Company FAQ

Question 1

Are coders U.S.-based or offshore?

Answer 1

Dexios employs a mix of U.S.-based and offshore coders. This arrangement caters to specific client requests, particularly those who prefer offshore coding for their in-house team, through Dexios’ Supplemental Services Division. This flexibility allows Dexios to offer tailored coding solutions to meet diverse client needs.

Question 2

Will dedicated interventional coders be assigned?

Answer 2

Yes, Dexios will have dedicated interventional coders assigned to your account.

Question 3

In what capacity, if any, is artificial intelligence used in your coding process?

Answer 3

Dexios integrates an Autonomous Medical Coding platform that employs artificial intelligence (AI) to enhance coding accuracy and efficiency, achieving an 85% direct-to-bill rate. This AI solution utilizes machine learning and generative AI to analyze clinical notes and reports, instantly generating accurate reimbursement codes. It benefits from real-time feedback from auditors and coders, ensuring compliant coding and high direct-to-bill rates. This approach allows for immediate availability of charges to billing systems, demonstrating a blend of domain expertise and advanced technology.

Question 4

Please describe your process for sendbacks/addendums.

Answer 4

Dexios’ process for handling sendbacks and addendums involves a systematic approach where charges identified for addendums are placed in a “Possible Addendum” bucket for review. The Addendum Coder evaluates these charges, and if the Addendum Coder agrees with the original coder, the addendums are compiled into a spreadsheet detailing key information for review. This key information includes Reading Radiologist, Patient Name, MRN, Location, DOS (date of service), Order Number, Code Description, Reason for Addendum Request, and Explanation for the reason we are requesting. The Addendum Coder sends the spreadsheet to the assigned Account Manager every Friday. The Account Manager reviews the spreadsheet and forwards it to the client for action. Clients are given two weeks to respond, with a follow-up reminder for outstanding addendums, totaling a four-week process before charges are coded as presented.

Question 5

What coding/documentation resources are available to our existing physicians and new hires?

Answer 5

Dexios provides extensive coding and documentation resources to existing physicians and new hires. Our management team utilizes our access to the RCC Navigator series, AMA Examples in Clinical Radiology, Dr. Z Interventional Radiology material, AAPC Codify resources, and the MedLearn modality series to provide your physicians and team coding insights. These resources are supplemented by educational materials created by the coding supervisor, aimed at ongoing education and addressing specific queries. All educational content is stored in a company-wide drive, accessible to the coding team and Account Managers for reference and guidance.

Question 6

What billing software (and version) do you use?

Answer 6

Dexios utilizes ImagineSoftware, the leading medical billing software used by radiology groups nationwide. Dexios is currently utilizing the v23.0.0.3 version.

Question 7

Are you planning to change or significantly upgrade software in the next 12-24 months?

Answer 7

Dexios is committed to continuous improvement and staying at the forefront of technology to serve our clients better. Within 6-18 months, we plan to transition to ImagineOne, leveraging its significant enhancements over the current Imagine Software platform. This upgrade is chosen for its comprehensive improvements that promise to streamline operations without the risks associated with software conversion. For detailed insights into ImagineOne’s capabilities and how this software update stands to benefit our service delivery, we have provided a link with comprehensive information.

Question 8

What level of access is provided to the billing system for our staff?

Answer 8

Dexios provides tailored access to our billing system for our client’s staff, ensuring both security and visibility for your team’s needs. We offer a basic level of access, including view-only permissions in specific system areas. This approach safeguards sensitive information while allowing your team to monitor and review billing processes and statuses as needed. We aim to balance maintaining the integrity and confidentiality of billing data and enabling your staff to have the requisite oversight for effective collaboration and transparency.

Question 9

Please detail any advanced analysis and reporting options, including standard and custom reporting.

Answer 9

Dexios offers standard and custom reporting, including month-end reports from Imagine and special reports tailored to client needs. With Flex Reporting in Imagine, reports are available monthly or as needed. Dexios is enhancing its analysis capabilities through Business Intelligence (BI) tools integrated with its AI coding platform, focusing on modality and procedure reporting. Dexios is also implementing BI for insurance A/R trends via ONQ. This dual approach ensures comprehensive analysis and reporting options to meet diverse client requirements.

