If you are a member of the MEDICAL BILLING COMMUNITY, the norms of the day-to-day have changed. With the recent COVID-19 pandemic and the ‘stay-at-home’ order, you may find yourself with either more time on your hands and/or an increase of claims with new patients. During this time, we want to offer you a couple of suggestions so that you can make the best use of the additional time you have, and also help you improve your billing processes.
The first thing to consider is to review your Accounts Receivable (AR)—to collect payments due you to INCREASE YOUR INCOME. According to the American Medical Association (AMA), claim denial rates range between 0.5% and up to 3% or more, and that 90% of claim denials are preventable. Some of the most common claim denial reasons can be rectified by correcting claim management workflows, including claim submission and patient registration procedures. The following are a few of the most common oversights for claim denial.
- Use EZClaim software to check automatically for missing information, including absent or incorrect patient demographic information and technical errors
- Make sure you do not have duplicate claim submissions
- Check that claims do not have services previously adjudicated
- Review for claims with services not covered by the payer
- Make sure the time limit for claim submission has not expired
Secondly, revisit and resubmit open claims. Surprisingly, 31% of providers still use a manual process to resubmit. Our partner, TriZetto Provider Solutions (TPS), has an Advanced Reimbursement Manager Pro (ARM) that has two great tools that can improve your ability to tackle collecting and repaying underpaid and overpaid accounts. Below are some key features that can be automated by their software, and will help to improve your billing processes:
- Identify common errors and payer trends
- Analyze contract performance
- Customize and assign work into queues
- Quickly access information from interactive dashboards
- Automate the appeal process
Thirdly, know that EZClaim and our partner TPS have worked together to bring you the most powerful medical billing software tools to solve claim denials. Our partnership not only simplifies the billing process but also helps resolve denied claims in an efficient way. In addition to that, our customer support team is available to help you learn best practices with these tools, and support you however you need it.
Finally, if you are frustrated with your current medical billing solution, investigate how EZclaim’s medical billing solution may work for you. You can either schedule a one-on-one consultation with our sales team or download a FREE TRIAL to check it out the software yourself. For additional information right now, contact EZclaim’s sales team at 877.650.0904 or send an e-mail to firstname.lastname@example.org.
A recent medical billing webinar on Telehealth that EZclaim hosted is now available to review.
On April 30th, EZClaim hosted a Telehealth Updates Webinar for our clients with guest speaker Sandy Giangreco Brown – Director of Coding and Revenue Integrity Health Care at CliftonLarsonAllen, LLP
We had one of the largest viewing audiences 101 active attendees in the session. Sandy shared informative billing codes and direct links to update hands-on information for billers actively coding Telehealth sessions. For those of you who missed it, we have provided on our website the recorded session ezclaim.com/webinars and can provide the presentation slides too! Just send a request to email@example.com
We continue to get views of this presentation and look forward to hosting more hot topics with the CLA Team.
With the onset of COVID-19 came a great opportunity for clinics and hospitals to offer Telehealth and Communication Technology Based (CTSB) services. The Centers of Medicare and Medicaid Services, or CMS, have provided many updates to the available services that can be provided and billed to the patients to help practices not only stay afloat financially but also and most importantly, to keep their staff safe and provide excellent care to their patients!
There were new guidelines released even after this webinar on 4/30/2020 (which can be found here – https://www.cms.gov/files/document/se20016.pdf, and now includes audio-only Telehealth for services such as psychotherapy, tobacco cessation and medical nutrition counseling as well as diabetes self-management training. CMS is also increasing the payments for the Audio Only services from $14-$41 nationally to $46-$110.
As of April 30, 2020, in order to bill Telehealth, RHCs are now required to bill the G2025–CG–95 from January 27, 2020, to June 30, 2020. Then from July 1, 2020, to the end of the PHE, they will be billing the G2025 with an optional 95 modifier, per CMS SE20016 Medicare Learning Network Transmittal.
FQHCs will need to report three (3) codes for their Telehealth Services:
- G0467 (or other appropriate FQHC specific payment code)
- 99214–95 (or other FQHC PPS Qualifying Payment Code)
CLA is on the frontlines and closely monitoring and analyzing activities related to Telehealth and other virtual health regulations
CMS Telehealth fact sheet, Frequently Ask Questions:
As your practice adjusts to Telehealth going forward, EZclaim’s medical billing solution can help you simplify patient billing and help you get paid for Telehealth visits. (Our recent medical billing webinar on Telehealth may just help you better understand the current situation).
So, to help you investigate how EZclaim’s medical billing solution may work for you, either schedule a one-on-one consultation with our sales team or download a FREE TRIAL to check out the software yourself. For additional information right now, contact EZclaim’s sales team at 877.650.0904 or send an e-mail to firstname.lastname@example.org.
