Financial Network Insurance Consulting Licensed in 50 States
Please contact us at: 800 767 1043
Financial Network Healthcare Insurance / PFNSA
FACILITATOR MANAGEMENT SERVICES
INSURANCE PRODUCTS MARKETING SERVICES
INSURANCE PRODUCER MANAGEMENT SYSTEMS
- MEDICAL MARKETING
- MEDICAL MULTI-PRACTICE
- MEDICAL BILLING MANAGEMENT
- MEDICAL OPERATIONS AUDITS
- MEDICAL SYSTEM CONVERSION
- EMPLOYMENT SERVICES
- INSURANCE APPLICATION MANAGEMENT SYSTEMS
HEALTHCARE FINANCE / MEDICAL BILLING / REIMBURSEMENT
Insurance Producer Consulting Servaices /Provider Contracts Managed Care Systems Patient Insurance Enrollment
Inpatient/Out Patient Medical Billing Systems Collections
State & Federal Compliance
Dynamic, visionary and results-focused change agent with Master's level training in Healthcare Management. Comprehensive knowledge of healthcare industry coding and 20 years of progressive contributions to provider contract development and management, revenue collection, compliance audits, problem solving, systems implementation, development of guidelines for healthcare providers. Provided management expertise in Operations, Accounts Receivable, Billing, Collections and special projects for major Boston medical providers. Implemented streamlined billing systems that maximized payment and assured compliance. Processed more than $3,500,000,000 in payments for medical services. Consistently increased provider collection ratios, improved efficiency and cost effectiveness of financial systems.
BUSINESS OPERATION TRACK
HEALTHCARE PROVIDER CONTRACT MANAGEMENT SERVICES
Financial Network Healthcare Insurances Services / PFNSA
Newton, MA, Please contact us @ Contact 800 767 1043
Consulting company specializing in insurance products, financial evaluations, strategic management implementation and process maintenance for the insurance healthcare industry.
Responsible for verifying over four billion dollars in revenue collection, performing skilled meticulous audits for service rendered. Boosted collection ratios, formulating tactics to restructure and economize client medical systems. Relieved client financial burdens through retrieving 75% of all disputed medical insurance claims. Designed and developed conversion systems, effectively implemented systems and provided installation support.
- Negotiated and authored key contracts with private practice firms and managed patient accounts, as Founder of Physician Financial Network Service, Inc.
- Analyzed and negotiated ancillary, hospital and physician contracts for the entirety of product lines.
- Ensured compliance with interior contracts such as finance and corporate legal departments, and with external agencies such as HCFA, HIPAA and OIC.
- Created and distributed renewal contracts for clients, as well as allocating follow up literature.
Managed new contracts, negotiated current and renewal contacts. Project entailed an in-depth understanding of contract issues involved in provider credential, financial solvency requirements, regulatory requirements, hold harmless clauses, patient access, and the grievance process.
- Factored in operational parameters such as claims turnaround time, contract assignments language, a variety of payment methodologies, coding classification systems, and several different rash and incentive arrangement.
- Ensured that provider contracts in full compliance with regulatory agencies like HCFA, State insurance commissions.
- Reviewed and negotiated parts or all of many hospitals, physician, and ancillary contracts for all products lines in a highly competitive environment.
- Sought out changes required in contacts provisions by finance, regulatory compliance, corporate legal and other departments in addition to external agencies such as HIPAA, OIC, and AND HCFA. Verified that all provider contracts changes accurately incorporated.
- Maintained the inventory of existing provider contracts, coordinated the renewal schedule, and negotiated many of ancillary services contracts.
- Coordinated the production, mailing, and follow-up for new and renewing contracts.
- Collected over three billion in revenue claims appeals and rebilled claims.