AR Rescue LLC

AR Rescue LLC Medical Billing, Consulting, Patient Relationship Management, Contract Negotiations and Information Technology for Physicians and Healthcare Facilities

05/12/2021
AR Rescue on Google

See how your medical discipline ranked in revenue for 2020.

AR Rescues medical specialty specific analytics just released. Contact us for the free report on your specialty.

Boo. This is absolutely awful. I lived through this "model" of care in the early 90's when everything went capitated. A ...
12/10/2020
Humana to offer own Primary Care First model in 48 states

Boo. This is absolutely awful. I lived through this "model" of care in the early 90's when everything went capitated. A turd is still a turd no matter how you repackage it. Poor providers again will be overworked, underpaid and just one more way of the carriers to capture yet again, more pennies out of that strained healthcare dollar. Until carriers are allowed to stop dipping their feet into all these inherently conflicting roles, costs will NEVER be contained and they will become even more powerful. Its pretty touch to serve multiple masters and at the end of the day answer to shareholders on top of it.

Boo. This is absolutely awful. I lived through this "model" of care in the early 90's when everything went capitated. A turd is still a turd no matter how you repackage it. Poor providers again will be overworked, underpaid and just one more way of the carriers to capture yet again, more pennies out...

01/21/2020
Infinity Business Media group

Our amazing and talented Director of Marketing Clay Overlien

The Infinity Business Magazine presents this weeks episode of Wake Up to the New Rules of Business with your host Tony Ferriera. This week Tony sits down with guest Clay Overlien, with AR Rescue. *Special thank you to our show sponsor Storage West Community Relations Team. To listen on podcast, please visit https://www.inblv.com/wakeuppodcast

Great volunteer day at 3 Square.
07/05/2019

Great volunteer day at 3 Square.

Give back December 2018 Goodness Gracious Ministries. Amazing and innovative to help serve our homeless. Feeding and ele...
12/13/2018

Give back December 2018 Goodness Gracious Ministries. Amazing and innovative to help serve our homeless. Feeding and elevating people! Love this organization. Please support them...

Economic Development and Small Business Awards (2019).
11/23/2018

Economic Development and Small Business Awards (2019).

Economic Development and Small Business Awards (2019).

11/13/2018
AR Rescue has been nominated by the Henderson's 19th Annual Economic Development and Small Business Awards for the Busin...
10/17/2018
Henderson Chamber of Commerce|Representing Business in Henderson NV - Henderson Chamber of Commerce

AR Rescue has been nominated by the Henderson's 19th Annual Economic Development and Small Business Awards for the Business on the Rise Award. The link below will direct you to Henderson Chamber of Commerce website. Click "Vote Now" to enter your information and cast your vote! Please be sure to share with anyone you feel may be interested in voting.
https://www.hendersonchamber.com/
Voting closes on Monday, October 29, 2018 at 3p.m.

Dedicated to the growth and progress of the community of Henderson, Nevada.

Congratulations to all the Doctors!
09/13/2018
Clark County Medical Society Members Recognized Among “Best Doctors in America”

Congratulations to all the Doctors!

The Clark County Medical Society (CCMS) proudly recognizes 49 physician members who were included in the Best Doctors in America List, an annual list published by Best Doctors that includes the nation’s most respected specialists and outstanding primary care physicians. Best Doctors, a global bene...

