The simple Rx for
Maximizing Reimbursements

 

We are the
Out-of-Network Experts

 

Revenue cycle management where
Every Detail Matters

 

Serving All Your Needs
Complex In-Network and Out-of-Network Issues

We are working with over 1,300 surgery centers, physician practices, laboratories, community and physician-owned hospitals, behavioral health facilities, dialysis centers and health systems throughout the country.

Experience that Matters
The Team that Built the Other Side of the Business

Our professionals have worked for health insurers and their out-of-network pricing parnters and possess a depth of knowledge with an intimate understanding of the tactics payors use to decrease your revenue.

Scaled for Success
Billions of Dollars in Processed Bills Handled Annually

We are the only company in the country focused solely on helping providers maximize reimbursements while leveraging a unique expertise and understanding of out-of-network bills.

Technology that Drives Results
Millions of Interactions Captured and Indexed Annually

Our algorithms automatically identify similar claim patterns, leverage prior agreements and use our knowledge of the insurance companies own strategies against them in driving higher payments.

Revenue Cycle Management
We do it ... so you don't have to

 

You entered medicine for one reason: to help people. You didn't do it to get stuck in the detail of billing and collections. As providers survey the landscape today, there aren’t many ways to increase reimbursements. Through reconciliation processes, workflow optimization, data and analytics, and unique payor-side knowledge, Collect Rx is your prescription for increasing cash flow and managing A/R as you focus your attention on patient care.

Collect Rx is not only a prescription for more cash, it is a prescription for reducing headaches caused by out-of-network negotiations.

It’s wonderful! I’d like to be a fly on the wall to see what you all do to get that done. It’s unbelievable!

Couldn’t be more pleased with the whole process. Collect Rx makes it so easy and your staff has been a pleasure to work with. Most importantly,we love the results!

What We Do
Our Capabilities

The Keys to Maximizing Claim Reimbursements

Knowledge of Payor-Side Incentives
Insurance company secrets

Understand the financial and customer incentives of health insurers and their vendors

Specialized Out-of-Network Expertise
We wrote the rules

The largest national database of out-of-network reimbursement patterns by all major payors

Healthcare Recovery Attorneys
We cover all the bases

Large staff of experienced healthcare attorney resources available at no extra charge

Comparable Data
Insight only we can see

Millions of claim interactions from more than 1,300 customers nationwide

Billing & Coding
The devil is in the details

Undivided attention paid to auditing and reconciliation

A/R Recovery
We catch it, we capture it

A unique combination of automation and optimized processes drive recovery rates

Security
Nothing gets past us

Defense in depth keeps your data from prying eyes

Focus
We're laser sharp

Devoted 100% to helping providers maximize reimbursements

Medicare
DRGs driving you down

Ensure procedural billing rates remain as billed

Out-of-Network
You have a problem...
You just don't know it

 

Successful management of the revenue cycle is a key component of a provider’s financial performance. One area of the revenue cycle that has been largely ignored is out-of-network bills. Yet with the rapid growth of out-of-network bills, insurance companies have become increasingly aggressive in reducing payments. Collect Rx can help you increase revenue by avoiding underpayments from third-party payors.

Don't Let This Happen To You!

60

Out-of-Network Bills Annually

22

Typical Reimbursement

Collect Rx provides a very valuable service. Before I saw this in action I never imagined it would be so profitable. Keep up the good work!

I’m very satisfied with your performance to date. Collect Rx has driven our reimbursement rate from less than 50% to over 90% on average! Needless to say, I’m thrilled!

Great work by your team right out of the gate. Now that we've streamlined our entire process, we're seeing the double impact of both increased payments AND reduced costs!

Our Team of Experts

Highly skilled professionals including physicians, former hospital executives and legal experts, all of whom are deeply experienced in maximizing healthcare provider reimbursements.

Don Greenberg, M.D., M.B.A.
Founder & Chairman

Dr. Greenberg has over 30 years experience in the field of health care cost management. As the founder and CEO of About Health, Inc. (later merged with Concentra Preferred Systems / Viant / MultiPlan), he was a pioneer in the out-of-network negotiation industry. His clients included CIGNA, Aetna, United Healthcare, Great-West Life, and various Blue Cross / Blue Shield plans. Dr. Greenberg is a skilled negotiator who has trained and supervised hundreds of health care claims negotiators around the country.

Dr. Greenberg served as President of Potomac Health Systems, a home infusion therapy company covering the mid-Atlantic region. As a consultant for Macro Systems, Inc., he managed projects involving health care cost containment, health statistics, and medical economics. In addition, Dr. Greenberg was Vice President & Medical Director of the nation’s first drug utilization review company where he was responsible for monitoring the drug use patterns of 15 million patients.

Dr. Greenberg is a graduate of the University of Pennsylvania School of Medicine and received his M.B.A. from the Wharton School. He began his career as a family physician in Allentown, Pennsylvania.

