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Autus Health

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An Interview with: Kimberly Monroe

Director of Patient Accounts

What does Autus Health do?

We offer medical billing, credentialing and consulting.

What areas do you serve?

We are an online company that services the entire U.S.

How long has Autus been in business?

We have been in the medical billing industry for 20 years.

Who are your typical clients?

We work with a wide range of multi-specialty medical practices, both large and small.

What are the benefits of outsourcing?

  1. Increases cashflow. We’ve increased all of our clients cashflow, anywhere from 10% to 30%.
  2. Frees up internal resources. We free up the medical staff so they can do what they do best: help patients.

What should a potential customer look for in a medical billing company?

  • Accountability – Are they transparent with their records? Are they getting you the best rate possible?
  • Knowledge – What area of healthcare do they specialize in? Is their specialty a fit for your practice?
  • Experience – How many years have they been in business? Are there any customer reviews about them? Testimonials?
  • Training – What is their process for keeping up to date with industry changes? Training? Background and experience?

What are the most commonly asked questions you get from potential clients?

  1. How much will it cost?
  2. How long has your company been in business?

“We want to help medical practices optimize their revenue by billing each procedure at the best rate.”

Kimberly Monroe, Director of Patient Accounts, Autus

How can Autus increase revenue for a practice?

There is often more than one way a doctor can perform a medical procedure. We want to help medical practices optimize their revenue by billing each procedure at the best rate. A vasectomy, for example, can be performed two different ways. Are practice billing the correct procedure? Also, correctly coding medical services is extremely important. Most billing staff will just bill whatever the doctor has written down because that’s the way they’ve done it for years. But in reality, there are several different ways they could improve their current coding process to maximize revenue. We find lost revenue that is left on the table that doctors do not even know they can bill for.

Do you require your clients to use a certain software?

No. Most practices already have their own medical billing software. We’ve learned to adapt to most medical billing software, so there is no need for our clients to switch over to an entirely new system. We can work with what they have.

How do you follow up on unpaid claims?

We take a look at every denial and find out why it was denied. If the denial code is not something we recognize or it’s a generic code, we call the insurance company and work through it with them. All of my employees have a daily list of any denials and follow-up calls of unpaid claims or denials they have to work through and complete by the end of each day.

How does a client know that their data is secure with your company?

We are HIPAA compliant and all of our files are encrypted.

What is your fee based on?

Our fee is based on a percentage of net collections within the practice.

What is unique about Autus?

We are well-known for our aggressive AR (Accounts Receivable) clean-up and management. We pride ourselves on having a higher than standard clean claim rate and collection rate on policies.

Insurance companies will usually deny a claim because they don’t have enough information to warrant payment. In the majority of cases, the medical billing staff will just accept the denial. Or, a common policy for practices is the following: try twice; if that fails, write it off. Most internal staff don’t have the time or know-how to make multiple attempts to get reimbursed for each claim. After 25 years of experience in the medical billing industry, I’ve seen at millions of unpaid insurance money go unclaimed and written off by doctor practices. That’s why hiring an aggressive medical billing company is so important: you want someone with the time and resources to make sure you get appropriately reimbursed for the services you provide.

“We offer a simple solution for a complex industry.”

Kimberly Monroe, Director of Patient Accounts, Autus

What excites you about your industry?

It is always changing. I love change and I love knowledge. I love cleaning up accounts receivable and doing a good job for my clients. In the end, it’s all about the numbers.

What is your company’s mission statement?

The healthcare industry is ever-changing and you really have to stay abreast of those changes. That’s a full-time job. We are the solution to the complexity. We want to maintain and hopefully increase a client’s cash flow. Most doctors don’t even look at their medical billing. And they shouldn’t have to. They should be able to trust that their medical billing team is appropriately handling all claims. In some cases, when we first come in to help a practice, we find that their accounts receivable is clear, which seems like a good thing. But it is clear because they were writing every denial off, which is NOT a good thing.

“We don’t write anything off unless it is absolutely 100% contractual or does not meet coding guidelines.”

Kimberly Monroe, Director of Patient Accounts, Autus

Tell us about a time when you went above and beyond for a customer.

We had a client who was an ophthalmologist. He performed a blepharoplasty procedure on a patient who had droopy eyelids. It was a $4800 (standard price) surgery to do both eyes. His insurance company denied the claim, stating that prior pictures are required to prove the necessity of surgery. The response of the doctor’s practice: “Oh, we didn’t take any prior pictures. We’ll just write it off this time and know we need pictures for the future.” But we pushed back and said: No, let us fight this for you. So we wrote an appeal letter to the insurance company asking: “where does it state in your contract that prior pictures must be taken before you perform a blepharoplasty?” The insurance company could not prove that was a requirement and guess what? They ended up paying for the procedure.

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