Announcement...So honored to be asked to serve and elected as a board member for Lutheran Social Services of Nevada, a l...
09/09/2018
About Us |

Announcement...So honored to be asked to serve and elected as a board member for Lutheran Social Services of Nevada, a leader in helping the homeless here in Nevada. http://www.lssnv.org/about-us/

Lutheran Social Services of Nevada is powered primarily by volunteers and has a variety of opportunities that fit your level of availability. Will you join us in serving those who are in need? Volunteering makes an enormous difference in the lives of others but it also helps you! From lowering stres...

https://www.beckershospitalreview.com/payer-issues/anthem-posts-1-1b-profit-as-membership-falls-888k.htmlIf Anthems prof...
07/26/2018
Anthem posts $1.1B profit as membership falls 888K

https://www.beckershospitalreview.com/payer-issues/anthem-posts-1-1b-profit-as-membership-falls-888k.html

If Anthems profits have increased 23% from this time last year to 1.1 billion in just the second quarter of 2018 ANDthey are insuring 888,000 less patients, why are insurance premiums continuing to RISE!? Greed and virtually no transparency as to how they spend their money, thats how.

Health insurer Anthem reported net income of $1.1 billion in the second quarter of fiscal year 2018, up 23 percent from $855.3 million in the same period last year.

Another great example of insurance carrier loopholes screwing the patient and especially the provider. So here's the rub...
07/17/2018
Georgia physicians sue Anthem over ER coverage policy: 5 things to know

Another great example of insurance carrier loopholes screwing the patient and especially the provider. So here's the rub...you experience chest pain in the middle of the night, get yourself to the ER only to find out that its a bad case of indigestion that turned into an anxiety attack. You pay for insurance for this very scenario. But guess what, now you'll be saddled with a huge ER bill for not having a coronary. Sounds fair right?! Let's ask one of the execs at Anthem what they would have done at midnight...get their ass to the ER or sat and waited it out hoping they didn't die. TIME FOR A CHANGE!

The Medical Association of Georgia and the American College of Emergency Physicians sued Anthem for denying payment for some emergency department services, according to a Bloomberg report.

07/15/2018
AR Rescue

Please pass along to any healthcare providers needing a boost in revenue.

07/15/2018
AR Rescue

Please pass along to any healthcare providers needing a boost in revenue.

More costs and underhanded business practices contributing to skyrocketing healthcare prices.
06/18/2018
Blue Cross accuses North Carolina hospital of overbilling by $76M

More costs and underhanded business practices contributing to skyrocketing healthcare prices.

The legal battle between a North Carolina hospital and Blue Cross Blue Shield of North Carolina continues after the hospital recently reasserted its claim that the insurer is wrongfully withholding reimbursement for lab tests, according to the Winston-Salem Journal.

This goes double for medical billing records. Someone needs to put a stop to. Oh, that's right... they will. Once a majo...
05/20/2018
Healthcare's Dirty Little Secret : Offshoring Private Medical Records | Crunchy Betty

This goes double for medical billing records. Someone needs to put a stop to. Oh, that's right... they will. Once a major industry wide crime takes place. Healthcare...reactive, not proactive.

Imagine you're at the emergency room. You have severe stomach cramps and you're throwing up every 10 minutes. While you probably just have the stomach flu, you're in so much pain and misery, you just want to make sure you're not dying. After waiting an hour or two, you're admitted - checked out by n...

LOVE our employees. So glad we could give them a mid day break for a painting party and lunch. They are the most awesome...
04/18/2018

LOVE our employees. So glad we could give them a mid day break for a painting party and lunch. They are the most awesome bunch. Missed you clay overlien!

"The POSITIVES and NEGATIVES of MACRA" October 2016 was the "Get Ready" month for MACRA.  2017 was the "Get Set" year fo...
01/12/2018
Physician Compare

"The POSITIVES and NEGATIVES of MACRA"

October 2016 was the "Get Ready" month for MACRA. 2017 was the "Get Set" year for MACRA. 2018 is the "GO" year for MACRA.

The "Go" will be good for qualifying MACRA compliant medical providers, and bad for qualifying medical providers who are not MACRA compliant.

The positives of MACRA are the potential of positive payment adjustments of anywhere from 4% and upward each year, plus a high ranking among the provider's peers on, https://www.medicare.gov/physiciancompare

The negatives of MACRA are the potential year end negative payment adjustments of anywhere from 4% and upward, plus a low rating among the provider's peers on,
https://www.medicare.gov/physiciancompare

As the general public is made aware of this "physician comparison" website, they will see how strong, or how weak, their provider compares with other medical providers.