Question 10

What is your turnaround time for Ad Hoc reporting, and is it included in your fee?

Answer 10

Dexios is committed to delivering exceptional service and flexibility in meeting our clients’ needs for Ad Hoc reporting. Our turnaround time for such requests varies based on each report’s complexity and specific requirements. When a requested report is not readily available within the reporting module of Imagine software, we initiate a formal request with Imagine to create the necessary report. This process may involve the development of a Statement of Work (SOW) to detail the scope and deliverables of the report creation. Our policy is to include the provision of Ad Hoc reporting within our fee structure, ensuring that our clients receive comprehensive support without additional charges for these requests.

Question 11

Please discuss processes and technology to ensure accurate and complete charge capture, including an audit of all charges submitted.

Answer 11

Dexios can provide Order Verification services if requested. The client will provide the required data elements in a file for Dexios to upload, automatically reconciling to received charges. Dexios will communicate any unresolved charges to the client for resolution.

Question 12

How do you handle charges transmitted from multiple locations/EHRs that may have insufficient information to code?

Answer 12

Dexios adeptly manages charges transmitted from multiple locations or electronic health record (EHR) systems, particularly those that arrive with incomplete information necessary for coding. In such instances, our team collaborates closely with our client’s data management team to address the discrepancies. This partnership involves either resubmitting the data with the required information or refining the existing data collection protocols to prevent future occurrences.

Question 13

Average number of days to submit a claim once charge information has been received.

Answer 13

Dexios averages a 4-day turnaround from receiving the charge and visit information to filing a claim with HCFA, ensuring timely claim submissions.

Question 14

What is your process for posting Time of Service payments?

Answer 14

Dexios employs a meticulous process for posting Time of Service (TOS) payments, which involves a manual approach. Each Explanation of Benefits (EOB) is carefully reviewed and posted by our skilled billing team. This hands-on method ensures accuracy in capturing and recording payments received at the time of service, allowing for a detailed and precise reconciliation of patient accounts.

Question 15

What is your process for posting patient or check payments made in person or mailed to our office?

Answer 15

For patient or check payments made in person or mailed to your office, Dexios offers a secure and efficient method for processing these transactions. We establish a Secure File Transfer Protocol (SFTP) connection with our clients, enabling the safe and encrypted sharing of payment files and related documentation. Once the payment information is received through the SFTP, our team proceeds with a manual posting process. Each EOB is carefully reviewed and recorded to ensure accurate reflection in the patient’s account.

Question 16

What is your process for posting patient payments? Do you use a lockbox service?

Answer 16

Dexios can facilitate the use of a lockbox service or utilize a Dexios P.O. Box to manage and process payments received via mail on behalf of our clients. This flexibility ensures we can align with each client’s requirements and preferences. The decision to use a lockbox service or a Dexios P.O. Box is influenced by various factors, including pricing and the client’s operational considerations. We aim to provide a streamlined, secure, and cost-effective payment processing solution that supports our clients’ financial operations while maintaining high accuracy and efficiency in payment posting.

Question 17

What statement vendor do you use? How many statements are sent?

Answer 17

Dexios partners with Data Media (DMA) for statement processing and distribution. The frequency and volume of statements sent are highly customizable and tailored to each client’s specific preferences and operational needs. Our client base exhibits a range of practices—some opt for as few as two statements, while others choose to send three or more. This flexibility ensures our clients can align their patient communication and billing practices with their unique business models and patient engagement strategies.

Question 18

Is the statement vendor contracted with, and are fees paid by you or the client? If yes, What is the pricing structure?

Answer 18

Dexios has established a contractual relationship with DMA to serve as our primary statement vendor, offering a high degree of integration and efficiency for billing and statement services. While clients can select a different statement vendor, we recommend Data Media for seamless data integration and operational continuity. The costs associated with statement generation and delivery are passed on to the client, including the choice between utilizing electronic delivery (Enhanced eDelivery), traditional paper statements, or a strategic combination of both.
For clients choosing Enhanced eDelivery through DMA, we suggest a dynamic approach combining text and paper communications in a calculated rotation to maximize payment outcomes. The pricing model for this service is structured to encourage the use of eDelivery by offering it at $0.30 per instance, which includes both the initial text and a reminder. Should the text communications not result in payment, and a paper statement is subsequently issued, the client receives a $0.30 credit towards the cost of the paper statement, which is priced at $0.70. This approach ensures that clients can benefit from the efficiency and reach of text-based statements without incurring additional financial risk, should paper statements become necessary.

