RAOps, dba Reimbursement Associates

Orland, CA - - Founded in 1991


REIMBURSEMENT ASSOCIATES (RA) WHAT ARE WE?

A medical billing service with clients in thirty states across the United States, processing health care claims totaling approximately $36 million per year.

Our Focus: Billing for clients who provide home care, specializing in infusion drug therapies, prosthetics, orthotics, durable medical equipment, skilled services and medical supplies.

OUR MISSION:

"Collect the maximum amount reimbursable in the least amount of time on behalf of our healthcare provider clients while maintaining the highest standards for our work and professional relations."

We bill all commercial lines of third party insurance plus Medicare, Worker's Comp, the VA and CHAMPUS.  But, billing is NOT all we do.  We also verify insurance benefits and follow each and every claim until it has fully resolved.  In addition, we are often required to provide patient estimates and calculate deductibles and patient coinsurance amounts; then make financial arrangements with patients to collect these amounts.  We also negotiate discount rates with insurance case managers and it is not uncommon for one single negotiation process to consume four to five hours of a manager's day.

We educate professionals of the home and personal care industry having had articles accepted for publication by the National Home Infusion Association, the CA Pharmacy Association, the National Association of Home Care Management, the National Association of Medical Product Suppliers and more. 

We have also provided speakers on a national level in various forums on topics related to home and personal care receivables management.

In addition, we publish a periodic Newsletter out of our Orland office which goes out to our national clientele and professional associates.

We are proud to have a fully functional Medicare Compliance Plan as well as Compliance, Privacy and Security Officers who provide management and staff with perpetual information, training, monitoring and quality assurance pertaining to the work done by our staff on behalf of our clients nationwide.

HISTORY OF THE COMPANY

We opened for business on October 21, 1991, with one infusion client in Racine, Wisconsin, and projected annual revenues of $30,000.00.  The Company was founded by Cindy Ussery, CPAM, CCAM.

Presently, RA employs twenty-six full and part time employees who together produce revenues in excess of $1.8 million annually. 

WHY AN AGENCY LIKE OURS? 

To begin with, the  home infusion drug therapy industry (historically) had a difficult time getting paid for services, for many reasons:

-The price charged for home infusion therapy is significant.  This is because even though the home care takes the place of an inpatient stay, the most expensive part of the hospital stay is often what they call "MED/SURG" and PHARMACY.   Home Infusion Therapy is the equivalent of Med/Surg and Pharmacy in the hospital.  Consequently, when the patient goes home on an infusion therapy, the only thing the plan really "saves" is the cost of the hospital room. 

-Because of the large dollar amount of each claim, our claims must go to the senior claims examiners as entry level staff are often not authorized to pay claims in excess of as little as $200.00.

-In the early years of the home infusion therapy industry, insurance companies would not pay for infusion therapy at home because their medical directors did not believe it was safe to conduct these therapies at home.  Back then, much time was spent on the phone trying to convince insurance companies that there was money to be saved by them if they would authorize the home care versus continued hospitalization.

-Most insurance plans have different benefits for different types of service: (Hospital, medical, dental, DME, Vision, Home Health, and Rx…).  Each portion of the insurance plan may be subject to it's own deductible and coinsurance percentages.  Along comes home infusion and it effectively forces the insurance carrier to evaluate four or more different parts of the health insurance benefit before making payment because home infusion therapy includes drugs (Rx plan); supplies (Major Medical); electronic and durable medical devices (DME); and, skilled nursing (Home Health).  In addition, because our claims are paid from various portions of the insurance plan, communicating the charges has required employees to posess high skill levels in medical claiming because until very recently, we used HPCPS codes for drugs and DME, Revenue codes for skilled services, and CPT4 codes for supplies.  This is absolutely unheard of in the medical billing industry, but was quite necessary for successful reimbursement due to the absence of standardized coding mechanisms for these and related services prior to the standardization of transaction code sets brought about under HIPAA.

These obstacles contributed to the fact that the average days of sales outstanding for the average provider doing billing in-house could be as high as 150!

Our expertise has allowed us to offer our clients a DSO of sixty or fewer days.  We expect this to improve when HIPAA is fully implemented and payers are forced to accept claims electronically from ALL health care providers. 

We watched the Centers for Medicare and Medicaid Services (CMS, formerly HCFA) consolidate the administrative functions for providers of durable medical equipment, prosthetics, orthotics and supplies in the mid 1990's and now work with all four Regional DMEPOS Carriers contracted to CMS for Medicare Part B claims administration.  This consolidation led us to expand our outreach to include durable medical equipment in 1999 and we added full service claims management for prosthetists and orthotists in 2001.  We now provide claims management services for all DMEPOS providers and suppliers nationwide and have established a successful and cooperative relationship with all four DMERCs.

OUR CULTURE and STAFF RETENTION EFFORTS:

Each year, our Company celebrates National Patient Financial Management week the third week of October.  It is during this week that the staff are honored for their contributions to the work of the Company.  We give productivity awards for "top producer",  "best DSO" and "most improved".  We also give President's Awards for overall Excellence in Management, Technical Assistance and Operations. 

Each month, staff nominate one another for Positive Person of the Month.  The monthly winners are then judged and the overall winner is named Positive Person of the year. 

