Summary

" ClaimPay* is dedicated to the management of the revenue cycle of any medical specialty, office, or clinic looking to outsource billing to a third party company."

Company Summary

ClaimPay* brings a doctors most needed resources to the table. We set out to increase profitability, with 10% to 35% more claims paid. Bringing accounts receivable up while decreasing accounts payable, allowing growth within the company and community. By effectively managing the revenue cycle we get the Doc paid.

These procedures include: Working directly with the insurance company. healthcare providers, and patients to get a claim processed and paid with in the minimum time expected.

As well as, handling all aged and collection accounts to insure balance is paid in full, with little write off's and with analytical report, showing the differences ClaimPay* has on your bank account. This allows the Physician more time to preform the quality care needed and is less of a hassle for the HR department.

"Pitch Deck"

Management Team

I am going to get the business started, and secure clients for myself through marketing and word of mouth. As ClaimPay* becomes established, I will hire staff as needed. i will provide the proper training and equipment needed for each hired on to also start a home based office. This will open the doors to a variety of people to join today's working class and help boost the local economy. With the experience and knowledge I have gained from previous employment, I will be of great support to the struggles many see within the billing cycle. I will follow a complete step by step structured guide line that is set with in the binding laws and regulations of Washington State, Department Of Health, and HIPPA's Privacy Practices. 

Customer Problem

ClaimPay* is a resolution specialist providing services to Medical Doctors, Physical Therapists, and Doctors of Chiropractics, who are paying out more than they are bringing in. Our services solves any billing issues with CPT or ICD-10 coding, data entry, claim submissions, claim follow ups, and collection accounts and will quickly gets you paid. Guaranteed or the next month of services will be free.

Products & Services

ClaimPay* will provide end to end billing needs, such as, patient intake, scheduling, data entry, coding, insurance verification, claim submission, payment posting, collections, and analytical reporting. We will offer customized service options, allowing you to make the right fit for you company's needs. There will be constant contact and open communication with the providers administration and with the patients. Our dedicated and supportive staff will be their to assist in the fine details of the entire billing process. Reducing headaches and easing the tension within your office. Our job is to get you paid for the services provided as quickly as possible. Providers will benefit from our services from the notable growth rate in there services paid for, which brings their net worth up, and their ability to concentrate more attention to the patients needs, and their plan of care.

Target Market

ClaimPay* is a home based office that is located in Kelso, WA. Serving the greater part of Cowlitz County and surrounding areas. 
Our targeted market is any medical providers who wants to outsource their billing department to cut costs and increase profits considerably. 
Our goal is to contract with local providers to improve revenue with in our community.

Customers

Our customers will be smaller medical offices who are seeing a shortage in account receivables from payments from insurance company's due to error rejections, denials, and ineffective follow ups from the in house billing departments and have a high average of unpaid aged accounts. We will increase profitability within one month guaranteed.

Sales & Marketing Strategy

ClaimPay* will have prices that will beat all competition and services of today's going rate for outsourced billing companies. The services we provide will be top priority for every customer we contract with. I will advertise on social media, become affiliates with the local medical associations and attend chamber of commerce meeting to get the word out. You will be happy with our services and see a boost in profits by the end of the first month guaranteed or the next month of our services are free.

Business Model

First rate, top of the line communication between the clients and insurance agency, along with highly detailed, organized and effective management skills ClaimPay* will gain 100% of its clients trust with fast and timely responses and quick turn around time for payments. At a considerably lower cost than having an in-house billing department and all competitors locally.

Competitors

Locally there is only one outsourced Medical Billing Office, that I have found and other than that there are several up north. The biggest issue will be selling my services to offices that are already using in house billing department and getting them to be willing to switch to an outsourced billing company.

