Anton Loman in his office.

Checks-and-Balances System Improves Revenues

Anton Loman, appeals manager, UCLA Faculty Practice Group (FPG), the Patient Business Office (PBO) and the Managed Care Contracting office have implemented an online database software program, Medical Present Value (MPV), to provide UCLA with financial tools to automate underpayment recovery and streamline payor contract management. The new system has resulted in increased revenue, better-performing contracts and improved cash revenue flow.

“Along with MPV, our office has been able to more effectively identify, appeal and recover underpaid claims, which can account for up to 16 percent of our claims,” states Anton.

Prior to MPV’s automated system, department representatives manually checked short pays and generated insurance appeals. With MPV, insurance payment verification and official appeals are now generated with a quick push of a button, resulting in a 90 to 95 percent increase in operational effectiveness, increased collections and more than $2 million in recovered appeals since September of 2007.

“We now have a great checks-and-balances system to make sure we are collecting the correct reimbursements, not being underpaid for our services, and providing our patients the best service at every level, from the time they are first seen, to when the last bill is processed,” Anton says.