Special Market Insights.

Anesthesiology

While anesthesia is a complex medical billing category, the industry demands consistent responsibility, reliability, security, and compliance review. Because anesthesia fees are calculated differently from all other specialties, the process must be complete and must calculate both the billing fee and expected allowed fees based on unique insurance and governmental regulations.  

We designed our anesthesia medical billing software, PhyGeneSys, to provide you with the greatest value, customizing it with the latest technology and the unique requirements of anesthesia medical billing. Our PhyGeneSys system monitors and manages all billing-related issues, including insurance plan configurations, specific reporting, and all follow-up needs. PHIMED team of experienced and knowledgeable staff consistently:

• Evaluate concurrency against all cases in the system.
• Deliver an extensive array of reports designed specifically for anesthesia reporting.
• Monitor developments in anesthesia billing and make changes accordingly.
• Improve flexibility with billing and expected allowed fee schedules to monitor contract compliance.
• Manage all associated insurance follow-up needs.
• Extend insurance plan configuration to meet anesthesia needs such as:
  • Automated appending of the Extreme Age Modifier.
  • Bill claims as doctor only, doctor and CRNA on the same claim, or bill doctor and CRNA on separate claims.
  • Append modifiers (AA, QZ, QY, QK, QX) based on the insurance plan.
• Offer unlimited handoffs between providers.
• Provide easy-to-understand statements minimizing the complications of team billing.

Emergency Medical Care

The stress level in the emergency department, and the need for immediate medical attention, often creates the “all hands-on deck” workflow that precludes administrative tasks. Medical staff possess vast amounts of medical knowledge and procedural skills necessary to skillfully diagnose and treat acute, undifferentiated patients of all ages and walks of life. 

With the wide variety of patient treatments, medical billing becomes an exceptionally time-consuming and complicated process. PHIMED is dedicated to supplementing ER competency in non-clinical, practice management issues with a system that is both robust yet easy to use and automates as much as possible the work of reimbursement, clinic management, patient experience, and MIPS coding. 

PHIMED works closely with emergency departments and clinics throughout the U.S. to drive costs out of emergency medicine practice management, collaborating with hospitals and optimizing the productivity of ER support staff. The end goal is automating error free claims for full reimbursements and allowing medical staff to focus on what they do best: providing excellent patient care.

• Task Management Strategies boost your effective communication and manage tasks across the organization.
• Comprehensive Account Summary provides access to critical account management information on the account home page.
• Extensive Custom Business Rules automate functions around your business parameters.
• Payment Action Scheme provides a flexible way to handle Coordination of Benefit (COB) codes with options: process the payment as acceptable and roll to the next responsible party or stop any financial write-off and place the account in follow-up until you have received the appropriate payment from the insurance company.
• Resource-Based Patient Scheduling Module with multiple facilities and multiple provider capabilities integrate fully within the system.
• Automated Upload and Download of Claims, ERAs, and other claim-related information productively manage time while completing a range of tasks.
• Expected Allowed Fee Schedules with user-defined payment tolerance identify payments made outside of your contracts.
• Enhanced Patient Engagement through patient-determined electronic communication methods (electronic statements, email and/or text.)

Large Medical Practices

The larger your practice, the more complex or diversified your patient base, service offering, and even office locations. Our software solution is scalable and intuitive with dynamic automation and communication. What’s more, PhyGeneSys is easy-to-use; helps alleviate the tedious work that leads to staff burnout.

No need to add modules for missing functionality. PhyGeneSys is a complete medical Practice Management System, efficiently processing ALL your most frustrating medical billing and coding tasks. Because we equip our system with advanced infrastructure, our clients become more productive practices who maintain consistent revenue progression. The following features govern the system:

• Billing workflow and patient management processes with streamlined control.
• Insurance and Guarantor Follow-up Modules aid the processes of improving business productivity and maintaining a consistent revenue progression.
• Task Management Strategies boost your effective communication and manage tasks across the organization.
• Comprehensive Account Summary provides access to critical account management information on the account home page.
• Extensive Custom Business Rules automate functions around your business parameters.
• Payment Action Scheme provides a flexible way to handle Coordination of Benefits (COB) codes with options: process the payment as acceptable and roll to the next responsible party or stop any financial write-off and place the account in follow-up until you have received the appropriate payment from the insurance company.
• Resource-Based Patient Scheduling Module with multiple facilities and multiple provider capabilities integrate fully within the system.
• Automated Upload and Download of Claims, ERAs, and other claim-related information productively manage time while completing a range of tasks.
• Expected Allowed Fee Schedules with user-defined payment tolerance identify payments made outside of your contracts.
• Enhanced Patient Experience

Medical Billing Companies

PHIMED offers an innovative solution for your specific billing service needs. Because PhyGeneSys utilizes sound practices and the latest technology, your business is assured greater accuracy and a consistent increase in revenue. 

Our technology simplifies data entry and captures any errors to assure accuracy and a consistent increase in revenue—cash flow. We reduce the resources required to bill services and enhance collections, which improves overhead. 

PhyGeneSys stands out with the following features:

• Automated Processes minimize expenses for routine work allowing the medical billing service to compete effectively in a very competitive environment.
• Insurance Plan Maintenance effortlessly retains the Enterprise and Practice levels separately.
• User-defined rules can be easily customized for each provider client.
• Billing Logic designed for the unique requirements of various specialties:
  • Anesthesia Concurrency and Modifiers
  • Global Period Calculations and Modifier validation
  • Multiple procedure discount calculations
  • Modifier schemes for Surgical Assistants
• Demographic and Clinical Interface Capabilities decrease data entry cost.
• Single ERA Process handles any ANSI 5010 835 compliant ERA.
• Billing Services form over 50% of the clients of PHIMED.