APEX IONM SOLUTIONS

BACKGROUND

Introduce your business and what you do there.

I’m the VP of revenue cycle for a company that provides intraoperative neuromonitoring (IONM) services. When clinicians go to the operating room and put electrodes all over a patient for brain or spinal surgery, we help monitor that patient’s nervous system to assist the surgeon in the appropriate direction. We also report back to the surgeon about any nervous system issues they can fix while performing the surgery. 

OPPORTUNITY / CHALLENGE

What challenge were you trying to address with APEX IONM SOLUTIONS?

We want to keep our bottom line secure in terms of billing and insurance claims, so we need IONM billing specialists that can work with us on a daily basis. We’ve tried to do our billing in-house but failed to make it work. Around 90% of IONM companies are billed externally instead of internally because the customs procedure code (CPC) that we have is built for clinical services and not for the operating room. Moreover, the appeals process for IONM companies is highly detailed. We need to provide plenty of documents to prove that we offer legitimate services. As such, we need APEX’s help. 

SOLUTION

What was the scope of their involvement?

APEX provides IONM billing services for us. They run all our insurance collections processes, so any insurance company that we’re billing goes through APEX. Their team also ensures that our electronic medical record (EMR) system is set up in a way that our company has the same lingo as the other IONM company. We also conduct meetings once a month where our teams get together to see if we need to make decisions around billing and insurance. They also check whether code updates affect us. 

What is the team composition?

The team is composed of seven people, and we have one primary point of contact, who’s also the director of the APEX team. We interact with them on a day-to-day basis. Apart from them, I also check in with their president on a regular basis to know what they’ve seen or heard. We try to know whether there’s any industry news that we can digest together. In other words, we have a strategic relationship with their executives. 

How did you come to work with APEX IONM SOLUTIONS?

We knew APEX specialized in IONM billing. They were also related to another IONM company under the same holding company as them. Meanwhile, we had a friendly relationship with that IONM company even though we were competitors. 

Eventually, we reached out to industry resources and decided that even though APEX belonged to the same holding company as our competitor, we felt comfortable with it. They felt the same, and the onboarding process wasn’t difficult at all. On top of that, our companies used the same EMR system for our clinical work. In other words, we already had a common platform, which would have otherwise been a major hurdle to avoid. Ultimately, we decided to go for them. 

How much have you invested with them?

We’ve spent around $4 million. 

What is the status of this engagement?

We started working together in August 2017, and the partnership is ongoing. In fact, we’ve just hit our four-year anniversary. 

RESULTS & FEEDBACK

What evidence can you share that demonstrates the impact of the engagement? 

APEX has specialized services for IONM companies, and that in itself is already a huge benefit for us. For instance, their director leads the team and handles our claims, but she also leads two other teams for other IONM companies. As a result, they have the ability to assimilate data on a level that other companies cannot. Given that, our team strategizes with them based on their learnings from the claims they serve. 

On top of that, we consider our engagement as a partnership and not a vendor-client relationship like with other billing companies. We work on a strategy together. If someone has an idea from either of our sides, we all listen, digest it, and work together to figure out the best solutions to move forward. Overall, their strategic assistance with billing and codes is invaluable.

How did APEX IONM SOLUTIONS perform from a project management standpoint?

While they’re not in our region, they’re quite close. As a result, we speak a common language in terms of healthcare jurisdictions. We might technically be from different jurisdictions, but we’re right next door to each other. Ultimately, it’s easy for us to see common numbers coming back from insurance companies.

What did you find most impressive about them?

The most impressive part of the relationship is the communication and strategic partnership we have as we engage to make higher-level decisions. This stands out to me because I’ve seen companies before that only try to get the claim as clean as it can be and send it out. By contrast, our companies take things to a much deeper level. Together, we look at what we’re getting and then decide if we need to make changes as partners to ensure that our revenue cycle and operational processes are appropriate. 

Are there any areas they could improve?

No, there aren’t any. I’ve seen them make changes internally based on our feedback as much as we’ve done the same for their feedback. Even if we come upon a negative situation or a difficult scenario, our ability to work through it has ultimately been a positive one.

Do you have any advice for potential customers?

Make sure that your EMR and other technology platforms are aligned with what APEX is using. If you come to them and say you’ll stick with your platform, they’ll still work with you. However, if you don’t have any big reason to use a different platform from what APEX has, it’s best to just use theirs.