Octopus Health Complete RCM & Medical Billing Services

FAQs

Ask me a question

Frequently Asked Question

It is best that you get a free consultation with one of our Solution Consultants to identify your needs so you can choose the right plan for your practice.

You can sign up now and start using your account immediately. Onboarding generally takes about 30-45 days. Refer to the onboarding guide to learn about the steps of onboarding.

Yes. Octopus does offer Data Import services. We are able to import a variety of data, ranging from patient demographics to insurance lists. There may be a charge for our import services, which will depend on the kind of data we will be importing. The price generally ranges from $250 to $1500, depending on the volume of data and time that it takes to transfer. We are able to complete most projects within 5-7 business days. You can provide your data in a variety of formats, including a Comma–Separated Value (.CSV) or Microsoft Excel (.XLS), Text (.TXT), Access Database (MDB), etc. Alternatively, if you are unable to export/acquire your data, we can remotely access your system and attempt to acquire your data for you at no additional charge.

Yes, Our Data Services team can help import a number of fields into your new Octopus account. Typically, as long as you are able to export those fields from your current system into Excel or .csv file format, we take it from there. Ask your Account Manager for a list of specific fields that can be imported.

There is no need to set up an account with a clearinghouse, and there are no additional fees for electronic claims and remittance services. Our Enrollments team will assist you in enrolling with Zirmed, the clearinghouses used by Octopus. Octopus offers an integrated platform that includes cloud-based medical billing software for your practice combined with electronic connectivity to insurers, all provided under one affordable fee structure.

Onboarding generally takes about 30-45 days. Refer to the onboarding guide to learn about the steps of onboarding.

We offer a complete onboarding and training program with your subscription. Our team will be available to answer your questions as you complete the essential steps of your onboarding including watching our training videos, setting up a provider, enrolling in electronic claims, sending your first batch of electronic claims, and having your claims accepted by at least one major insurance company.

 

Upon sign up, you will be assigned a Success Coach who will be with you through your entire setup process. In addition, our Octopus Training Specialists will help guide you through our training webinars. For more information visit

Kareo offers convenient self–service customer support resources at no additional charge with every subscription. This includes online help, user manuals, guides, training videos, knowledge bases, and our user community forum. You also receive ongoing help with any electronic claims or electronic remittance enrollment questions at no additional charge. We also offer email, chat, and phone support options.

Kareo support can be reached Monday through Friday, 5 AM – 5 PM (Pacific Time), excluding national holidays.

Yes, we offer you the flexibility to accept credit cards online, over the phone, or storing patient credit cards on file. It’s simple and affordable to set up an account and start processing credit cards in Octopus. The payments are processed through a merchant account, deposited directly into your bank account, and posted to Octopus. This can be used in conjunction with or without a card swiper. It allows you to accept all forms of card types, including FSA, HSA, debit, Visa, MasterCard, and American Express. Rates are per transaction as follows:

 

  • Patient present in office charge: 2.3% + $0.30 tax per transaction,
  • Patient credit card on file or paying online 3.9% + $0.30 tax per transaction.

You can submit electronic claims to more than 4,000 insurers through Octopus We support Medicare, Medicaid, Blue Cross, Blue Shield, and Tricare in every state. We also support major national insurers, such as Aetna, Cigna, Humana, and United Healthcare, as well as local IPAs and smaller insurers. To find out if you can submit electronic claims to a specific government payer or commercial insurance company.

We currently support professional claim formats, used for provider charges, using the CMS 1500 paper claim format and ANSI 837p electronic claim format. We also support institutional claim formats, both UB-04 and 837I, for Ambulatory Surgical Centers (ASC), Comprehensive Outpatient Rehabilitation Facility (CORF), and Outpatient Rehabilitation Facility (ORF).

It is our experience that each insurance company may have a different policy regarding how they reimburse for medical claims associated with Out-of-Network providers and the level of electronic services (electronic claims, remittance, and eligibility) they support with Out-of-Network providers. These varying policies are independent of the medical software or clearinghouse used to bill them. So we recommend that you call each insurance company to receive a definitive answer regarding their claim reimbursement process and the electronic services they will allow as it relates to Out-of-Network providers.

Once you sign up with Octopus, a dedicated CSC will contact you within 24 hours to welcome you and assist with account set up. Your CSC will help coordinate your entire onboarding timeline, which includes initial account setup, enrollments, claims processing, and ERA receipt. Additionally, our Octopus Training Specialists will help guide you through available e-learning options.

 

We are committed to your success and expect to have your account fully implemented within 90 days of your account being setup. To learn more about the onboarding process, visit our help page to learn more about the steps needed to get started.