Question 19

Average number of days to post payments.

Answer 19

For electronic funds transfers (EFT) and electronic remittance advice (ERA), Dexios ensures current-day posting, reflecting our commitment to efficiency and timely account reconciliation. The process typically takes approximately one week for payments received via EOB or paper checks. This timeline allows for the careful handling and processing of paper-based transactions, ensuring accuracy and thoroughness in posting to patient accounts.

Question 20

What is your reconciliation process between your billing system and the bank? Is it done daily?

Answer 20

Dexios reconciles our billing system and the bank by balancing to the bank log or lockbox. This reconciliation process is critical to our financial management practices, ensuring accuracy and integrity in our financial reporting. To accommodate our clients’ varying needs and preferences, we offer flexibility in the frequency of this process, with options for daily or weekly reconciliation. This approach allows us to maintain rigorous oversight of financial transactions while also providing the adaptability to align with client-specific operational workflows and requirements.

Question 21

Will you be able to report revenue daily?

Answer 21

Dexios is equipped to provide daily revenue reporting through the Imagine software platform, utilizing the “Practice Activity by Day” report feature. This report offers a comprehensive overview of daily practice activities and revenue, which can be emailed directly to you daily. This capability ensures timely and accurate financial data at your fingertips, enabling informed decision-making and continuous monitoring of your practice’s financial performance.

Question 22

What collection agencies are set up for automatic turnover and posting?

Answer 22

Dexios is flexible in working with collection agencies, focusing on maximizing client satisfaction and recovery rates. While we have a list of preferred collection agencies based on their effectiveness and reliability, we are fully prepared to collaborate with any collection agency chosen by our clients. This approach ensures that our clients have the freedom to select an agency that best fits their specific needs and preferences while still benefiting from our expertise and support in managing accounts receivable and optimizing collections processes. Here is a list of our suggested Collection Agencies:
Capital Accounts, LLC
CBM Services
Central Professional Services
CMRE
Fairway Capital Recovery
Revenue Enterprises, LLC
Specialized Collection Systems, Inc. (SCS)

Question 23

What are your collection thresholds?

Answer 23

Dexios tailors collection thresholds to align with clients’ unique preferences and operational requirements. This customizable approach allows us to work closely with our clients to define specific criteria and thresholds for initiating collection efforts, ensuring that the collections process aligns seamlessly with their business practices and financial strategies.

Question 24

Are collections posted at the charge level?

Answer 24

Dexios ensures that payments received from insurance providers and patients are accurately posted to the specific charge line within our billing software corresponding to the billed services.

Question 25

How are one-time agreements handled?

Answer 25

Dexios handles one-time agreements by ensuring they align with the Medicare fee schedule and comply with the No Surprises Act. Agreements are accepted unless the client specifies otherwise.

Question 26

Please describe your credit balance refund process for both insurance payers and patients.

Answer 26

Dexios approaches the credit balance refund process with distinct strategies for insurance payers and patients to ensure accuracy and compliance. For insurance credit balances, our preferred method involves adjusting the billing records by sending corrected or voided claims. This process allows for the recoupment of funds through subsequent remittance advices, avoiding the need to issue a check directly. This efficient method aligns with standard industry practices for reconciling insurance overpayments. Regarding patient refunds, our policy considers the possibility of outstanding charges for different dates of service (DOS). If there is an open charge for another DOS, we initially hold the credit balance for up to two weeks to allow any pending insurance payments to be processed. This waiting period enables us to reallocate funds appropriately to any new patient responsibility lines that may arise. If no reallocation is needed or after the two-week period, we aim to process and issue refunds to patients within 90 days. This careful approach ensures that refunds are managed promptly while accounting for the complexity of billing cycles and insurance payment timelines.

Question 27

Please describe your program (and success) of submitting claims documentation for MIPS.

