Jul 29, 2021 | Medical Billing Software Blog, Partner, Waystar
As patients return to doctor’s offices and health systems around the country, healthcare organizations find themselves in uncharted waters, with a greater need than ever to make data-driven decisions that grow revenue. Per a recent report from KLAS, 63% of hospitals found themselves struggling with real-time data analytics.
It should come as no surprise then that investments in new analytics tech and training are on the rise. According to a report from the Society of Actuaries (SOA), 42% of surveyed healthcare executives reported an improvement in patient satisfaction since implementing predictive analytics, while 39% said they had cut costs. Since 2011, over $39B has been invested in digital health tech, including $7.48B in 2019 alone. It’s estimated that roughly 20% of that has been funneled into the development of technology-focused on managing health records and analytics. Furthermore, some models have estimated improving available data collection and analysis tech could save the healthcare industry roughly 25% of its total costs.
The question is, what can you do to unlock that potential within your own organization? There’s a deep well of data that each revenue cycle feeds into, which if properly analyzed, can help organizations operate at their most efficient and effective. Here are the four stages of data analytics workflows that are key to developing those actionable insights.
1. A trigger, or the point in your revenue cycle that sets up the call for deeper analysis
2. Interpretation of data to determine root causes and identify appropriate next steps
3. Intervention to improve specific metrics
4. Tracking of said metrics to chart success in achieving desired outcomes
Let’s examine what a successful version of each stage looks like.
1. Trigger
The trigger occurs when you notice something that needs further investigation. With the right analytics tool, you can easily access all of your key performance indicators, financial goals, and more, providing the visibility you need into your rev cycle. When something looks amiss or needs improving, you can drill down to the level that shows what’s really going on.
2. Interpretation
Even a wealth of data amounts to nothing without an efficient way to process and communicate key takeaways. You’ll need to equip your team with access to concise reports, smart visualizations, and relevant historical data in order to get them to the insights that drive action.
3. Intervention
Now is the time to take action. Intervention is ultimately tied directly to your ability to drill down into the data underlying problematic areas of your revenue cycle and clearly communicate takeaways with your team. Success at this stage depends on designing a plan based on your best understanding of underlying issues and the most effective way to address them.
4. Tracking
Your intervention plan is built on KPIs that naturally intertwine with the way you measure success across your revenue cycle. With proper implementation and tracking, running with the analytics cycle can become a simple addition to your everyday workflow. More than delivering on your initial goals, the true power of analytics is the ability to deliver repeat value on your initial investment.
A strong analytics solution does more than deliver a more fully developed picture of your rev cycle performance. It provides actionable business intelligence, cuts down on time between analysis and action, and lessens the strain on your IT department.
Beyond the actionable internal insights it can provide, analytics is also a key tool for helping you benchmark performance in comparison to peers in the industry. And with the right analytics solution, competitive analysis is a simple task, using automation that reviews customizable benchmarks for a tailored review of the claim, payment, and denial performance.
Looking for a truly comprehensive analytics solution to help improve performance and enhance your benchmarking capabilities? Find out how Waystar can help you harness the power of your data through analytics. Visit Waystar.com
Heading to AMBA in October? Visit Waystar and EZClaim while you’re there! Stay tuned for more event details.
ABOUT EZCLAIM:
As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.
[ Contribution from the marketing team at WayStar ]
Jul 27, 2021 | HIPAA, Live Compliance, Partner
HIPAA Social Media Do’s and Don’ts in Healthcare
There are many benefits to social media in the healthcare industry, however, there is also huge potential for HIPAA violations of patient privacy to be violated on social media networks. The Privacy Rule protects All “individually identifiable health information” held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper or oral. The Privacy Rule calls this information “protected health information (PHI).”
Did you know that more than 71% of recorded data breaches in the healthcare industry are attributable to employee actions?
The most important rule is to never share Protected Health Information or Personally Identifiable Information on social media. Social media may include personal blogs and other websites, including Facebook, LinkedIn, Twitter, YouTube, or others of the like.
A few common identifiers include but are not limited to:
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- demographic data
- medical histories
- test results
- insurance information
- and other information used to identify a patient or provide healthcare services or healthcare coverage.