Competitive Advantage

With a highly detailed and efficient mind set ClaimPay*s goal is to preform top notch service with error-less claim submission allowing a fast turn around time for payments, at an extremely lower cost than all competitors. We want to gain the trust of our customers by showing them that outsourcing really is the best option for their billing needs. 
We use the best technology and the highest reviewed clearing houses found, as well as, actively research the going rates for services provided and adjust our prices, to lower than any of our competition. The point is to gain the trust of providers, so that they continue to outsource billing needs to us, which will allow ClaimPay* to thrive and grow into a more nationally known company. 
It is known that more than 50% of home workers are able to put 25% more time and effort in to the job to get it done, and that will be shown consistently by the improvements in your company bank accounts.

Healthcare Technology Vision 2015

That's according to a new Accenture report, Healthcare Technology Vision 2015, which lays out five key trends in the industry that show adaptation might be the best business model.

First, Accenture analysts are calling it the "platform revolution" – that is the ever-increasing ubiquity of mobile and cloud platforms that far surpass merely the ability to track in real-time a patient’s health. Rather, this is a platform that addresses interoperability, "that captures the data from disparate sources such as wearables, phones and glucometers, and pulls it all together to give a patient and caregiver a holistic and real-time view of the patient's health," they write.

[See also: Healthcare to enter 'third wave of digital'.]

The second trend, as the report emphasizes, is around the "outcome economy." In other words, "it's about delivering results." Hardware, nowadays, brings with it new intelligence. Better intelligence than ever before. And that's going to make patient data accessible with a mere click. It's going to give patients the convenience, and it’s ultimately going to lead to better outcomes, according to the report.

The third trend is around data, what's billed in the report as the "intelligent enterprise" – essentially a "data explosion" that will lead to tremendous clinical outcomes opportunities.

In fact, big data has gotten so big that some 41 percent of healthcare executives say the data volume their organization manages has increased by a whopping 50 percent just from a year ago.

Tomorrow, Accenture officials say, this trend will turn into an EMR including a "lifetime's worth of data"; it will be used regularly to predict ER visits. Consumers will be able to snap a photo of a skin rash and have a diagnosis shortly. Considering this trend, it may come as surprising that still only 28 percent of docs say they routinely use CPOE systems.

Coming it at No. 4 is the "Internet of me" trend – that is personalized medicine. And as more healthcare organizations invest in this technologies and system capabilities, they’re seeing positive results. In fact, an overwhelming 73 percent of health execs surveyed say they've seen ROI after investments in personalization technologies.

The last trend may make some feel a bit uneasy. And it's about the emergence of machines. It's the "workforce re-imagined." Think digital self-scheduling, sharing your own electronic medical record, training machines and connecting with physicians via social platforms.

According to Accenture data, 66 percent of health systems in the U.S. will have self-scheduling by the start of 2020. And nearly half of health execs strongly agree that within three years, they'll need to focus on training machines just as much as training employees. What does this mean exactly? Just think algorithms, machine learning and intelligent software.

"Patients can actually begin to care for themselves – relieve the burden of the delivery system and get a better result," says Kaveh Safavi, MD, global managing director of Accenture's healthcare business, in a video announcing the report. "That's truly workforce reimagined, because now you've made the patient part of their own care-giving team, and the technology makes it possible."

Are you satisfied with your EHR?

Link to download mdcr era for Medical Billing

https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/AccesstoDataApplication/MedicareRemitEasyPrint.html

Related: 6 Things I Wish Somebody Had Told Me When I Started My Small Business -3

3. A focus on a specific market segment

As a startup founder, you won’t have the marketing resources or brand recognition to appeal to all consumers. Instead, find and quantify the specific demographics of the subset that your solution best fits, and target all your features and messaging to those customers. Targeting multiple segments almost always weakens your business.

BILLING SOFTWARE OR CLOUDS

This type of buyer...	Should evaluate these systems
Integrated suite buyers	Allscripts, MedLedger, CareTracker, SuiteMed
Inpatient care providers	Inpatient care providers Sage Intergy, athenaCollector, NextGen
Outpatient care providers	AllegianceMD, LeonardoMD, AdvancedMD
Cash-based providers	MDConnection, MediTouch
Outsourced services	Practice Admin, AdvancedMD, NueMD

4 SIGNS YOU NEED TO OUTSOURCE

     



"As reimbursement pressure 
grows and underlying costs rise,
 margin pressure will persist."

