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Staff Achieves Clean Claim "Gold Standard'

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A Lincoln, NE, radiology imaging center, Advanced Medical Imaging (AMI), has a 95 percent first-pass success rate for Midlands Choice claims.  Recently we asked Georgia Blobaum, Director of Operations, Teresha Mowry, Controller, and Jeralyn Klingenberg, EDI Specialist, to describe the strategies behind their clinic's billing success.

Here is a summary of the conversation:

  • Details get attention before a patient gets treated.
    Insurance information is checked first when appointments are scheduled, second at registration and third by a medical data specialist.
    "We eliminate denials by being thorough up front," Blobaum said. "For Midlands Choice claims, that includes having the correct group number, employer name and the carrier name.  This approach takes resources, but you have to be committed to doing the job right
  • Local, personal service.
    With 19 radiologists and fellowship-trained subspecialists, AMI is the largest radiology imaging center in Nebraska. Yet AMI processes its claims in-house and each patient is assigned an account analyst.
  • Stay current with technology.
    Claims are submitted electronically; "pre-scrubbing" helps ensure that claims won't be rejected once they reach Midlands Choice or one of its delegated payers. Staff also utilize Midlands Choice's website when necessary to verify that group/employer/payer data is correct on claims.
  • An Obsession With Timeliness.
    Claims are submitted within 24 hours of treatment and billed each month for treatment provided in that month.
  • Trend-spotting and staff training.
    New information or procedural changes are discussed and explained in weekly "dashboard" staff meetings.

Advanced Medical Imaging strives to be the gold standard for radiology services in Nebraska. With its record for timely filing of Midlands Choice claims and the shortest possible distance between filing and payment, the clinic's billing staff is well on its way to achieving that standard.