Case Study: JSE Emergency Medical Group, Inc.

Dr. Joseph S. Englanoff, M.D. has both an office practice, and a medical corporation, JSE Emergency Medical Group, in which he provides a team of physicians to four Southern California hospital emergency rooms. In the beginning, MedBill Partner only provided services for his private practice. During that time another company handled the billing and claim management services for the ER operation. However, Dr. Englanoff was encountering several challenges with that entity.

Accounts Receivable moved slowly due to a 30-day turnaround time for medical records to be coded prior to billing. The company used out-of-state ER coding specialists to handle JSE’s medical record coding needs.

Medi-Cal claim revenue was lost due to the company taking more than a year to secure Medi-Cal provider numbers for the JSE physicians.

Poor claim activity – the company did not pursue claims with balances under $200.00 – resulting in substantial lost revenue.

Inadequate and sometimes inaccurate reporting made it impossible to predict cash flow with any certainty.

Dr. Englanoff decided to give MedBill Partner the opportunity to take over the billing services for the ER operation, despite the fact that MedBill Partner had no prior experience in handling ER claims.

MedBill Partner Solutions

ER Coding
MedBill Partner’s implementation program started with finding local, experienced ER coding specialists. Our staff attended a three-day seminar with the coders to gain an understanding of the intricacies of ER coding and billing. Having a local coding specialist enabled MedBill Partner to secure a ten-day turnaround time for receiving, coding, and returning medical records for billing.

Provider Agreements
Applying for and securing Medi-Cal provider numbers for the JSE physicians was completed within 90 days.

Revenue Cycle Management
Claim management services required no changes, as MedBill Partner already had established protocols for following up and pursuing denied claims. With no changes in coding levels or patient census, MedBill Partner was able to nearly double JSE’s average monthly revenue- all due to established revenue cycle management services, and a few unique services tailored directly for the client.

Decision Support
Medi-Net reporting services enabled Dr. Englanoff to better manage cash flow, and resource utilization and identify business opportunities in his rapidly expanding enterprise.