-You may be 

told by your team 

that there are

 no costs left to cut. 

"Respectfully disagree."

Understanding Healthcare Start Up Issues

Health Care

Use this guide to help understand the laws and regulations that apply to health care businesses and the health care industry.

Click on one of the following links to jump to that section of the page:

• Antitrust
• Environmental Compliance
• Eye Care
• Facilities Management
• HIPAA
• Mammography Services
• Medical Device Reporting
• Medical Practitioners
• Medicare & Medicaid
• Taxes
• Workplace Health & Safety
• 

Here are some highlights to look for in a premium health care clearinghouse:

– Eligibility Verification – Determine patient portion before appointment
– Electronic Remittance Advice (ERA) – Automatically updates Payments & Adjustments
– Claim Status Reports – Know the status of a claim at all times
– Rejection Analysis – Have error codes explained in plain English
– Online Access – Edit and correct claims day or night online
– Printed Claims – Have claims automatically dropped to paper when necessary but still be able to track and manage them online.
– Patient Statement Services – Have your patient statements put on ‘autopilot’ at a cost less than what you can mail them out yourself.
– Real-time Support – The best clearing houses offer 1-on-1 personal support and training provided by experienced billers.
– Affordability – When you take into consideration the cost of purchasing forms, the cost of printing, envelopes, postage, and time spent; a clearinghouse ends up costing far less than processing paper claims, plus electronically you have the many added benefits.

WHY ClaimPay MD?

ClaimPay, LLC can help.  We offer our expertise combined with customized software solutions that result in additional income and reduced overhead.  We can even offer Electronic Health Records (EHR) solutions with internet access from anywhere.

We earn our practices a 10-30% increase in revenue.

We have local account managers and you and your staff will see us regularly.

We get claims are paid in most cases within 12-20 days.

We will train you with the best coding techniques.

We customize your billing process just for your practice.

We are persistent and tireless during the claim and appeal process.

We train your staff on the best practices for increased revenue.

We professionally handle all patient calls about billing.

We will do a monthly analysis of your practice and keep you informed.

Contact us today and benefit from the revenue increase your practice deserves along with the peace of mind that comes with the freedom to focus on good patient care.

THE HEALTH CARE FOUNDATION

THE HEALTH CARE FOUNDATION
P.O. Box 308,
Longview, WA 98632

• (360) 423-3591
• Mary Jane Melink,
  Executive Director
• thehealthcarefoundation@gmail.com
• 
  
• 
  

• 
  

Sole Proprietors Insurance Costs and Definitions

Being a sole proprietor is the easiest way to start a new business. The business entity consists solely of one individual, the owner. Insurance coverage is very important for any business especially for a sole proprietor. It provides a safety net for sole proprietors in case of any unforeseen risks that occur in running the business. This is important since a sole proprietor guarantees a business with his own money as well as money from the business.

Errors & Omissions Insurance

Every business, regardless of size, should consider errors and omissions insurance. This is particularly important for sole proprietors who bear the financial burden of the business alone. This insurance covers when a business makes a mistake and the mistake causes financial harm to another individual or entity. This insurance protects a sole proprietor from having to fund the entire cost of defending against an action that occurs during work. This insurance can also be referred to as malpractice insurance or professional liability insurance. The average cost of errors & omissions insurance can vary from $500 to $2500 a year for a sole proprietor, as of July 2011.

General Liability

Another type of insurance for sole proprietors to consider is general liability insurance. This basic insurance covers injury claims, property claims and advertising claims. Most sole proprietors carry this kind of insurance since it covers all kinds of employment. Insurance companies require sole proprietors to fill out questionnaires answering numerous questions before they give quotes. Costs for general liability insurance depend on the location of the business, yearly revenue and the past claims history of the sole proprietor. It could be as low as $500 to as high as $15,000 a year for a sole proprietor, as of July 2011.