Finally, the most prestigious award of all is our Randy Morgan Award for "Astonishing" Customer Service.  For those of you that have yet to hear Randy Morgan speak, we offer the following:

Randy Morgan, Assistant General Manager at the Coeur d'Alene Resort on the Lake in Coeur d'Alene, Idaho is single-handedly responsible for staff morale and motivation at this world famous resort.  Our GM had the opportunity to hear Randy speak at a conference she attended in the Fall of 1994.  She was so impressed with Randy's "Attitudes for Astonishing Service" that she purchased his video tape series and brought the concepts back to our Company in Orland, CA.

Randy believes that everyone gives good service and some companies even give great service.  BUT only the companies that provide astonishing customer service will survive in the future.  Randy says this is because the US population has come to "expect" good and even great service and that means that "anything short of "astonishing" is nothing more than mediocre."  We agree.  Randy Morgan helped our staff to see that providing excellent service is vital and that it is a matter of "wanting" and "choosing" to and that we have more fun at our work when we choose to "astonish" people.   Hence, the "Randy Morgan Award for Astonishing Customer Service".

Our clients submit nominations each year and an outside source provides us with judging services.  The winner of this award receives a $400.00 cash prize plus a few other perks.

As you can see, we are "into" customer service.  The more astonishing the better!

In addition to PFM Week:

We enjoy a family picnic or group event every summer and a Christmas party every December (both are hosted by the Company).

We honor staff on their birthdays and have eleven paid holidays PLUS two "floating" holidays for each staff member per year. 

Staff elect the "Positive Person of the Month" each month and the winner receives $50 in cash.  All monthly winners are eligible for the annual award of $250.00!

We have a "good times" committee that organizes our monthly pot luck lunches and other season events (like the Halloween costume contest) and other fun things.

We "adopted" the residents of a local assisted living center in our town and we celebrate the birthdays of each of the residents.  At the end of each year, we coordinate and sponsor a special Christmas party for all the residents who each prepare a "wish list" for us in advance.

EMPLOYEE BENEFITS:  In addition to above-scale hourly wage, staff enjoy a monthly spending credit (which can be applied toward the purchase of health insurance, child care or other qualifying expense within our Section 125 Cafeteria Plan) and a 401K retirement plan.  In addition, staff are eligible for flex time and we often have at least a couple of elementary school age children in our lunch room after school doing homework and enjoying an after-school snack while their parents finish their work day.

Finally, we manage a Christmas Club account for staff wishing to set earnings aside for this purpose.

How busy are we?

We make every effort to have fun, but we're very busy:

    Our long distance phone bill ranges from $5 to $6 thousand a month

    We receive more than three hundred pages of fax transmission daily

    UPS makes three stops at our office each day, Fed Ex one or two

    We have more outgoing mail (on a daily basis) than any other Company in the entire county and we

          rank among the top three in incoming mail daily.

    We maintain in excess of six thousand open patient files on site on any given day and handle close to

          one hundred thousand patient files per year.

    At any given time, we are actively in pursuit of $6 to $8 million which has been billed but not yet paid

          by insurance.

MEET THE OTHER PEOPLE WHO MAKE IT HAPPEN:

Guy L Ussery, Director of Operations

Guy brings strong customer service skills to our team having been the recipient of several national customer service awards for excellence in the auto industry prior to joining our staff.  Guy is responsible for monitoring customer satisfaction, maintaining our physical facilities, purchasing and payables, and oversees company receivables.  Tenure with the Company: twelve (plus) years.

Kristie Ellis, Director of Patient Financial Services

Kristie is an honor graduate of CSU Chico (majoring in economics).  Kristie came to us with a wealth of experience with EDS (the Medi-Cal Fiscal Intermediary for the state of CA), Blue Shield of Northern California as well as having worked for a local hospital and physician in her career.  Kristie and her staff of eight managers and eight assistant managers are responsible for the actual work product of the Company, which is medical claiming and receivables management.   Tenure with the Company: eleven (plus) years.

Emily Hansen, Director of Systems and Information

Emily came to us, in April 2002, with four years of management experience.  She is responsible for our systems maintenance, electronic claiming and e-communications, work audits, regulatory compliance, regulatory development and implementation, and serves as special projects coordinator.  Emily is also responsible for reception and operations staff.   Tenure with the Company: two (plus) years.

Jennifer M Sites, Director, Compensation and Benefits

Jennifer is an honor graduate of CSU Chico with a major liberal studies.  She is primarily responsible for our Cafeteria Plan, Retirement Plan and other staff benefits. Jennifer also works closely with our accountant and serves as Chairperson of the RA Board of Trustees.  Tenure with the Company: twelve (plus) years.

Other principals include:

Sheila Ekis, Senior Patient Financial Manager

Jessica Allen, Senior Patient Financial Manager

AND: The friendly voice answering most of our incoming calls belongs to Irene Landeros, Secretary of Operations.

Conclusion:

Our Company has seen tremendous growth since its inception in 1991, and we have assembled an excellent team of professionals (many have been with us for eleven or more years).  We have implemented many changes throughout our history which have had positive impact on productivity and staff retention.  Our President believes that if the Company takes care of the staff, the staff will take care of the customers…

We look forward to being in business for a long time and to providing a professional atmosphere for people who want to work hard, continue to learn and grow and enjoy above scale wages for the work they produce.  We also look forward to continuing to provide our customers with "Astonishing Customer Service"!

We welcome your inquiries and will happily respond to all requests for additional information about the Company and the comprehensive range of services we offer.

Thank you.

Reimbursement Associates


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