John Bartos, J.D.
Chief Executive Officer

Mr. Bartos is a veteran in the field of healthcare and information technology. As President of DrFirst, Inc. and Executive Vice President of Prematics, Inc., Mr. Bartos has specialized in providing cost containment services to health insurers and various products and services to hospitals, health systems, and other healthcare providers. Previously, Mr. Bartos was an attorney at Kirkpatrick & Lockhart, LLP (now K&L Gates) where his practice focused on litigation.

Mr. Bartos' clients have included a wide range of for-profit and not-for-profit health insurers, including Blue Cross Blue Shield of Florida, Humana, Capital BlueCross, Kaiser Permanente of the Mid-Atlantic Region, CareFirst, and BlueCross BlueShield of Massachusetts. Mr. Bartos has also worked on behalf of numerous hospitals and health systems, including Henry Ford Health System and MedStar Health, along with hundreds of physician practices.

Mr. Bartos is a graduate of Princeton University and received his J.D. from The American University, Washington College of Law where he graduated Summa Cum Laude and was a member of Law Review.

Ira Brenner, Ph.D.
President & Chief Technology Officer

Mr. Brenner is a technology and healthcare entrepreneur, investor and executive, with extensive experience leading capital formation strategy for technology start-ups and designing, building, integrating and deploying complex product solutions for demanding customers.

Previously, Mr. Brenner was the founder of Prematics, a provider of fully-managed clinical IT services that improve the safety, quality and efficiency of health care that includes the delivery of ScriptTone, the nation’s leading electronic prescribing service for office based physician practices. In addition to formulating the business plan, organizing and executing the capital formation strategy and conceiving and leading the design and build of the ScriptTone service, Mr. Brenner, in his executive capacity, built a world class team that included healthcare luminaries Dr. David Brailer and James P. Bradley among its board members.

Mr. Brenner did his Ph.D. work in Biomedical Engineering at Johns Hopkins University. He was with the Genome Database (GDB) team at Johns Hopkins University. Established in 1990, GDB is the official central repository for genomic mapping data resulting from the Human Genome Initiative. Mr. Brenner was responsible for developing limited-search space applications and enabling GDB as one of the first public databases made available through a web interface. He earned his MS degree in Biomedical Engineering from the University of Texas and was a National Science Foundation fellow, completing his thesis work at Tskuba University in Japan. He received his BS degrees in Electrical Engineering and Biology from the University of Michigan.

Sonny Bloom, M.B.A.
Chief Strategy Officer

Sonny Bloom has over 30 years experience in the field of health care cost management. He served as a Vice President with Concentra Preferred Systems / Viant for ten years and as COO of About Health, Inc. prior to its merger with Concentra / Viant / MulitPlan. In both positions, he had lead responsibility for the development, implementation, and operation of Professional Negotiation Services provided to health insurance companies – achieving industry-leading results. This included the oversight of negotiations on more than $1 billion in out-of-network bills annually.

Previously, Mr. Bloom worked for several years as a senior management consultant to hospitals and physicians across the U.S. in the areas of cost containment, productivity improvement, and strategic planning. He also served as a consultant to the U.S. Department of Health and Human Services, assisting with their managed care initiatives.

Mr. Bloom holds an M.B.A. degree from Harvard University and a B.S.E. degree in Industrial Engineering from The University of Michigan.

Richa Singh
Executive Vice President, Sales

Ms. Singh has served in senior sales management positions for 10+ years. She was employed in the Information Technology field – first with Cisco Systems and then with Vocus, one of the nation’s leading companies in public relations software. Her IT experience has provided her with key skills applicable to her current role at Collect Rx.  Ms. Singh also served as Account Executive for Merrill Lynch.

Having joined Collect Rx in 2010, Ms. Singh now serves as Collect Rx’s Executive Vice President of Sales. Her responsibilities include: developing and implementing corporate-wide sales and marketing strategies, sales management reporting and systems, overseeing the sales/marketing/account management staff and functions, and serving as lead relationship manager with several of the firm’s largest clients.

During her tenure at Collect Rx, she has been instrumental in the firm growing its client base to more than 1,300 healthcare provider organizations located throughout the country.

Ms. Singh holds a bachelor’s degree in Computer Science from the University of Maryland, supplemented by certification programs and advanced training in sales management information systems.

Josh Keller
Vice President, Service Development

Mr. Keller has over 15 years of experience in the insurance field, beginning his career at a third party administrator for employer self-funded plans.  For Coventry Health Care, a large national insurer, he was responsible for the administration of employee benefits.  As consumer driven health plans emerged, he joined Lumenos (which was acquired by WellPoint) dealing with complex subrogation claim issues and real-time data exchanges with external vendors of health savings and health reimbursement accounts.

As the first employee at Collect Rx, Mr. Keller has served in many roles in the company over the years. He has personally negotiated thousands of claim settlements covering charges of approximately $100 million dollars.  In addition, he developed many of the operational procedures utilized by the company and created the functional requirements for the company’s custom built data and analytics tool, CRXIS (Collect Rx Information System).

Mr. Keller is a graduate of the University of Wisconsin, obtained the Certified Employee Benefit Specialist (CEBS) designation co-sponsored through the International Foundation of Employee Benefits Plans and the Wharton School of the University of Pennsylvania, and a Master's of Science in Human Resource Management from Boston University.