Answer 27

Dexios will submit MIPS for the Quality Category of the program as determined by the client. Dexios provides our clients with a yearly update on MIPS changes where the client chooses which Quality measures they would like Dexios to review and extract numerator data on eligible denominators. Dexios is implementing a coding platform that can extract undesirable performance before coding takes place so clients can addend reports to add appropriate Quality information before submitting to CMS via the claims method. Most of Dexios' clients opt to report via a QCDR rather than claims submission.

Question 28

Do you utilize a Qualified Registry or QCDR for MIPS submission?

Answer 28

Dexios works with multiple registries to upload MIPS Quality data and recommends the ACR QCDR for our clients as they offer specialized QCDR measures for radiology, which are not topped out at 7 points. Dexios provides our clients with a yearly update on MIPS changes and the measures supported by the ACR so that clients can choose which measures are relevant to their practice and quality goals. Dexios will then track and upload the selected measures into the registry of clients' choosing. Dexios has successfully tracked measures and provided feedback to our clients who work with Dexios to achieve high performance in chosen measures. Dexios will also submit clients chosen Improvement Activities via the ACR registry.

Question 29

How are manual and one-offs handled?

Answer 29

Dexios employs an SFTP for manual and one-off tasks to ensure secure and efficient handling of these unique or non-standard requests. The use of SFTP allows for the safe transmission of sensitive data, supporting our commitment to maintaining data security while accommodating specific, ad hoc needs of our clients. This method enables us to manage and process these tasks with the high level of security and efficiency that our clients expect, ensuring that even the most unique requests are handled effectively and in compliance with data protection standards.

Question 30

What structure and processes do you have in place for contract billing? Is it provided under a separate fee structure?

Answer 30

Dexios has a comprehensive structure and process for contract billing, leveraging a specialized module within the Imagine software to facilitate invoice creation and management. Our approach is designed to ensure precision and customization, aligning with the specific requirements of each contract. The process encompasses: 1. Detailed Communication: We initiate by discussing contract specifics with the client, ensuring a mutual understanding of the terms and expectations. 2. Contract Build: We build the contract within the Imagine system based on the agreed specifics, which involves posting charges to individual contracts using contract-specific fees and generating monthly invoices. 3. Payment Follow-up: We undertake diligent follow-up activities after invoice generation to ensure timely payment. Our system allows for the precise pricing of fees for each CPT billed, which may differ from the fees submitted to insurance companies. This capability ensures flexibility and accuracy in billing according to contract terms rather than standard insurance billing rates. This specialized billing service is provided under a separate fee structure, reflecting the additional customization and management involved in contract billing. This arrangement allows us to offer tailored billing solutions that meet the diverse needs of our clients, ensuring that contract billing is handled efficiently and accurately.

Question 31

Please summarize your compliance program for billing activities and HIPAA security, including whether internal and external audits are conducted.

Answer 31

Dexios maintains a comprehensive compliance program dedicated to billing activities and HIPAA security, designed to meet and exceed regulatory requirements while protecting sensitive patient information. Since 2019, Dexios has continuously upheld annual compliance accreditations from the HBMA Compliance Accreditation Program, showcasing its steadfast commitment to meeting regulatory standards. As a trusted partner with HBMA and Healthcare Compliance Pros, Dexios consistently exhibits expertise in navigating the dynamic healthcare compliance landscape, ensuring client satisfaction, and contributing to healthcare excellence. Our program is also distinguished by its rigorous approach to internal and external audits, ensuring a robust framework for compliance and security. Internal Audits: Dexios regularly conducts internal reviews and audits of our billing practices, including assessing our procedures and systems for handling protected health information (PHI) to ensure they align with current regulations and best practices. Any identified discrepancies or areas for improvement are promptly addressed to maintain the highest standards of compliance and security. External Audits: To supplement our internal efforts and provide an additional layer of assurance, Dexios engages with independent auditors. These external audits objectively evaluate our compliance with billing regulations and HIPAA security standards. Incorporating external feedback ensures our practices meet and often exceed industry standards. Our commitment to a robust compliance program demonstrates our dedication to upholding the integrity of our billing operations and the privacy and security of PHI, ensuring we are in full alignment with legal mandates and best practices in healthcare billing and information security.

Question 32

Do you conduct regular risk assessments for all security measures?