What is a breach and what can I do to avoid it?
A breach is, generally, an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of the protected health information. This means employees should refrain from posting, commenting, or sharing patient information on social media including patient names, photos, and descriptors that would identify the patient.
What is considered identifiable information?
The most common social media HIPAA violations include:
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- Posting of images and videos of patients without written consent
- Posting of gossip about patients
- Posting of any information that could allow an individual to be identified
- Sharing of photographs or images taken inside a healthcare facility in which patients or PHI are visible
- Sharing of photos, videos, or text on social media platforms within a private group
“Friending” patients on social media websites is also strongly discouraged. This can lead to accidental identifying of patients, especially if your place of work is listed in your profile and accidental ‘discussion’ about the patient’s care. Therefore, employees in inpatient care roles generally should not initiate or accept friend requests. Do not enter into social media discussions with patients who have disclosed PHI on social media.
Employees should also refrain from messaging or texting PHI or PII on social media or messaging applications not approved by your organization. In general, no personally identifiable health information should be sent in any manner which does not ensure communication encryption in transit and at rest.
So, what do you do if you think you may have exposed a patient’s protected health information or personally identifiable information?
In general, it’s advised to, follow your organization’s Incident Response Policy immediately and notify your supervisor and/or designated HIPAA Security Officer for immediate next steps.
At Live Compliance, we make checking off your compliance requirements extremely simple.
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- Reliable and Effective Compliance
- Completely online, our role-based courses make training easy for remote or in-office employees.
- Contact-free, accurate Security Risk Assessments are conducted remotely. All devices are thoroughly analyzed regardless of location. Conducting an accurate and thorough Security Risk Assessment is not only required but is a useful tool to expose potential vulnerabilities.
- Policies and Procedures are curated to fit your organization ensuring employees are updated on all Workstation Use and Security Safeguards in the office, or out. Update in real-time.
- Electronic, prepared document sending and signing to employees and business associates.
Don’t risk your company’s future, especially when we are offering a free Organization Assessment to help determine your company’s status. Call us at (980) 999-1585, or email me, Jim Johnson at Jim@LiveCompliance.com or visit www.LiveCompliance.com
For more information about DarkWeb breaches please contact us at (980) 999-1585 or email us at support@livecompliance.com
ABOUT EZCLAIM:
As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.
Jul 26, 2021 | Partner, Trizetto Partner Solutions
Medicare is the largest payer for most practitioners, so it’s important that providers maintain current credentials. Medicare requires providers to revalidate every five years to verify credentials and ensure they meet Medicare qualifications. Providers must confirm or update information including the legal entity name, physical address, phone, fax, national provider identifiers, employer identification number, and board certifications and licenses if applicable.
While typically a straightforward process, if not completed correctly and on time, providers will be terminated from the program and required to reapply. Until a new application is processed and approved, which can take anywhere from 90-120 days, reimbursements will stop, disrupting the revenue cycle.
Occasionally, providers may receive off-cycle revalidation requests. These are typically triggered when anomalies are identified such as billing rates that are significantly higher than other providers in the same geography, billing for services not rendered, or billing patients for services that Medicare doesn’t allow.
To comply with Medicare revalidation requirements, providers need to know their revalidation schedule and make sure applications and supporting documentation are submitted through Medicare’s PECOS online application portal. Revalidation dates cannot be extended, so it’s important they’re submitted on time. Using a third party to navigate the nuances of Medicare revalidation and PECOS removes the burden from provider staff and ensures accurate and timely filing.
TriZetto Provider Solutions (TPS) offers an end-to-end credentialing service that includes continuous payer follow-up and insight into enrollment status. Our dedicated team takes provider data, verifies it for accuracy, and submits credentials for revalidation through PECOS. All Medicare-participating providers are subject to revalidation, and mistakes made before or during the process can result in loss of eligibility and other penalties.
Having nearly four decades of experience working with payers and providers, the TPS credentialing experts understand the importance of maintaining current credentials. Contact us to learn more about our Medicare revalidation services.
ABOUT EZCLAIM:
As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.
