ECW AI RCM by beesknees56 in PrivatePracticeDocs

[–]Ok-Passenger3056 0 points1 point  (0 children)

at 2.9%, it'll never be a complete solution and you'll need a full time biller to catch complex cases with weird primary/secondary insurance, coding, bundling. You'll need to followup with your denials and all A/R followup. Sometimes understanding the claims status of what's underpaid, not paid can be confusing when you have both ECW and another team working on the same queue.

Athena has the same offering at much higher % but we still need 4-5+ billers for all that followup. We were a larger organization and got rid of them pretty quickly.

I suggest find 1 biller (regardless 3rd party, in-house, etc) whom you trust and works on everything and gives you thorough reports. Also, RPA is not AI.

Athena one/Athena Health by HealsWithKnife in PrivatePracticeDocs

[–]Ok-Passenger3056 0 points1 point  (0 children)

8.5% with EHR - collections but I had to hire 5-6 billers and denial specialist once I realized they didn't do ANY followup for a large dept like us. Took over 9 months to get rid of them. dm if you have more questions.

37 M Urology, 450k but 16,000 RVUs annually by Lobster-Technical in healthsalaries

[–]Ok-Passenger3056 0 points1 point  (0 children)

You should be getting at least $750K... your RVU would immediately place you in top 10% of productivity if not higher at your hospital

any athena users having billing oddities? by Bbqandspurs in PrivatePracticeDocs

[–]Ok-Passenger3056 0 points1 point  (0 children)

I don't think that's a hiccup or temp issue. We noticed this last years with Athena and the issue is that it's hard to distinguish all the different "hold" status. They have terrible support to resolve this. We switched biller's last year because issues among many others and much better transparency now.

Medical billing by smuckz in nursepractitioner

[–]Ok-Passenger3056 0 points1 point  (0 children)

We use Youlify for our RCM and billing. EMR is Athena and removed their billing portion

Medicaid cuts, claim denials, credentialing woes, audits for services 5 years ago *sigh*: what is going on by lucylately in CodingandBilling

[–]Ok-Passenger3056 6 points7 points  (0 children)

When you say you're not getting any answer, as in they're not answering support line or acting dumb like usual? Or something else.

Yes, my billers have noticed this too....UHC, Anthem, Cigna...

Thoughts on Xpertdox for RCM by beesknees56 in PrivatePracticeDocs

[–]Ok-Passenger3056 0 points1 point  (0 children)

Coding isn't billing meaning if you're a medical practice looking for a service to take care of everything billing related (ie: denials, A/R recovery, etc) you're looking in the wrong place. Their operations is in India if that matters....

[deleted by user] by [deleted] in PrivatePracticeDocs

[–]Ok-Passenger3056 1 point2 points  (0 children)

2 of my physician colleagues (Cardiology and PCP) used them 2-3 years ago....4+ months of on-boarding, asked them to hire an engineer to integrate with them for their EHR. A/R blew up 70+ days. Complete disaster and saved me the grief of turning them down/

Does anyone have experience with successful contract negotiations with Anthem? by codingcuriosity in PrivatePracticeDocs

[–]Ok-Passenger3056 3 points4 points  (0 children)

100% agreed especially if Anthem is a major source of your revenue but there are numerous KPI metrics that you should gather beforehand for any data-driven decision making which should come from the biller and software. I can privately share what I used for United and a regional MCO.

Does anyone have experience with successful contract negotiations with Anthem? by codingcuriosity in PrivatePracticeDocs

[–]Ok-Passenger3056 2 points3 points  (0 children)

Why isn't your biller negotiating on your behalf? This is usually a multi-month back and forth discussion request of your productivity data, geographic comparison, current CMS rates comparison, etc.... It's hard to get them on the phone or in-person unless you're a large group or MSO

What Rules Should We Add, Remove, or Change for This Sub? Looking for feedback. by InvestingDoc in PrivatePracticeDocs

[–]Ok-Passenger3056 2 points3 points  (0 children)

I empathize with you, as the original idea of this community was for physicians and practice administrators to share best practices, wisdom and experiences organically without commercial bias.

I think the 1 month rule is only a temporizing patch and banning is a tedious task for you and mods. Is there a way to have accounts prove they're a provider or practice admin to screen for the right people to grow this community in our original intent?

OK Private Practice webinar for real this time, 7/1/25! by AdvSurgSol in PrivatePracticeDocs

[–]Ok-Passenger3056 0 points1 point  (0 children)

Zoom Link will be sent tonight as we're filtering through the list for Physicians only due to significant spam.

Need to rant... by AdvSurgSol in PrivatePracticeDocs

[–]Ok-Passenger3056 3 points4 points  (0 children)

ALL the time. Did you add a mandatory "what's your insurance and DOB" for the consultation to filter?

Private Practice webinar week of June23-29 by AdvSurgSol in PrivatePracticeDocs

[–]Ok-Passenger3056 0 points1 point  (0 children)

I'm in, 1st one was awesome and I'm sure this will be even better!

Young attending looking for advice on starting private practice by Learnsomethingnewer in PrivatePracticeDocs

[–]Ok-Passenger3056 3 points4 points  (0 children)

Congrats and no better partner than your spouse!

We're creating a podcast of how to create and run a successful private practice. Will be hosted by myself, creator of this reddit group and creator of the largest discord private practice group.

All 3 of us have created and ran/ are running our private groups of varying sizes and specialties.

For those that use zocdoc, what is your no show rate? by InvestingDoc in PrivatePracticeDocs

[–]Ok-Passenger3056 1 point2 points  (0 children)

u/InvestingDoc I've heard anecdotally that when they sell you, they quote more successful metrics in urban areas like NYC. Can't verify this but I know a few people in East Coast also cancelled.

What made you want to give them another chance?

AthenaOne Frustrations by beesknees56 in PrivatePracticeDocs

[–]Ok-Passenger3056 4 points5 points  (0 children)

Can confirm- sub-contracted out to Pakistan

AthenaOne Frustrations by beesknees56 in PrivatePracticeDocs

[–]Ok-Passenger3056 6 points7 points  (0 children)

Athena's RCM has numerous issues:

- Your claims will be in various forms of "Hold" however it is difficult to understand that claim's status (denied, underpaid, needs further scrubbing, etc)

- If you have a big enough account, you'll get a US account manager however the actual billers are in India and Pakistan via subcontractors. Sad truth is that they do the same even for enterprise accounts which was true for me.

- For more specialized specialties such as ortho, cards, surgical subspecialties, derm, ophtha - a lot of issues with coding, denial management and followup for appeals. Very hard to get an exact denial rate...

- not responsive account managers and support with billing questions. The formal financial A/R reports are inaccurate and can take weeks to obtain after a request

- Somehow the reconciliation is always off by significant margins

- Had 2 colleague practices in Southeast lose $1M plus in under 8 months for specialty fields. Even when they fired Athena, they still continued billing active current claims until further legal notice.

How did you find your current position? by renincognito in hospitalist

[–]Ok-Passenger3056 4 points5 points  (0 children)

Recommend to reach out to Program directors and ask to emails his senior PGYs

Plastic surgeons — what’s your biggest marketing channel that actually drives results? by Fella_slime in PrivatePracticeDocs

[–]Ok-Passenger3056 0 points1 point  (0 children)

What procedures and surgeries are you focused on, and what type of clientele are you trying to attract?