Case Summaries

  1. Problem: Due to inappropriate use of visit codes, a physician received sanctions from a major payer.
    Solution: A well-designed physician education program, endorsed by the payer.
    Result: The payer removed its sanctions and normal payment patterns were resumed.

  2. Problem: An eight-physician practice in California was inadvertantly using an incorrect procedure code, creating a situation of overpayment.
    Solution: Negotiations between the payer and the client and a plan of resolution was developed.
    Result: Penalties of greater than $250,000 were avoided by the practice.

  3. Problem: A family practitioner leaving a large established group practice has no billing system or trained billing staff.
    Solution: Transfer billing responsibilities to MMS.
    Result: Practitioner experienced a 31.8 percent increase in net collections.

  4. Problem: Physician was complaining he was working harder while revenues were decreasing.
    Solution: MMS provided a comprehensive billing audit that discovered dropped charges.
    Result: MMS saved the client thousands of dollars.