You can begin sending electronic claims to all commercial insurance companies, such as Aetna, Cigna, United Healthcare, and many others, within 48 hours of signing up for Octopus. A few payers, such as Medicare, Medicaid, Blue Cross/Blue Shield, may require authorization of an enrollment form before you can submit electronic claims. Once these payers process your enrollment form, typically within 5-30 days, you can then send electronic claims to these payers through Octopus.

Subscription fees are billed a month in advance of service, except for the first month when you are billed a prorated fee based on the number of days you had access to Octopus on the following month’s invoice. We accept payment by direct debit to your checking account or by Visa, MasterCard, Discover, or American Express. Payments are due on the tenth day of each month.

We specialize in a wide range of billing specialties, including:

 

  • Anaesthesia
  • Cardiology
  • Dentistry
  • Dermatology
  • E/M, Consultations
  • Emergency Room – ER | ED
  • Family Practice/Internal Medicine
  • Gastroenterology
  • General Surgery
  • Gynaecology
  • Hospital In-Patient
  • Intensivists
  • Neurology
  • Nephrology
  • Oncology
  • Ophthalmology
  • Orthopaedics
  • Pain Management
  • Pediatrics
  • Plastic Surgery
  • Podiatry
  • Pulmonology
  • Radiation Oncology
  • Radiology
  • Trauma and Burn
  • Urgent Care
  • Urology
  • Wound Care

 

Additionally, we provide Revenue Cycle Management (RCM) services through various Electronic Medical Record (EMR) and Practice Management System (PMS) platforms, including:

 

  • AdvancedMD
  • Allscripts
  • Athena
  • Cerner
  • CollaborateMD
  • eClinicalWorks
  • Epic
  • Kareo – Tebra
  • ModMed
  • Nextech
  • NextGen
  • Practice Suite
  • PrimeSuite

 

Our expertise spans a diverse array of medical specialties and is complemented by our proficiency in managing billing processes through different EMR and PMS systems.

Our billing service fees are straightforward and cost-effective, prioritizing your profitability. We apply a 3-6% charge based on the revenue generated, all while ensuring savings of up to 35% on your overall billing costs!

Our clients have the flexibility to continue using their existing practice software. We conduct a brief demonstration based on your software, ensuring seamless integration. We have experience with various software, including AdvancedMD, Allscripts, Athena, Cerner, CollaborateMD, eClinicalWorks, Epic, Octopus – Tebra, ModMed, Nextech, NextGen, Practice Suite, PrimeSuite and more…

After the signing of the HIPAA BAA and the Services Contract, we provide clients with a tentative go-live date. The suggested date considers the current circumstances and any software or credentialing requirements. In optimal conditions, we can expedite the go-live process within one week.

Our commitment to delivering exceptional service includes providing specialized billers and coders with expertise in your field and software, supported by a high-quality team on-site or off-site based on the requirement.

We provide individual attention for every client engagement. The team assigned includes associates, a quality team, a customer relationship manager, and a Business Intelligence team.

With a rich history spanning two decades, we have accumulated valuable experience in the industry. Over this time, we’ve had the privilege of serving and satisfying the needs of more than 100 clients.

Adhering strictly to compliance and HIPAA regulations in both RCM operations and IT Operations, we prioritize the security of Protected Health Information (PHI). Our billing professionals undergo regular HIPAA training sessions, and we conduct HIPAA audits on a half-yearly basis, with reports meticulously reviewed by our HIPAA Compliance Officer. Additionally, our commitment to information security is affirmed by our ISO 27001 certification.

At Octopus, we are dedicated to providing our clients the time to focus on their core activities—caring for their patients—while staying informed about their collections. We believe in regular reporting, updating our clients daily, weekly, and monthly, allowing for discussions on how we can enhance performance for their clinic.

Octopus ensures service quality by maintaining and monitoring Turnaround Time (TAT). We provide regular reports to physicians and actively seek their feedback, enabling continuous process refinement. We closely monitor RCM KPIs for practice health.  Additionally, we closely monitor key RCM KPIs such as charge lag days, aging days, aging buckets, denial percentage, gross collection ratio, net collection ratio, and more to ensure the overall health of the practice.

Our corporate office is located in New Jersey, and we have two Global Delivery Centers. We provide our services in all 50 states.

Octopus’s AR and denial Management services are underpinned by a robust framework of quality metrics designed to ensure exceptional performance and tangible results for our clients. Our focus on quality extends across various key metrics, including but not limited to:

 

  • AR Days: We prioritize reducing the average number of days it takes to collect outstanding payments, aiming to optimize cash flow for our clients.
  • Collection Rate: Our goal is to consistently improve the collection rate by efficiently tracking and recovering outstanding payments, ultimately enhancing our clients’ revenue.
  • Denial Rate: We are dedicated to minimizing denial rates through proactive measures, ensuring that claims are accurately submitted and swiftly rectified in the event of denials.
  • AR Aging: We aim to reduce the aging of accounts receivable, thereby streamlining the financial health of our clients’ practices.
  • Appeal Success Rate: We strive to achieve a high success rate in appealing for rightful reimbursements, ensuring that our clients receive the full compensation they deserve.

