Full Service Billing - FAQs

We Focus On Your Business, so You Can Focus On Your Practice

Time is a practice's most precious resource.

Are you spending more of it running your business than seeing patients? Are you wondering why you spent so much time in medical school; if most of it each day was going to be spent on human resources, information technology and accounting details - just to get paid? Or worse, are you worried that you aren't spending enough time to assure that you are actually collecting everything that is due? Does your billing stop when your office manager is out of time, on vacation or unavailable?


Let Akamai's team of medical billing professionals take the worry and time commitment out of your daily billing, claims processing and banking tasks. Free up your office for what you are there to do, provide care for your patients.


Why do practices outsource their billing?


The reasons are myriad. Many are centered on personnel; unavailability of experienced personnel, frequent staff turnover or over-dependence on a single person.


Other reasons are managerial; lack of time to appropriately oversee billing staff, insufficient knowledge, time, or motivation to review financial reports.


Others are financial; practices don't want to hire full-time, experienced billing staff when they are first starting out, want to minimize upfront costs of getting paid, or want billing costs to be a fixed and predictable cost as a percentage of revenue.


What services does Akamai perform?


Although there are occasionally variations, for most clients, Akamai provides the following:


  • Detailed demographic registration
  • Review of charges and entry
  • Claims submission (for most practices 85%+ will go electronically)
  • Patient billing
  • Payment and remittance posting and reconciliation
  • Deposits to your bank
  • Telephone inquiries from both patients and insurance payers
  • Follow-up on unpaid claims
  • Courier service (on Oahu)
  • Easy to understand management reports
  • Remote access to your practice management system
  • Annual payer recertification

In general, we attempt to relieve the practice from as much billing responsibility as they want, while still retaining enough control to maximize collections.


What does all of this cost?


Start-up costs are minimized and for most offices there is little or no IT expense. 99% of monthly costs are based on a percentage of what is collected and deposited into your bank account. This approach aligns Akamai's goals with the desires of your practice (to maximize collections) and keeps cost low during times when collections are constrained (perhaps when a practice is first starting out) and only increases as revenue grows to afford it.


The percentage is based on a combination of factors, including specialty, complexity of the billing and insurance mix. There are no "hidden" monthly fees for banking transactions, access to your data, on-line reporting or monthly minimums.


Our transparent pricing approach includes virtually all costs associated with your "revenue cycle management" including billing staff payroll, software and server expenses, postage and materials, forms, supplies and telephone (even long distance) charges.


What is the term of the billing agreement?


Our contracts are nearly always for an initial term of six months, which then convert to a month-to-month format. If we are not performing to your expectations the agreement can be terminated with sixty days notice. You should expect your billing organization to earn its keep every single month, and frankly, we are happy to accept this responsibility.


Furthermore, we feel that agreements longer than this place unreasonable restrictions on the ability to manage a practice efficiently. A physician shouldn't be put in a set of handcuffs that restricts making changes if performance isn't acceptable, if practice patterns change or if it is decided that in-office billing would eventually suit them better.


Can I see my billing information and what does that cost?


With Akamai's full-service billing, your practice will have access to the most up-to-date practice management system available in Hawaii. It has been completely designed with the specific idiosyncrasies of Hawaii's healthcare environment in mind. It is currently used to bill for approximately 600 physicians statewide.


Your data resides on Akamai's server and you have the option to access it securely over the Internet. This provides the ability to look up patient balances, transaction histories and run reports. For office-based practices, our practice management system also allows online scheduling, automated eligibility checking, forms generation, lab requisition printing, chart pull lists and a variety of additional office efficiency functions.


All that's needed for access is a PC and a broadband Internet connection. There is no charge for access for the first two computers per practice.


How will I know who to contact at Akamai?


For solo practices, we assign a single account manager who is primarily responsible for your practice's collections. They become the designated point of contact for billing questions, procedural issues and day-to-day interaction.

Although there are obviously others who may periodically assist with your practice, your account manager will not just monitor your practice's overall performance, but will be actively involved in all phases of your billing and collection effort.


The account manager is assisted by a team of other billers, our billing department manager and our staff accountant who reviews every account each month.


Who is responsible for following up on un-paid insurance claims?


Akamai and not the office; plain and simple.


Other billing services frequently rely on office staff to contact payers, resolve problems, research payment issues or even identify unpaid claims. These are all our responsibility.


Of course, the office may be asked to provide additional information such as operative notes to justify appeals of payment denials and we will need a primary contact person in case we need information only available from the charts.


Please note that the responsibility for prior authorizations, referrals and clinical justification for care is the responsibility of the practice.


Who is responsible for patient balances?


Akamai, in conjunction with the office.


Obviously everyone benefits when payment for co-pays and other predictable patient balances are collected at the time of the visit. Furthermore, if a patient has a delinquent balance, we would expect the office staff to address this if the patient comes back to the office.


However, it's Akamai's responsibility to contact responsible parties, get clarifying insurance information when needed, follow-up on unpaid balances and, when necessary, suggest balances that need to be turned over for more advanced collection proceedings.


Our most successful practices work closely with their account manager to resolve any delinquencies.


How long have you been doing this?


Akamai's principals have been involved in collecting for providers in Hawaii (through Akamai and predecessor companies) since 1981. The experience that we have garnered and feedback from our clients have allowed us to refine our software and procedures to provide optimum results.


What can I expect in terms of results?


The vast majority of our clients see significant improvements to their collection efficiency within the first four to six months of Akamai assuming billing responsibility.


However, let's be honest. A high percentage of our new clients are hiring us specifically because they have current problems and really need our assistance. It's no wonder that we can make substantive improvements for these practices.

Sure we have great professional staff and they work with exceptional technology. But we have no magic bullet. A well trained and dedicated office staff, armed with the same technology should be able to do an equally good job.


What we can promise is that stresses of personnel issues, oversight of the billing process, cash control concerns and worries about timely submission of claims will all go away.


The vast majority of our existing billing service clients have been with us for a very long time and would never dream of taking the billing process back "in-house"


What about document storage and access?


All paper documents related to the practice's billing are scanned and available on line. These include correspondence, registration forms, encounter forms (superbills) and remittance documents. Electronic documents (principally EOBs from HMSA, Quest and Medicare) are also available online.

This relieves the practice from storage issues associated with the monumental avalanche of paperwork and provides ready access when needed.


What about EMRs?


Akamai works with more EMR programs than any other practice management company in Hawaii. In general it's possible for us to integrate with most EMR packages and we have integration experience with both in-office and hosted EMR options.


What about appointment reminders?


For clients that access our practice management system in their office for scheduling, an option exists for automated appointment reminders. This cost-effective and efficient system automatically calls, emails or text-messages patients with reminders about upcoming appointments.


Our studies have shown that this service easily pays for itself and effectively reduces the number of no-shows. If interested, please contact us for specific information applicable to your practice.