Will patients "shop" for the best ranked providers? Time will tell.

WRITTEN BY: Clay Overlien, Director of Marketing

12/05/2017

A Crucial "to do" before joining or buying a practice.

An appraisal is required before purchasing a home. Banks always require an analysis of financials and an appraisal before lending to anyone.

Why is it then, that most Doctors join and/or purchase a practice without first determining the "Fiscal Health" of the practice they are considering?

A practice assessment/evaluation will find those fiscal issues the banker and CPA have no knowledge of. These issues include improperly coded medical procedures, rejected claims, missed surgical procedures, missed timely filing dates, and the list goes on.

Bankers and CPAs only see what the prepared financials show them. They have no idea of the 25% to 30% of lost revenue found by having a proper assessment completed.

A practice assessment takes a few hours to complete, with results being presented within a day. It is a "non-invasive" procedure, needing very little from the requesting party. The only requirements are a temporary password into the practice's system, and a signed BAA/HIPAA form. This assessment can be performed on cloud based as well as server based systems, normally with no special I/T considerations.

Every, and I mean every Doctor absolutely must see if the practice they are about to purchase or join is fiscally unsound ("hemorrhaging revenue"). An assessment now can literally means millions over the course of your career.

11/27/2017

CONTRACT NEGOTIATIONS FOR PHYSICIANS

As a healthcare provider, one of the trickiest and often most overlooked areas of your practice is renegotiating your insurance contracts. Reimbursement rates by insurance companies have gone down steadily year after year. It is getting more difficult and cost intensive every year to get paid for the same services you have always provided. Healthcare providers that have been in business for more than 10 years are, typically, being paid the same or less than when they first opened their practice. What profession do you know that you have to train for as many years, stay current on new developments and take on such liability as healthcare providers and then receive no pay raises or increases? Only healthcare and it is not sustainable.
A few questions you need to ask yourself about your insurance contracts:

1. Do I have the most recent fee schedule for every contract in my office?
2. Am I being paid more today than I was when I first credentialed with insurance carriers?
3. Are all the procedures I perform for patients reimbursable under my current contracts?

My guess is the answers you have to these questions will be somewhat disturbing. Our studies show that less than 3% of healthcare providers have actually negotiated or renegotiated their insurance contracts. The following are some tips to get you started:

1. REVIEW YOUR CONTRACTS. Most insurance carriers issue 2-year contracts with healthcare providers. These often are self-renewing and come with nothing more than a letter stating how pleased the insurance company is to extend a renewal of the healthcare providers contract. When receiving your renewal letter or notice, immediately request a complete and revised fee schedule. We are amazed at the number of healthcare providers that simply accept the renewal without reviewing the new rates or details. Some carriers will automatically renew your contract with nothing more than a letter stating such. You have between 30 and 60 days to review and contact the company with any concerns you have. If they don’t hear from you during this time, the fine print says “I accept these modified terms.” The terms are often modified and not in your favor. By digging deeper, most healthcare providers can find a reduction in overall reimbursement for the codes they bill for and additional requirements put on the provider in order to get paid. For example, a procedure you performed more than 500 times last year that did not require prior authorization, may, all of a sudden, now require that authorization. This can be a huge detriment to the efficiency of your practice and an additional cost factor you must absorb by allocating staff to perform this now required function. We have performed more than 100 reimbursement analyses for practices over the years and find the majority of these practices are being paid less than they were when they first started, with more red tape to cut through just to get paid. It is the systematic nickel and diming approach that slowly suffocates healthcare providers over the years. Shouldn’t healthcare providers be paid slight increases every contract renewal to at a minimum keep pace with the additional regulations and service they are required to produce?