Presently, our services do not include patient contact for claims. We coordinate with practices for this activity.

Our pricing model remains consistent at 3-6% of collections, tailored to volume and medical specialty. Whether clinic-based or hospital-related, our transparent approach ensures stability and continuity, accommodating diverse practice structures with an equitable billing approach.

Our commitment extends beyond billing, encompassing consultancy, credentialing support, software assistance, practice promotion, healthcare trend updates, and customized reporting. While prioritizing value delivery, we offer RevvPro, a real-time performance dashboard, ensuring comprehensive support for your practice’s success. Check out our complete list of Services.

At Octopus, we value transparency and simplicity. We don’t burden clients with extra expenses or startup fees, fostering a cost-effective partnership. Our commitment is to provide immediate value without imposing unnecessary financial burdens during the onboarding process.

We have a 30-day exit clause for all our service engagements.

With a rapid turnaround time of 24 to 48 hours, we emphasize the prompt delivery of our services. At Octopus, we recognize the significance of timely results, ensuring you receive your services ahead of schedule.

Our billers and coders boast an average of over 4 years of experience and hold prestigious certifications, such as Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CPC-H) from AAPC, and Certified Coding Specialist (CCS) from AHIMA. These qualifications highlight their expertise and proficiency in medical billing and coding.

At Octopus, we prioritize the utmost security to safeguard sensitive information. Our comprehensive security protocols include

 

Physical Security:

 

  • 24/7 On-Campus Security Staff
  • Strict No Tailgating Policy
  • Adherence to the Clean Desk Approach
  • Secure and Dedicated Infrastructure
  • Controlled Access to Printers
  • Staff Screening and Background Checks
  • Confidentiality Agreements in Place with Staff
  • Critical Documents and Electronic Data Stored in Fireproof Cabinets

 

System Security and Access Controls:

 

  • Implementation of Firewalls
  • User-IDs and Passwords Required to Log into Client Systems
  • Data Storage Disabled on Local Systems
  • Utilization of Anti-Virus Software
  • Encrypted E-Mails for Enhanced Security
  • Disabled of CD Drives, USB Ports, Wi-Fi, etc.

 

Monitoring:

 

  • Regular Reviews of Firewall Logs
  • Client Audit Teams Conduct Audits on Dedicated Networks
  • Periodic Network and Host Vulnerability Audits
  • Information Security Management and Information Control Audits
  • Ongoing HIPAA Training for Employees to Ensure Compliance

 

Our commitment to security extends to regular audits conducted by our quality and regulatory team, ensuring strict adherence to compliance standards within the organization.

Explore Our Secure IT Infrastructure:

 

  • Wide Area Network (WAN): We ensure robust connectivity using Internet Leased Lines, Cisco Routers, and RAD Modems. Backed by redundant Internet Bandwidth from three providers, our WAN is actively monitored, and security is fortified by Link Sys Firewalls.
  • Local Area Network (LAN): Experience high-speed connectivity with our TCP/IP-based LAN operating at 100 and 1000 MBPS. Managed by Link Sys Switches and D-Link/Link Sys Switches, our LAN ensures efficient performance.
  • Data Handling: Your data’s security is our priority. We employ secure channels like E-Fax, Email, FTP Servers, and VPN. Backed-up data is stored on DLT Tapes within fireproof cabinets. Our stringent controls, shredding practices, and confidential agreements enhance data security.
  • Security Measures: Feel confident in our secure environment with Bio-Metric Access Controllers, dedicated healthcare-focused infrastructure, and robust firewalls. Controlled printer access, mandatory user credentials, and encryption ensure secure point-to-point connectivity.
  • IT Staff: Our certified IT professionals are at your service 24/7, ensuring uninterrupted support. For custom applications, our in-house development teams are ready to assist.
  • Monitoring: We maintain a proactive security stance through periodic vulnerability tests, routine internal audits, and regular scrutiny of firewall logs.

When opting for outsourcing with Octopus, payment can be made through three flexible models:

 

  • A percentage of collections, typically ranging from 3% to 6%.
  • FTE (full-time employee) model, with rates approximately between $1,200 to $1,800 per FTE per month.

 

For medical coding services, charges are based on a per-chart basis according to specialty. To obtain more detailed pricing information, please get in touch with us.

Our dedicated customer relations team will seamlessly guide you through the process of initiating and finalizing the contract or work order. Your satisfaction and understanding of the terms are our top priorities, and we’re here to assist you every step of the way.

Simply complete our contact form, providing details about the services you need and information about your project. We’ll promptly reach out to you to advance our outsourcing relationship to the next level.

Contact us for free consultation