Related Reading: Sole Proprietorship & Health Insurance

Factors in Cost

There are many factors that are considered in determining the cost of insurance for a sole proprietor. These factors include the type of business being insured, the state where the business is located, the annual revenue for the business, the number of professionals providing service and whether or not there have been any claims in the past. Sole proprietors are the only individuals that need to be insured for their business, a factor that usually reduces the cost of the insurance.

Other Insurance

Besides general liability insurance, sole proprietors need to consider the cost of health insurance. Health insurance premiums can be deducted from sole proprietor's income for tax purposes. The price of a health insurance plan depends on a number of factors including the age of the individual and whether the individual smokes or is overweight. These risk factors typically lead to higher premiums. Health insurance premiums under a sole proprietor can range from $508.76 for an individual and $1,294.31 for a family as of July 2010.

ClaimPay MD - Payment Options

Need to Pay Your Bill?

ClaimPay MD offers convenient online payment by credit card or checking account. All you need is your ClaimPay MD's account number and ZIP code.

Account Billing Plan

ClaimPay MD's account billing plan* is similar to how credit card statements work. We bill you for individual insurance policies just as a credit card company bills you for purchases made at individual retail and service stores. Then we apply your payment on your monthly balance to your account, not to individual insurance policies—the same way a credit card company applies your payment to your monthly balance, not to individual purchases.

Flexible Payments
With the account billing plan, you may pay the minimum monthly amount due, the full account balance or any amount in between. If you pay more than the minimum due, we apply the difference as a credit to your account. You won’t receive another bill until the credit in your account is not enough to pay the minimum amount due..

Payment Schedule
We issue your statement at least 20 days before the payment is due. To continue your policies in force, you need to pay at least the minimum amount due. If we receive less than the minimum due, all the policies in your account could be canceled. If your policies are not canceled for the non-payment, the full account balance may be required on future billings.

View a sample personal insurance billing notice
View a sample business insurance billing notice

Electronic Funds Transfer

With electronic funds transfer, your payment is automatically deducted from your bank account each time your premium is due. No checks to write. No postage to pay. No need to worry about forgetting to make your payment.

Each payment appears on your bank statement for easy record keeping. When you use electronic funds transfer, you avoid transaction charges that are applied to monthly billings when you pay by check or credit card.

To sign up for electronic funds transfer:

• Download, print off, fill out and sign the Policyholder Authorization for Electronic Funds Transfer
• Attach a voided check or savings account slip
• Mail the Authorization Agreement and voided check or savings slip to your insurance agent

Be sure to pay the current amount due on your policy and any additional invoices you receive. This will ensure that your coverage is continued until your electronic fund payments begin.

Online Payment

If you are not set up for electronic funds transfer and need to make sure your insurance payment arrives on time, you can use your credit card (Visa®, MasterCard® or Discover®) or checking account to pay your bill online. All you need is your ClaimPay MD account number and the ZIP code shown on your billing statement. Enter your payment through our website:

Make Online Payment Now

Payment must be entered on the website by 6:45 p.m.Pacific Time, Monday-Friday (excluding holidays), to be credited to your account the same day.

The same transaction fees that apply to mailed payments are applied to each online payment. A payment entered on the website is applied to your credit card or taken from your checking account the following business day.

For website assistance, contact IT Support between 6 a.m. and 6 p.m. CT, Monday-Friday (excluding holidays).

Phone:
Toll Free:
Email: 

If you get voice mail, please leave a number where you can be reached.

If you have billing questions, contact your independent insurance agent.

Payment by Phone

To make a payment by phone, call (360)  and respond to the automated prompts. You can choose to pay by checking account, savings account or credit card.

Pay-by-phone is available to all direct-billed policyholders for standard invoices, as well as audits. Accounts currently registered for electronic funds transfer (automatic payments) are not eligible.

Payment by Mail

* Electronic funds transfer and online credit card and checking account payment are available to business insurance policyholders in the states where ClaimPay MD has business..