For over two decades, EZClaim’s foremost goal has been to make medical billing easier and more efficient. Let’s look at the features in EZClaim that h.
Templates
Templates are a great way to save time and ensure accuracy by pre-filling fields that will be consistent across patients or claims. EZClaim has two types of templates to choose from
Patient templates
Patient templates can be used to pre-fill patient demographic information. These templates are extremely useful and flexible across a range of scenarios where you know that patient demographic information will be the same.
For example, if your office has one doctor that only serves Medicare patients, you can easily create a template that will pre-fill Medicare as the payer for that doctor. Maybe you have a payer that requires a specific qualifier. This can be quickly loaded from a template with the necessary fields pre-filled.
Claim templates
Claim templates work much the same way that patient templates do. They make it easy to create claims around “standard” visits. In pediatrics, a common usage might be a claim template for a well-visit and immunizations. Standardizing these visits with a template not only saves you time but also helps ensure you are collecting all the applicable charges and that nothing gets left off.
Another common example that we see is using templates for modifiers for tele-health visits. The template gives you a standard foundation to make sure everything is in order.
A similar functionality that many find useful is using the “previous claim” pre-fill functionality. This copies the fields from the previous claim into a new one, which you can then alter as needed.
Both patient and claim templates serve as a flexible tool to standardize your process, reducing repetition and increasing accuracy.
Validation rules
Another great tool to ensure clean claims is by validating inputs. EZClaim comes with several default validation rules, for example, a billing provider must be set before the claim can be submitted. This tool can also be used to create custom rules. Rules can be set around how to validate:
- Patient entries
- Payer entries
- Physician/Facility entries
- Sending claims
Like the templating functionality, validation rules are extremely flexible and can be adapted to your individual needs. As an example, one custom validation rule revolves around Medicare member numbers—because we know that all Medicare member numbers are 11 characters, we can set a validation rule that enforces 11 characters for all claims where Medicare is set as the payer. Maybe for your use case certain CPT codes require extra documentation, or certain types of claims that should be flagged for extra review before being submitted. These rules can all be standardized and enforced with custom validation rules.
It might be the case that certain rules have exceptions. Validation rules can be set up to trigger with an error, so that the claim cannot be submitted, or with a warning, so that the user is made aware that a rule has been broken but it will not prevent the claim from being submitted. Custom rules are a powerful tool and must be used with caution—you don’t want to prevent clean claims from being sent out. However, if you find that you are continually running into a particular issue with a category of claims, it can be a great way to ensure accuracy.
