Medical Billing & Revenue Cycle Management

Evolution Consultants uses innovative processes and programs to streamline the flow of information to and from your office, thus reducing the paperwork and filing clutter. Our office has the capabilities to be paperless. We utilize and/or have experience with over seven different software solutions, many of which are fully utilized EHR software. We have the capabilities to learn new software with an accelerated learning curve and can fully implement EHR software and map your billing accurately. 

Evolution Consultants medical clients enjoy decreased days in aging within the tolerance of MGMA standards for their specialty. This means that from the time you bill the claims, you are seeing payment within 20-45 days depending on your payer mix. Please note that for a high volume of workers compensation claims this may be slightly higher.

Evolution Consultants offers CPA-style reporting at the close of each month. These reports display total month production, monthly collections, monthly adjustments, Net and Gross collections percentage, days in aging, average day gross revenue (ADGR), and monthly over-the counter collections. We also offer specialized reporting for practice-specific interest such as DME/Orthotics, X-Rays, and Vaccines. We have overview monthly meetings with our clients.

Evolution Consultants considers the best way to handle collections is to get insurance resolution sooner, and get the patient a statement as soon as possible. We use a set collections cycle once the practice determines the parameters. Our standard timeline is to send three patient statements then to send a 10-day letter if the patient has not communicated with our office or set up a payment plan. Once the ten days have elapsed and the account has been approved by the client, the account is submitted to third-party collections. It is important to note that some providers do not want to pursue collections. Our clients lead the way in determining our collections attitude.

Evolution Consultants works with a wide range of specialties from Orthopedics to Primary Care and have shown the ability to adapt to a specialty very quickly. However, we choose not to work with physical therapy or chiropractic care. We do retain at any time at least two certified coders on staff who are directly involved and oversee quality control on billing/coding and documentation requirements. We provide outstanding communication to our client regarding code combinations and chart documentation. We are never authorized to code or alter codes, but we do scrub charges to provide feedback to the clients.

Evolution Consultants benchmarks our practices on a monthly basis when we compare our client's performance to accepted standards such as MGMA as well as offering comparisons to other date ranges. For those clients who have been with us for years, we have a really compelling history of growth and development with the practice. The better quantity of data, the more interesting comparison we can make.

Evolution Consultants is an audit style billing office. It does take time to perfect the processing and uncover all the information we may need to perfect your practice, but our overall goal is to perfect your practice and have the highest recoveries possible. Partnerships are however, a two way street and we expect a professional ethical partner from the client as well. Our clients have to be able to make changes and monitor their own quality control for responsibilities assigned to the practice.

Evolution Consultants and all of our staff must go through yearly training on CMS Fraud, Waste, and Abuse guidelines. We are a downstream compliant organization. We also train yearly on Red Flag guidelines, HIPAA Compliance, Federal Fair Debt Practices Act, and the Texas Collection Practice Act. We retain certified coders and meet all annual requirements for continuing education and each of them have a keen eye for detail and coding integrity. We are compliant to the Workers Compensation Guidelines as well as investing in continuing education literature from Medicare. We always utilize current year CPT and ICD10 guidelines.

Evolution Consultants performs billing quizzes to test the skills of potential billers. All hiring candidates participate in working interviews, and we check all references. We have excellent staff retention after the first year of employment. Our standards are set high and not all can endure this type of environment. We always promote from within, and are looking for the coachable and pleasant few who shine.