[Contributed by Sandy Giangreco Brown – Director of Coding and Revenue Integrity Health Care, CliftonLarsenAllen LLP]
Telemedicine was already growing in popularity prior to the onset of the Coronavirus pandemic. So, as the adoption rate increases, EZClaim clients may have questions about sending telemedicine charges and getting paid for Telehealth visits.
Telehealth challenges can range from issues with technology to getting paid. With Telehealth becoming the norm for many doctor-patient visits, it is important to have a thoughtful approach in place regarding collecting patient payments. To stay in business, you have to get paid for the work you are doing. So, establishing a process for Telehealth consultations is vital to your business, and it should be a top priority to build a successful program from beginning to end.
The answers to the following questions will help set the baseline for how to collect patient payments for
- What is my process for charging for copays?
- How and when do I collect outstanding balances?
For example, if you collect payment before an in-person visit, you should collect payment before a Telehealth visit, too. There is no need to re-create your process completely. Just change what is needed to match your current in-office routine.
Sending Charges Before a Telehealth Visit
A simple way to send pre-visit charges to patients is to provide them with a link that takes them directly to the payment site. EZClaim’s medical billing solution is integrated with BillFlash LinkPay, which enables customers to provide payment for the upcoming visit. So, before the Telehealth session begins, the practice simply sends a link to their patient via an e-mail or text, making the appointment confirmation and the payment processing part of the check-in process. After the payment transaction is complete, it will immediately show up on the practice’s BillFlash report. LinkPay is designed to be easy to use and doesn’t require patients to remember a login or a chart number.
Here’s how EZClaim enables the process through BillFlash:
- Prior to Telehealth visit, the patient is sent a link to pay through LinkPay, and another link to join the Telehealth call
- The patient pays the required amount through LinkPay, which is immediately confirmed and processed
- The patient joins the Telehealth session
- Results and follow-up are completed electronically
- Insurance billing is completed
- The patient receives a paper statement or eBill notification for any remaining balance
- The patient is directed to pay the remaining balance online at MyProviderLink.com
Automate What Can Be Automated
With so many changes taking place in healthcare, a great way to help protect the financial stability of your practice is to automate what can be automated. This saves your staff time and decreases your cost of doing business.
One way to do this is to set up automatic payment plans for patients, particularly for those who have been hit hard by the economic impact of COVID-19. A payment plan is a good way of keeping the revenue flowing in, and it shows your patients that you are compassionate and willing to help them through these unprecedented times.
BillFlash also securely stores payment information, so patients will not need to re-enter their information every time they pay a new bill.
As you continue to adjust to Telehealth going forward, BillFlash can simplify patient billing and payments significantly and help getting paid for Telehealth visits.
So, for a LIMITED TIME (during May 2020), EZClaim customers can try BillFlash statement and eBill services for FREE for 30 days. Click on this link for more details about BillFlash or try it out for the next month.
For additional information, call BillFlash at 435-940-9123, or contact EZclaim’s support team at 877.650.0904 or email@example.com.
[Contributed by James Easley VP, Marketing NexTrust Inc.]
Ransomware Targeting Medical Billing Companies
As the number of healthcare providers taking advantage of Telehealth increases during this uncertain time, the number of ransomware attacks continues to increase as well.
Ransomware is a type of malicious software designed to block access to a computer system until a sum of money is paid. Microsoft says, “Multiple ransomware groups that have been accumulating access and maintaining persistence on target networks for several months activated dozens of ransomware deployments in the first two weeks of April 2020.”
The attacks are targeted towards aid organizations, medical billing companies, manufacturing, transport, government institutions, and educational software providers, however, Microsoft says that it doesn’t stop with critical service groups and suggests all networks are aware of these attacks and taking necessary steps to limit risk. NetWalker ransomware, for example, gained notoriety for targeting hospitals and healthcare providers with e-mails claiming to provide information about COVID-19.
Have you had an Accurate and Thorough Security Risk Assessment and/or penetration testing?
If you haven’t completed an accurate and thorough security risk assessment, you could also be penalized under ‘willful neglect’ (this category alone is $50,000 per violation!) in addition to the higher risk of ransomware attacks. What we do is keep this from ever being a worry for you! We perform your security risk assessment and manage all of your requirements, in a clean, organized cloud-based portal.
Don’t risk your company’s future, especially when we are offering a FREE Organization Assessment to help determine your company’s status.
It’s easy! Call us at (980) 999-1585, or email me, Jim Johnson at jim@LiveCompliance.com or visit
Live Compliance has partnered with EZClaim medical billing software to strengthen what they can provide for you. It provides all of your HIPAA Privacy, Security Requirements, and Measures. HIPAA compliance is a requirement for Covered Entities and Business Associates to safeguard personal, private, and protected health information—allowing organizations to relinquish the struggle of compliance requirements.
You can investigate the EZClaim medical billing software by either downloading a FREE DEMO or just contact our knowledgeable sales staff to answer any and all of your questions by phone at (877) 650-0904 or by e-mail at firstname.lastname@example.org.
[ Contributed by Jim Johnson of Live Compliance ]