Consulting

NYS Workers Compensation Electronic Billing Partner

Book Consultation

Let us help you strengthen performance across your entire revenue cycle.  With 40+ years in medical billing, collections, and consulting, K&K Systems is a leader in the Medical Billing Industry.  Fluent in complex insurance such as accident billing (NYS No-Fault & Workers’ Comp), K&K Systems helps practices turn intricate rules into a predictable cash flow.  Your financial strength is directly tied to timely, accurate billing and reimbursement; our consulting program is built to make that your norm.

Review — Objective Snapshot of Today

We begin with a structured assessment led by our Practice Management Consultants:
  • Front-desk to claim submission workflow mapping (eligibility, intake, authorizations, documentation).
  • Coding review (CPT/HCPCS, modifiers, ICD-10, medical necessity, frequency limits).
  • Payer-mix analysis (Commercial, Medicare/Medicaid, No-Fault, Workers’ Comp).
  • A/R & denials baseline (aging by bucket, avoidable denial categories, write-off patterns).
  • Compliance posture (HIPAA handling, PHI touchpoints, internal controls).
  • System audit (PMP/EMR settings, superbills/templates, clearinghouse edits).

Analyze — Targeted Plan to Improve Results

Next, we quantify impact and design a prioritized improvement plan:
  • Role & task design: clarify job scopes; remove rework and bottlenecks.
  • Coding & documentation uplift: align codes/modifiers to payer policies; tighten documentation prompts and templates.
  • Edit rules & clean claims: payer-specific edits, attachments checklists, and claim-scrub sequences.
  • A/R acceleration: follow-up cadences; appeal templates by payer/program; attorney coordination (where applicable).
  • Submission framework: first-pass yield, denial rate, days in A/R, net collection %, productivity per FTE.
  • Governance & controls: close loops for PHI handling; change control for fee schedules and templates.

Implement — Coach, Measure, and Iterate

We make the plan real with light-touch, high-impact support:
  • Staff training & job aids: role-based sessions for front desk, billers, coders, and providers; quick reference cards and checklists.
  • Template & tool updates: refreshed superbills, cleaner charge entry, payer-specific edits, and routing rules in your systems.
  • Weekly working sessions: unblock issues, track tasks, and escalate denials.
  • Monthly executive review: A/R dashboard, KPI trends, and next-step adjustments.
  • Updated workflows/templates loaded into your system.
  • A living dashboard and Monthly Summary you can share with leadership.

What We Cover (Scope Examples)

  • Accident billing mastery: NYS No-Fault & Workers’ Comp forms, timelines, and documentation standards.
  • Eligibility & benefits: front-desk prompts and real-time checks to prevent avoidable rejections.
  • Coding optimization: CPT/HCPCS, modifiers, ICD-10 specificity, medical necessity alignment.
  • Denial prevention & appeals: root-cause fixes, appeal kits, and escalation paths.
  • A/R workflow: 0–30/31–60/61–90/90+ strategies; attorney/patient coordination where appropriate.
  • Reports that matter: provider-level, payer-level, and service-line insights that tie to action.

What You’ll Notice

  • Cleaner first-pass claims and fewer denials
  • Faster reimbursements and steadier cash flow.
  • Less staff rework; clearer roles and fewer handoffs.
  • Better visibility for day-to-day operations.