world of ICD-9, ICD-10, HCPCS, SPARCS and CPT coding. We have developed standard operating procedures that allow us to proactively respond to frequently- issued coding updates.

Our staff delivers the highest level of skill crucial for appropriate assignment of codes based upon the provider documentation. Clients who also utilize our billing service in coordination with our coding services streamline their entire claims submission process. The bottom line for your organization – our expert coding services offer a value that can be easily justified by the adjudication rate of your claims on initial submission.

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COMMERCIAL ACCOUNTS
Our expertise is widely recognized by many industries as a leader in collection services for commercial accounts. We provide a complete and outstanding collection service, which may include the use of our "in house" law firm if litigation is required. We've also partnered with exceptional service providers in other related fields. Sullivan-Hernandez Agency not only provides Insurance services, but understands the mechanics of insurance coverage and is able to . We provide a hand-holding process that would include on-site meetings and conference calls to assist our commercial accounts in understanding and working with insurance carriers. Combined, CCS and Sullivan-Hernandez work to help you in dealing with insurance companies on all levels, including billing services and collections.

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Practice Management

The financial and operational management of physician practices has become increasingly demanding. Practices are entrusting these responsibilities to certified and experienced professionals so that time and attention can be focused on providing quality healthcare to their patients.

FMS’ knowledge and professionalism in the area of practice management has established us as an industry leader. Our highly trained Practice Management professionals have experience with numerous medical specialties. We will assist you in making well-informed decisions, supported by reliable data and statistics, to empower you to gain full control of your organization.

The cornerstone of our practice management services is a full operational review. Your practice will undergo a complete structural evaluation by our practice management team. FMS immerses itself into the inner-workings of your standard operating procedures and analyzes their functional efficiencies. We review all procedures, including the patient registration process to third party submission. A full operational review is comprised of a series of individual reviews focused on specific aspects of your infrastructure. Some of the core reviews include:

FMS will make recommendations and propose realistic solutions that will automate your procedures and maximize your staff’s productivity. It is our goal for you to achieve a compliant and streamlined operational organization that is specifically designed to maximize the financial potential of your practice.

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Value Added Services

 Electronic Data Exchange

FMS has adopted all HIPAA Mandated Electronic Data Interchange (EDI) standards and formats, assuring the easy and secure exchange of data with your systems:

 System to System file Exchange

 Virtual Private Networks (VPN)

 File Transfer Protocol (FTP)

 Secure Internet Linkage

 Encrypted E-Mail

 Tape Transfers

 Data Conversions

 Claim Quality Assurance

 HIPAA Compliance

 Insurance Eligibility Verification

 Insightful Analysis

 Useful Reporting

 Educational Training Sessions

 Chart Auditing

 Charge Ticket Design

 Expand Your Billing Management Team

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