Sunil Wadhwa, CEO, MedXPrime Revenue Recovery (mr2)
Returning to this year’s ‘Top 10 RCM’ companies is MedXPrime Revenue Recovery, known as “mr2” to its many clients. mr2 has earned its reputation for being fully engaged in the true spirit of partnership with their clients and for diving into the details to create successful, out of the box, solutions.
“MedXPrime Revenue Recovery’s commitment to our clients is to maximize their profitability with forensic A/R recovery and highly efficient and effective billing”. So says CEO Sunil Wadhwa as this unique California-based company charts its course for 2021. Wadhwa says, “potentially being able to recover tens of thousands, perhaps hundreds of thousands of dollars to our clients bottom line gives us immense credibility with our doctors. In our opinion, Insurance accounts receivables are on a crisis level.”
There’s more to mr2’s commitment level to its clients than just A/R recovery and improved billing. mr2 has recently introduced 12 new enhanced services to focus on increasing revenue and easing their clients’ administrative burden at no additional cost. Typically, these are services that other billing companies charge for. Wadhwa states, “We’ve made the strategic enhancements to resources that move us to a whole new level of enhanced services. By providing these additional services at no additional cost, we can be hyper competitive and increase our distinctive differentiators.”
Mr. Wadhwa describes these as the “One Percenters” for their billing clients; those things they do that other companies don’t do:
1. Provider Credentialing:
NO COST! Other billing companies charge $200 to $1,000 per contract!
• Benefit to Client: More contracts, more patients, more billing! Best of all, no administrative burden to practice; we do it all. Unlimited credentialing services at no additional cost. Bottom line potentially increases practice revenue.
2. Insurance Eligibility Verification/ Pre-authorizations:
NO COST! PAs are a key reason for denials. Other billing companies charge $7/$10 for each eligibility verification; PAs will cost surgeons on average $150. Family practice pre-authorizations generally cost $10/$15 each.
• Benefit to Client: Reduced administrative tasks for client; reduction of workflow; reduces number of denials and unpaid claims, bottom-line potentially increase practice revenue.
3. Contract Renegotiating:
NO COST! mr2 analyzes their client’s insurance contracts to ensure maximum billing charges are included and conduct an ‘Annual Payment Review’, a review of the reimbursement rate with each payer and compare with their other clients, renegotiating the reimbursement rate with the payer when necessary. With other billers this typically cost the provider $1,500 - $2,500 per contract negotiation.
• Benefit to Client: Maximizes client revenue to ensure payments are as they should be compared to other insurance company clients. Reduces administrative tasks for practice; enhances workflow and productivity, bottom-line potentially increase practice revenue.
4. Patient Statement Reminders:
NO COST! mr2 sends patient statements via email once each month with two reminder statements on the 60th and 90th day from the first statement. If the patient has not responded to the three statements, mr2 will send the list of patients to the doctor.
• Benefit to Client: Enhanced revenue for client; patient payments! Fewer tasks for front-end employees; possible reduction in practice staff. Bottom-line potentially increase practice revenue.
5. Coding by Specialty:
mr2 has certified coders with minimum 5-years of experience that are experts who will review each patient’s chart and confirm best coding.
Coding is always the practice’s decision but mr2 will make suggestions according to what may be improved.
• Benefit to Client:
MedXPrime Revenue Recovery’s (mr2) commitment to our clients is to maximize their profitability with forensic A/R recovery and highly efficient and effective billing
Maximizes revenue by ensuring coding is at the highest level; reduces denials due to coding errors (a favourite reason for denials). Doctors usually pay a premium for specialized coders at this level of expertise. Bottom-line potentially increase practice revenue.
6. Denial Management:
mr2’s denial capture is done immediately once their payment posting team receives the ERA/EOB (improved workflow)
• Benefit to Client: Proactive payment to clients; claims are worked faster, reduced A/R, more money - sooner! Bottom-line potentially increase practice revenue.
7. Enhanced Expanded Reports:
Detailed weekly and monthly reports are provided on every claim. Every quarter, mr2 analyzes all patient visits, billed amount, collected amount, average reimbursement per visits, and provide a detailed report to their clients with tips to improve the cash flow. mr2 also sends a weekly billing metrics report which provides transparency in the billing processes.
• Benefit to Client: Confirmation that all is well with their billing; peace of mind; complete transparency builds confidence; relieves the practice of having to run the reports; identifies clerical and coding errors; improved workflow for staff. Bottom-line potentially increase practice revenue.
8. Monthly AR Review Meeting:
mr2 calls the payers to check the claims status of all claims above 60 days. Each month they send an AR report with the claims status of every single claim aged over 60 days, noting claim status, global issues, resolved billing issues, required information from the clinic, and any other matters of importance.
• Benefit to Client: Greater transparency; total clarity; an opportunity to discuss any issues or concerns; peace of mind. Bottom-line potentially increase practice revenue.
9. Patient Demographic Information Confirmation: mr2 reviews each patient file for accuracy: “dotting the i’s, crossing the t’s”.
• Benefit to Client: Ensures accurate patient info; reduces number of denials and unpaid claims; reduces administrative tasks for client. Bottomline potentially increase practice revenue.
10. Provider Documentation Education:
mr2’s medical coding experts will review the client’s clinical documentations and provide the doctor with physician education documents including examples and areas of documentation improvements.
• Benefit to Client: Prevents continuing miscoding errors; enhances provider and staff knowledge and coding ability; increases revenue by coding to the highest level without corrections; avoids insurance company audits and ‘takeback’. Bottom-line potentially increase practice revenue.
11. Telehealth Billing:
In the world of COVID many practices want to add Telehealth capabilities but require assistance in establishing necessary protocols. mr2’s experienced team can bill and collect for Telehealth services across various specialties. They educate the provider on billing out the correct telehealth codes with appropriate modifiers and place of service which are payer-specific.
• Benefit to Client: doctors service more patients; increased billing opportunities, enhanced revenue to practice. Bottom-line potentially increase practice revenue.
12. Work Comp/Auto Claims: This is a very specialized area of billing which many billing companies avoid or are not good at. mr2’s proactive approach helps to prevent delays in payments due to ”not on file” claim denials.
• Benefit to Client: opens up a whole area of patient care and billing that will enhance the practice and increase their revenue. Bottom-line potentially increase practice revenue.
Summing up, Mr. Wadhwa states, "Bottom line, MedXPrime Revenue Recovery is a highly specialized firm focusing on forensic A/R recovery with a history of unparalleled customer service. Because we are great at A/R recovery, we are amazing at increasing monthly cash flow with expert and efficient billing."