Answer 32

Dexios Corporation is committed to maintaining the highest levels of security by conducting regular risk assessments on all our systems and applications. Our approach is grounded in thoroughly and systematically evaluating potential vulnerabilities and risks, adhering to relevant regulations and standards. By employing a risk-based methodology, we determine the appropriate frequency and scope of these assessments to ensure comprehensive coverage across our technological infrastructure. The primary objective of our security assessments is to proactively identify potential vulnerabilities and implement robust security controls to mitigate identified risks. This proactive stance on security ensures the integrity, confidentiality, and availability of the data we manage.

Question 33

Is security handled by an outsourced company or with an internal information technology staff?

Answer 33

At Dexios, our approach to security involves a collaborative model that leverages both internal expertise and external resources. Our internal information technology (IT) staff is critical in overseeing and managing day-to-day security operations, ensuring that our systems and data are protected against evolving threats. In addition to our internal team, we engage with an external security company to complement our efforts. This partnership allows us to access specialized security expertise and technologies, conduct in-depth security assessments, and implement best practices and advanced security measures.

Question 34

Do you have a formal disaster recovery/business continuity plan? If yes, please describe.

Answer 34

Dexios has a formal Disaster Recovery and Business Continuity Plan (DR/BCP) in place, ensuring uninterrupted business operations under adverse conditions. This strategic framework addresses various risks, including natural disasters, cyber incidents, and other potential disruptions to our operations. The plan clearly defines recovery objectives, prioritizes essential business functions, and outlines the steps to resume operations swiftly and efficiently. Key components of our plan include: Comprehensive Data Backup and Protection Measures: We employ robust data backup strategies and protective measures to ensure data integrity and availability. Dedicated Emergency Response Team: A specialized team executes the disaster recovery plan, ensuring a coordinated and effective response to incidents. Structured Communication Strategy: Our plan includes a communication protocol to ensure timely and clear communication with employees, clients, and stakeholders during a disaster. Detailed Recovery Procedures: We outline specific procedures for recovery operations, including infrastructure restoration, data recovery, and business process reinstatement. Regular Reviews and Updates: The disaster recovery plan is subject to regular audits and updates to reflect changing risks and technologies, ensuring its continued relevance and effectiveness. Annual Drills: We conduct annual drills to test the plan's effectiveness, identify areas for improvement, and ensure staff are well-prepared for actual disaster scenarios.

Question 35

Do you have any SOC certifications?

Answer 35

Dexios does not hold SOC certifications.

Question 36

Describe your proposed staffing plan for this group (team in the home office, personnel in geographic area, etc.)

Answer 36

Dexios employs a strategic staffing model of 85% remote and 15% in-office, designed to leverage the best talent in radiology billing and coding. This model enables us to attract highly skilled professionals with specific training in the Imagine software platform nationwide. Our partnership with Imagine significantly enhances our recruitment strategy; whenever an in-house billing group associated with Imagine is winding down, Dexios is promptly informed. This insider knowledge allows us to engage directly with the affected billing groups' billing management to identify and onboard top-performing employees during their transition.

Question 37

How does your staff handle patient accounts or insurance questions?

Answer 37

Dexios operates a dedicated call center for patient account inquiries with knowledgeable agents ready to assist patients with their questions. When a call center agent encounters a question they cannot answer, the call is escalated to a Tier 2 support level for more in-depth assistance. Additionally, for accounts with balances exceeding $200.00, our agents are tasked with making follow-up calls, attempting one final collection effort before considering turning the account over for further action, but only after ensuring that all proper billing statements have been sent and received. Regarding insurance-related questions, our agents are trained to contact insurance companies for clarifications and information directly. The training covers a broad range of scenarios, equipping our staff with the guidelines necessary to handle various insurance questions effectively. This structured approach ensures that patient account inquiries and insurance questions are managed efficiently, providing clear, accurate, and timely information to support our clients and their patients.

Question 38

Describe your proposed processes, efforts, and team dedicated to denial management for our practice. Include any write-off thresholds.

