FREQUENTLY ASKED QUESTIONS

Company Background

Q: How many years has FDM been in business?

A: FDM has been in business for 23 years.

Q: How many clients does FDM have?

A: FDM currently bills for 15 different medical groups. FDM’'s largest medical group comprises 15 physicians.

 

Coding

Q: Does FDM employ Certified Coders?

A: Yes, FDM not only employs certified coders, but also uses a professional coding company called The Coding Network.

Q: How is the quality and accuracy of coding monitored?

A: FDM has a comprehensive compliance plan that requires coding audits.

Q: Who is responsible for coding?

A: The client is ultimately responsible for all coding; however FDM reviews the accounts for errors.

Q: How does FDM communicate/resolve coding problems and/or communications for updates with client physicians?

A: Each week a coding report is provided to the designated representative for the client. The report lists all CPT codes that are inconsistent with the physicians'’ reports. It also lists by MRN #, the reports that require an addendum in order to facilitate reimbursement (if appropriate). FDM attends monthly sessions with all client supervisors in order to share trends, discuss coding issues, request modification in methods on the front desk, and provide carrier feedback.

Q: What coding resources does FDM make available to staff members?

A: Part B News, MedLearn Matters, HBMA Coding Listserv, ICD-9 & CPT Professional Coding Books by Ingenix, AMA Coding Manager, CodingToday Online, CMSD Bulletins, and Specialty-Specific Provider Bulletins.

Q: Describe FDM’s continuing education program for billers.

A: FDM employees are sent regularly to government and commercial payor seminars, and billing and coding webinars are brought in-house through the HBMA.

Q: How does FDM verify the accuracy of claims prior to submission?

A: All billing is checked through the payor websites for eligibility. Additionally, all charges over $1,000.00 are audited prior to billing.

 

Information Systems and Support

Q: What billing software does FDM use?

A: FDM uses and is a VAR (Value Added Reseller) for the MedInformatix Enterprise Practice Management software.

Q: How does FDM ensure data redundancy and integrity?

A: FDM employs a real time data redundancy system between the California and Idaho offices. Data is replicated through a secure channel over the Internet on a minute by minute basis. Deep database integrity scans are performed on a weekly basis.

Q: Does FDM have an in-house IT department?

A: Yes, FDM has a full IT department that is managed by Curtis Jessup. Curtis and his team have full responsibility for the phone systems, computer hardware and software, connectivity, and output for the company and the clients. FDM has a full, redundant system at its site in Idaho. FDM also handles custom programming internally and can provide custom reports and solutions to the client in a prompt manner.

 

Billing/Collections Processes

Q: Does FDM have a formal procedures manual in place for billing and collections processes? How often is it updated?

A: Yes, FDM has a formal procedures manual. The policy and procedures for the company are updated by change, addition, or deletion regularly. Once a year all employees of FDM are required to be formally trained on the compliance plan.

Q: As health savings accounts continue to grow, how has FDM changed its private pay collections procedures to more efficiently work with these accounts?

A: FDM aggressively pursues these monies. Patient pay accounts are handled based on the dollar amount of the claim.

Q: How does FDM handle patient calls requesting a discount?

A: A request form is submitted to the compliance officer with the patient’'s MRN and request. Only the compliance officer for the practice is authorized to sign off on a financial hardship discount or special circumstance for the practice.

Q: When would you normally write an account off to bad debt?

A: When the insurance carrier has paid their portion, the patient has received three statements, and one phone call has been made to collect the balance without success; the account is changed to the “collection” financial class, a report is run for authorization from the compliance officer and the account is automatically written off.

Q: In the event a problem occurs with missing or problematic information from the physician, how is this reported to the client?

A: Each week a report is generated to the client providing the patient information and asking for the missing or updated information.

Q: Does FDM outsource any processes to foreign countries?

A: FDM has never outsourced any processes to foreign countries. FDM outsources the data entry functions to its own company in Coeur d'’Alene, Idaho. This satellite office was developed to both lower data entry costs and provide data redundancy with the California office.

Q: How often are claims submitted and statements sent to the patient?

A: Claims are submitted on a daily basis. FDM has four statement cycles with one cycle running each week. A patient will receive a statement every fourth week.

 

Regulatory Compliance

Q: Do you have a written compliance plan in place?

A: Yes, FDM has a written compliance plan based on the OIG guidelines for third party billing companies.

Q: How do you handle a compliance problem that has been detected in one of your client physician groups?

A: The issue would be brought to the attention of the compliance officer for the client in order to make them aware and allow them to rectify the situation. In the event that an error occurred that required refunding money to a Federal program, the FDM healthcare attorney would be contacted.

Q: How are new employees introduced to corporate compliance?

A: Prior to starting work for the company all staff is required to read the compliance plan, receive training, and pass a compliance test.

Q: What is the company records retention and destruction policy?

A: All client documents are scanned into the computer system and stored for 10 years. Hard copies of the records are destroyed by shredding with written permission from the client.