Toni Grimsley
Vice President, Operations

Ms. Grimsley has spent the past 20 years as an operations manager for several of the leading managed care network and out-of-network reimbursement service firms in the U.S.  Supporting commercial payers, she served as an operations manager with About Health,  Preferred Payment Systems, Concentra, Viant and Multiplan. Previously, she worked in the pharmacy/home infusion field, focusing on vendor management and contract coordination.

Since 2012, she has directed Collect Rx’s operations in support of the firm’s successful efforts to obtain the highest possible reimbursement for its provider clients. Ms. Grimsley has in-depth experience in developing, implementing and managing complex work-process and electronic-based workflows that support thousands of bill resolutions monthly. She also ensures that Collect Rx quality assurance and productivity benchmarks and strategies are fully complied with – a critical function in Collect Rx maintaining the highest level of client services for over 1,300 provider organizations across the country.

Patricia Dixon
Senior Director, Bill Resolution

Ms. Dixon has 20 years of experience in the health care reimbursement field, working on behalf of both payers (prior to joining Collect Rx) and providers. She currently oversees Collect Rx negotiation activities on behalf of the firm’s 1,300+ provider clients. Her role includes overseeing the Collect Rx staff who directly engage payers and their vendors to obtain the satisfactory reimbursement of out-of-network bills. Prior to joining Collect Rx, Ms. Dixon served as a manager at About Health, then remaining in that capacity after it was acquired by Concentra (now re-named Viant and owned by Multiplan).

In addition to managing negotiation staff, Ms. Dixon’s experience includes: establishing and conducting Quality Assurance audits for payers and providers related to reimbursement; negotiating out-of-network claim discounts with providers on behalf of the largest commercial payers in the U.S., as well as third-party administrators and self-insured groups; and recruiting providers to join managed care networks. Ms. Dixon has worked with virtually every type of provider in the arena of out-of-network reimbursement – including hospitals, physician groups, ambulatory surgery centers, nursing homes, behavioral health facilities, home infusion and durable medical equipment providers, and dialysis firms.

Lisa Stovall
Senior Director, Bill Resolution

Ms. Stovall has over 15 years of experience in the out-of-network healthcare reimbursement field.  She oversees Collect Rx’s Negotiation (Pre-Payment) Service for the Company’s 1,300+ customers.

Her role includes overseeing the Collect Rx staff who directly engage payers and their vendors to obtain maximum reimbursement for providers on out-of-network bills.  As such, she is responsible for managing the myriad array of variables that support strategies for obtaining the highest reimbursements on out-of-network bills.   Her experience includes reviewing claims to validate code edits (as a Certified Coder) and investigating claim details to get the highest reimbursements possible.

Prior to her current role at Collect Rx, Ms. Stovall worked with many of the leading insurance companies and payer-focused cost containment vendors, including United Healthcare, National Care Network (NCN), Emdeon, TC3 Health and Zurich.

Patrick O’Connor, M.B.A.
Director, Account Managment

Mr. O’Connor has worked in operations management and analysis for 10+ years. Prior to coming to Collect Rx, Mr. O’Connor worked as an Operations Analyst dedicated to process improvement, cost containment, and staffing solutions for a large national Legal Process Outsourcing company.  His unique ability to analyze and quantify data and put it into a client’s perspective makes him a great fit at Collect Rx.

Having joined Collect Rx in 2013, Mr. O’Connor now serves as Collect Rx’s Director, Account Management. During his tenure he has managed the Operations team in developing complex process workflows, team building, and client reporting initiatives, all aimed at reducing the revenue cycle and increasing the efficiency and productivity of Collect Rx.

Mr. O’Connor holds a M.B.A. degree from Loyola University of Maryland and a bachelor’s degree in Communications from The University of Maryland.

Franklin Smith
Director, Revenue Cycle Management

Mr. Smith has worked in the revenue cycle management industry for 30+ years.  He was employed by Calvert Memorial Hospital for nearly 16 years, serving in numerous capacities as a transformative revenue cycle leader. Previously, Mr. Smith consulted as a revenue cycle operational efficiency expert and fiscal improvement strategist for a variety of mid and large sized healthcare providers. He began his career in the healthcare industry by working in the claims management department for Blue Cross Blue Shield. Mr. Smith's experience with billing operations and the ability to provide strategic leadership and sales support regarding client revenue cycle inquiries continues to be an essential component of Collect Rx's rapid growth in the RCM business.

Mr. Smith holds a B.S. Degree from Virginia State University and a certification as a Certified Revenue Cycle Executive from the American Association of Healthcare Administrative Management (AAHAM).

The Collect Rx service is awesome. Not only is your service the best in the industry, you define the industry!

Thanks, you do excellent work and it’s very important to our center. We're lucky to have you as part of our team.

All I have to say is WOW and thank you!

301-230-2440

info@collectrx.com

6720 Rockledge Drive · Tower B, Suite 600 · Bethesda, MD · 20817

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