Answer 38

Dexios approach to denial management involves assigning agents to handle denials, with the allocation based on the volume of procedures and denials received, ensuring that we have the appropriate resources to address and resolve denials effectively. We have established a dedicated Accounts Receivable (A/R) department with detailed processes and guidelines. These guidelines are customized to meet state-specific regulations and account for non-payable CPT codes, ensuring that our approach is compliant and optimized. Our write-off thresholds and adjustment standards include several categories, such as small balance adjustments, procedures deemed not payable, services considered inclusive within other charges, decisions stemming from appeal processes, and issues related to timely filing. The criteria for these adjustments and the thresholds for turning over accounts to collections are established in collaboration with our clients. This client-centered approach ensures that our denial management and write-off practices support your practice's overall financial strategy while focusing on recovering the maximum amount possible.

Question 39

How often would management team members be available to meet with the group’s leadership?

Answer 39

The availability of Dexios’ management team for meetings is flexible. We can arrange weekly meetings during the initial phase of our partnership or when specific needs arise, ensuring close collaboration and alignment on billing processes, performance metrics, and any areas requiring attention. Once it is determined that weekly meetings are no longer necessary, we recommend transitioning to biweekly or monthly meetings. These regular biweekly or monthly sessions are designed to maintain open lines of communication, address any emerging issues proactively, and discuss strategic initiatives.

Question 40

What are your business hours (including time zones)?

Answer 40

Dexios operates Monday through Friday, from 8:00 AM to 5:00 PM Eastern Standard Time (EST). We are closed on weekends, ensuring that our team is available during standard business hours to support our clients and manage all radiology billing and coding aspects with efficiency and expertise.

Question 41

Please provide the call center location(s) and hours.

Answer 41

Dexios operates its Call Center from 8:00 AM to 5:00 PM Eastern Standard Time (EST), catering to a wide range of client needs with English and Spanish-speaking agents. Our Call Center staffing strategy includes a blend of state-side and offshore agents to ensure comprehensive coverage and accessibility for all our clients. Our call center locations are Michigan, Tennessee, Panama, and Kenya.

Question 42

Are your call center personnel domestic or offshore?

Answer 42

Dexios employs a three-tiered approach to call center support. Our offshore team provides the initial level of support and can address a wide range of inquiries and issues. For situations that require more specialized attention or escalation, the second level of support involves our American-based call center team. These domestic agents bring additional expertise and familiarity with local practices and nuances. The third and final level of support is provided by our call center Supervisor, who oversees the resolution of complex issues and ensures the highest service quality and customer satisfaction standards. This structured approach allows Dexios to manage customer interactions efficiently and deliver superior support across all levels of inquiry.

Question 43

Please provide an overview of your onboarding process.

Answer 43

Dexios Radiology Billing provides a step-by-step statement of work to ensure a quick and seamless implementation process for our clients. Our implementation process takes 90-120 days on average, which is the standard in the industry. During this time, we will need to promptly receive the necessary documentation and information below to complete this process. Please see our attached New Implementation SOW and brief overview below: Initial team introduction call involving the client and Dexios team. Exchange essential information: The healthcare practice shares crucial data with Dexios to initiate credentialing, data exchange, etc. Execute credentialing and enrollment process. Implement data integration and conduct a testing phase to verify the precision and efficiency of data exchange. Provide training and educational feedback from the Coding Supervisor based on reviews of reports from data exchange. Go-Live, following the successful completion of preliminary steps. Continuous support and communication, including regular check-ins, reporting, and feedback facilitated by the Account Manager.

Question 44

Do you have a dedicated Onboarding Team?

Answer 44

Dexios has a dedicated Onboarding Team comprised of implementation, credentialing, and IT specialists. This team ensures a comprehensive support structure throughout the onboarding process, providing direct lines of communication and expertise in each critical area to facilitate a smooth transition for new clients.

Question 45

What is your historical time frame for ramp-up and normalizing of revenue patterns?

Answer 45

Generally, our implementation go-live period spans 90-120 days, depending on the client’s participation and ability to provide necessary information timely. The normalization of revenue patterns typically takes approximately six months, assuming minimal issues with implementation.

Question 46

Describe any orientation plan you offer for physicians as part of your start-up process.

Answer 46

Dexios provides an orientation plan for physicians with detailed coding guidelines and information on Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs). This orientation plan aims to ensure medical necessity and documentation requirements are met to maximize reimbursements, reduce the need for addendums, and prevent denials. Additionally, Dexios offers specific processes and guidelines for addendums, further supporting physicians in adhering to billing and coding standards.