CODING AND BILLING

Navigating today’s complex billing terrain of emergency medicine requires specialized expertise. NES Health’s coding and billing division, ProBill, is supported by the latest technologies and strategically designed to meet the demands of multi-specialty physician services. ProBill’s services are centered on increasing reimbursement, maximizing compliance, and providing you with day-to-day peace of mind about your EM billing operations. NES is committed to aggressively pursuing those harder-to-collect dollars on behalf of our clients.

ProBill’s medical billing solutions include the following:

  • Claims submission and follow-up
  • Physician documentation training
  • Medical coding audits
  • Fee schedule evaluations
  • Advanced reporting capabilities for greater financial insight
  • Timely turnaround and support

Our commitment to our clients:

  • Maintain meticulous, compliance-focused coding practices.
  • Assist physicians in improving their documentation.
  • Pursue unpaid and denied claims.
  • Provide vital practice insight through business intelligence reporting.
  • Ensure timely claims turnaround and support.

We do this in one of two ways:

Hospital Revenue Cycle Services: From cost analysis to medical coding and medical record audits, ProBill’s outsourced solutions enable you to lighten your administrative load while improving your fiscal picture. Learn more

Physician Practice Revenue Cycle Services: As a physician-owned company, we understand the challenges inherent in optimizing profitability while maintaining compliance. Beyond helping you maximize collections, our experts work with you to identify opportunities to enhance revenue. Learn more

Hospital Revenue Cycle Services

The multi-specialty nature of emergency department services makes documentation and coding uniquely challenging; however your hospital can’t afford to it ignore if you provide revenue cycle services for your emergency physicians. Poor documentation and/or coding of your patient records can not only comprise revenue, but put your facility at risk.

Backed by a premier team of certified medical coders, our coding services for medicine clinicians includes

  • Cost analysis
  • Documentation training for physicians and mid-level providers
  • Medical coding audits
  • Revenue enhancement consulting
  • Timely turnaround
  • Responsive and knowledgeable support

ProBill’s medical coding solutions are modeled after methodology and policies derived from years of emergency medicine coding and reimbursement experience. From teaching your doctors how to properly document patient encounters to performing random audits, we help you strike that balance between compliance and profitability while enjoying greater peace of mind.

Backed by specialized expertise and leading-edge technologies, our billing and coding services for ED physician practices include

  • Appropriately coding all billable medical records.
  • Sending out insurance claims and patient bills quickly and accurately.
  • Enrolling your physicians and mid-level providers with third-party payers.
  • Helping you set an appropriate fee schedule.
  • Evaluating your existing managed care contracts for efficiency.
  • Negotiating favorable payment rates with managed care payers.
  • Conducting daily audits to account for all of your billable patient charts.
  • Collecting deductibles and co-payments from your patients.
  • Researching and handling all refunds.
  • Providing state-of-the-art reporting that gives you a clear view of the financial and clinical wellbeing of your practice.

Physician Practice Revenue Cycle Services

Your emergency department physicians work each and every day to keep patients healthy. But who’s looking after the health of your ED physician practice?

Through our comprehensive revenue cycle management services, NES Health helps physician practices like yours optimize revenue and cash flow while improving compliance. Not only do we work to collect more of the money you’re owed, faster, but we also actively seek additional ways to improve your department’s finances.

Backed by specialized expertise and cutting-edge technologies, our billing and coding services for ED physician practices include

  • Sending out insurance claims and patient bills quickly and accurately.
  • Appropriately coding all billable medical records.
  • Enrolling your physicians and mid-level providers with third-party payers.
  • Helping you set an appropriate fee schedule.
  • Evaluating your existing managed care contracts for efficiency.
  • Negotiating favorable payment rates with managed care payers.
  • Conducting daily audits to account for all of your billable patient charts.
  • Collecting deductibles and co-payments from your patients.
  • Researching and handling all refunds.
  • Providing state-of-the-art reporting that gives you a clear view of the financial and clinical wellbeing of your practice.

Compliance

Between intricate coding guidelines and ever-changing HIPAA laws, navigating the complexities of today’s highly regulated healthcare environment can be hard—and it’s not getting any easier. Fortunately, when you partner with NES Health, your hospital’s compliance is one less thing to worry about.

Our extensive Corporate Compliance Program is designed to ensure tall our activities conform to applicable federal, state, and local laws and regulations.

NES Health’s commitment to compliance is a fundamental part of who we are as an organization. From staying informed about changing Medicare and Medicaid regulations to performing routine risk assessments, you can trust us to always keep your ED physician practice one step ahead of the compliance curve.

 

This program includes:

 

  • Adherence to rigorous, standards-based coding practices.
  • Ironclad internal privacy policies and procedures.
  • A team of experienced and certified medical coders.
  • Intensive and ongoing staff education.
  • Physician documentation training.
  • Routine coding audits and risk assessments.
  • Use of leading-edge technologies to safeguard client and patient data.
  • A designated Compliance Officer and committee.
  • The NES Health Compliance Hotline (1-877-866-2688).

We’ve invested generously in the software, people, training, and processes to put us at the forefront of the industry for nearly four decades.

Our suite of cost-effective financial solutions is designed to help your hospital or physician practice improve profitability today—and secure a prosperous tomorrow.