2. TAKE A PROACTICE APPROACH. Sitting in the wings does not serve anyone but the insurance companies. Get on the radar in a positive way. Offer to provide in-service events for your specialty for their members. Get involved with their corporate process by understanding their culture. Offer you or your staff’s time at health fairs, health screenings and other such opportunities.

3. UNDERSTAND THE NUMBERS. Insurance companies have cutting edge software and teams of professionals that crunch your numbers and those of other healthcare providers in your field. The approach that you should be paid more because you are a better healthcare provider simply does not work. You need data to back up your claim. Why should an insurance pay you more than Dr. Smith down the street? You’ve both been in business the same amount of time. You are both double board certified in your specialty. You both have served the community for many years. All of that means absolutely nothing when it comes to asking for more money. The insurance carrier will tell you your reimbursement is standard for your field of expertise. You must put a dollar value to what you do and back it up with data.

You need to produce data that the insurance company cannot ignore. Come prepared with patient outcomes equated in a “dollars and cents" practical nature. Show how your approach to treatment has a better and more cost-effective outcome for the insurance company. Your data should easily illustrate that by performing that surgery, it will significantly cost less than the currently approved treatment plan by the insurance company over time. Show your dedication through your numbers. How long does it take your office to schedule patients for their members? How long does it take to schedule procedures or surgery for a patient? What is the satisfaction of your patients with your office (support staff and providers)? An easy to use online questionnaire shows commitment to quality assurance and does matter to insurance carriers. Prove your commitment to cost containment. Illustrate through your numbers your proper utilization of ordering labs, testing and diagnostics. If you perform a lot of surgery and/or procedures, track the patient outcomes and use this data to your advantage. Explain, in a dollars and cents methodology, how performing a higher end, more costly surgery now can reduce costs later. You can easily do this by tracking your clinical data showing reduced utilization of required follow up visits, reduction in such peripheral items such as reduced physical therapy costs, and showing how, if the insurance carrier pays you now, the patient can avoid more costly forms of treatment later. These numbers can be produced and presented in a professional and effective manner with the right software program and expertise to put it in a succinct and powerful presentation. This no different than when an employee comes to you for a raise. Are you going to give that employee a significant raise just because? Of course not! If they came to you well prepared with reasons and supporting documentation as to why you should give them a significant raise, you would be far more likely to do it. This commitment to understanding the business side of your reimbursement will pay immense dividends, especially when considering it is magnified over time. A pay increase of just 5% on your most frequently billed codes can yield tens of thousands of dollars over time.

4. ASK! The fear of repercussion often paralyzes many healthcare providers. I’ve heard horror stories of physicians losing their entire contract because they asked for more money. This goes against common sense. The carriers expect and are pleasantly surprised when you do not come asking for more money. This negotiation is like many other things in life, you must have good relationships. Insurance companies are run by people and developing those relationships are key to unlocking more money. You should view the insurance company as your ally, not your adversary. When sitting down at the table to negotiate, be prepared. Understand your numbers. Show your commitment to quality and cost savings. Get across your appreciation for the carrier’s commitment to the same principles you have. By bringing the discussion to this level, you automatically set yourself apart from the majority of the healthcare providers in the marketplace. Do not demand a raise but instead offer consistent and powerful data that supports them seeing you as a valuable asset in the delivery of healthcare to their members, while always having your eye on costs. It is then that a reasonable pay increase should be asked for.

5. THINK OUTSIDE THE BOX. Asking for an increase to your current fee schedule is not the only way you can earn more money. Many carriers are open to more unique approaches in rewarding physicians such as bonuses for production, cost management and adherence to diagnostic and testing procedures. Ask to participate in these program as well as suggest some of your own.

Written by: Christian Gitersonke, CEO AR Rescue 2017

Address

7385 Prairie Falcon Rd
Las Vegas, NV
89128

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Another grateful client! I'm happy they appreciate me, but it's MY privilege to work with them!