As medical insurances become more and more restrictive with payment, the challenge confronting the in-house billing department of any sleep practice is being succinct and accurate. Ironically, billing for sleep is a lot simpler than the traditional medical billing paradigm because there are only a hand-full of codes. That said, why out-source this process?

The Low-Hanging Fruit Syndrome

Given how busy a typical sleep lab is, there is a tendency for in-house billers to confine their efforts at reimbursement to the low hanging fruit, meaning the contracted rate with the insurer. Patient co-pays are all too often uncollected since in order to know in advance what this co-pay is, one has to verify patient insurance prior to the sleep study. In theory, this shouldn’t be hard for the staff. In reality, getting through to insurance companies can take hours of time on hold with subsequent routing to “voice mail jail”. Imagine, your employees being on hold while other office lines are ringing off the hook! This is a lose-lose proposition resulting in employees abandoning the call to the insurer in order to pick up the ringing line. In other words, employees attend to what they think is potential revenue rather than be perceived as giving bad service.

How much does this really cost the lab?

Co-Pays are typically 20% of allowable reimbursements, give or take a few points. If an average sleep study is $1000, then $200 per study is left on the table if co-pays aren’t collected. Using this model, if the lab is doing 50 studies per month and 80% of these studies have co-pays, the lab loses $8000/month due to lack of billing diligence.

Data versus Information

Even when a lab uses an outside billing company, an inordinate number of companies return data to their clients. For example, an aging report is data…NOT information. Information is something proactive that a lab owner can act on to improve the financial performance of his/her lab.

What do we mean by this ? Given that payer mixes change every month, the average revenue per study for a given month changes from month to month while the lab’s cost for the most part is fixed. Information is when the average revenue from the previous month is given to the lab owner so that he/she can adjust budgets dynamically. Now, realistically, how many billing companies can provide this INFORMATION?

Another important financial detail is to know and understand the gap between your true collectibles and your actual collections. Why is this important ? It will tell you whether your billing company is ONLY going after what is easiest and most expeditious for them. The gap between true collectibles and actual collections should be in the high 90% range. If it is not, then you know that your billing company is not collecting co-pays and deductibles.

Why n2sleep Billing

Insurance Verification

As part of our services, we guarantee we will do insurance verification for you. Prior to a study being performed, your office manager will know how much to collect. History has shown us all that it is easier to collect BEFORE a study than AFTER. We have an established Call Center specifically assigned to insurance verification services.

State of the Art Software and People

At n2sleep billing, we invest in technology and people. We use the most advanced billing software and just as importantly, we don’t hire billers and then teach them finance and accounting. We take the opposite tact by hiring people with professional accounting and/or finance backgrounds, then teach them billing.

Practice Management Information that you may not get from your present biller

Since our billers all have finance or accounting backgrounds, we can deliver practice management information from the data we gather from our software. The information you receive is not retrospective but, instead, proactive.

Medical Billing for the Dental Practitioner

With the intense growth in Dental Sleep Medicine, more and more dental practitioners are becoming involved in treating patients in their own practice who suffer from obstructive sleep apnea. Their role in detecting this disease, complete with all its co-morbid conditions has become invaluable. Further, the dentists’ inititiative does not need to compete with the sleep lab, it can indeed compliment the sleep clinic. However, if there is one hurdle obstructing the average dentist, it is billing medical insurance carriers for the fitting of oral appliances. n2sleep specializes in medical billing on behalf of the dentist’s practice.

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