Jul 22, 2021 | BC Medical Billing, Medical Billing Software Blog
After Pandemic Impact and Outsourcing Revenue Cycle Management
The impact of the COVID-19 pandemic will be felt in every industry for many months to come. For medical providers, they are facing some of the most challenging financial times they will or have known. Therefore, we understand that it is crucial for providers to re-access their business and look for ways to cut costs with minimal impact on their practice or their patients.
To compound the issues providers are facing, there has been a wave of changes in recent years with new coding and telemedicine requirements that are making it difficult for provider offices to remain independent. Add on the constant rise in the cost of living and expenses while insurance reimbursements continue to decrease, and the issues get worse and worse.
Many have decided that outsourcing to a complete revenue cycle management company could help alleviate some of the undue burdens, cut costs, and keep providers compliant with their coding and billing. Ultimately this allows providers to continue to focus on patient care, which is their goal. As providers, you understand that revenue cycle management is a crucial part of your physician’s office. If not managed properly, it could result in an office leaving thousands of dollars on the table in unclaimed revenue. Over the years, our free audit services have allowed providers to have a free, transparent, and unbiased assessment of how their accounts receivable department functions. We are always amazed at how many providers do their billing in-house, and sometimes even when they outsource, are not aware of how much money they have sitting in their accounts receivables. Getting this knowledge is the first step to increasing revenue and efficiency.
In-house medical billers and third-party outsourced revenue cycle management companies should be giving provider offices monthly aging reports to assess their financial forecast. Each accounts receivable bucket over 60 days should hover at approximately 1 0% or less of the entire revenue balance. If account receivable buckets are higher than 10%, providers may be leaving money on the table, and the account may not be getting worked as providers think they are. In efforts to avoid unpaid claims and a spike in accounts receivable, outsourcing your revenue cycle management to a third-party medical billing company, such as BC Medical Billing, could help providers in countless ways. Many practices recognize that keeping their revenue cycle management optimized is key in delivering regular practice operations; however, they are not always sure how to achieve that. Outsourcing may be the solution!
Outsourcing alleviates the practice from managing a new medical billing employee, paying a salary and benefits, completing training and onboarding protocols, and managing the lost time from a learning curve. Many providers feel that it is not a wise use of the back office executive personnel’s time to worry about finding coders in-house and then wondering if the charges are captured and billed correctly. Instead, the business office should be focusing on how to grow the providers and the physician practice.
Our free audits will help you determine if you have found the right solution for you. If not, we are always there to assist and always increase the provider’s revenue.
ABOUT EZCLAIM:
As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.
[ Contribution from the marketing team at BC Medical Billing ]
Jul 14, 2021 | BillFlash, Partner
There is no surprise that the cost of healthcare continues to rise creating financial hardships not only for patients but for physicians as well. While the COVID-19 pandemic severely impacted how patients interacted with their physician’s office, it is important to understand that patients want to be financially responsible for their medical bills and have preferences on communication methods to increase revenue.
In order to improve the overall patient experience and collection of revenue, it is important for physician offices to truly understand the demographics of their patients and the differences amongst their generational behaviors. Using a one-size-fits-all approach to communicate with patients is an outdated method and oftentimes leads to patient frustration, lack of engagement, poor retention, and missed opportunities to enhance revenue collection.
In a recent article published last month, physicians must adapt to the patient’s digital experience in order to enhance receiving payments for medical bills (Healthleaders, 2021). Patients desire modern payment options such as a payment portal, mobile ability, texting capabilities, and/or scanning a QR code. In addition, 76% of healthcare consumers desired a contactless method that allowed them to view their statements online and make payments without the need to visit the doctor’s office. According to (Healthleaders, 2021), the number one payment option patients desire is contactless debit and credit card options. In addition, patients desire payment options to help them manage their medical expenses such as payment plans and/or auto-pay methods.
As a medical billing expert, EZClaim can help medical practices improve their revenue through their billing and scheduling software in conjunction with BillFlash, which provides contactless and modernized communication methods that patients highly desire. Let EZClaim and BillFlash enhance the options to modernize your medical billing and communication systems.
ABOUT EZCLAIM:
As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.
