Why I Use EZClaim – A Billing Expert Interview

Why I Use EZClaim – A Billing Expert Interview

If you’re thinking of investing in medical billing software, there’s no better person to give you the answers you need than Chelsea Graven, a revenue cycle director for Alert Medical Alarms. With over ten years in the medical billing industry, she’s been in numerous roles including billing and claims submissions. A longtime customer and champion of EZClaim since 2013, Chelsea has referred the software to many other partners because she knows firsthand not only how simple it is to use, but how effective the software is.

Recently, we found time to interview Chelsea about her start in the industry, why she continues to recommend EZClaim, and her advice on anyone starting out in medical billing.

EZCLAIM: Working with EZClaim’s medical billing software platform, what role does their software impact your work?                               


GRAVEN: “The company I currently work for was originally either submitting paper claims or billing through portals. EZClaim has allowed us to transition to electronic billing and it cuts the amount of time we spend in provider portals or filling out those forms. I would say seventy-five percent of the workload has been cut using EZClaim. Previously, it took one person three weeks to bill 6,000 claims. Now, we are billing 7,000 claims in a matter of minutes just by submitting and using the features within EZClaim, such as the recurring claim option.”


EZCLAIM: If you were going to share something with your colleagues about EZClaim, what would it be?                                                     

GRAVEN: “How spot on the name ‘EZClaim’ is. It’s exactly what it’s called, EASY. Other software programs do not accommodate the simple recurring billing that we need. EZClaim is the only software I have used that does that and makes it easy. Of all the billing software platforms I have used, EZClaim is the simplest to use and the most user-friendly.”


EZCLAIM: What would you say are some strengths needed to be an effective medical biller?                                                                       

GRAVEN: “Analyzing, troubleshooting, and resolving. There is a lot of that involved. You must be able to troubleshoot and independently find resolutions in order to be effective at billing. I think EzClaim has customized reporting capabilities that allow the companies to better follow current trends that they are seeing in claims, denials, and payments. Tracking the trends is what will lead to the troubleshooting, analyzing, and resolving of any issues, having customizable reporting makes all the difference to successful billers. You can’t fix something if you don’t know it’s wrong, EzClaim reporting brings all of that to the biller, so you don’t have to go looking for problems/solutions on top of your daily billing processes.”


EZCLAIM: Do you have any advice for anyone who is starting out in the medical billing industry?


GRAVEN: “EZClaim is my go-to for anyone who is doing medical billing and is wanting to learn and get into the industry because it is the simplest software to use. EZClaim makes it easy to grasp the electronic billing end-to-end process without feeling overwhelmed by the complexity of the software. I would say for anyone starting out the first thing I would do is find an electronic billing solution and a clearinghouse.”


EZCLAIM: Why did you get into the medical billing industry?                                                                                                                             

GRAVEN: “I actually fell into this industry by default. I was working on private pay collections for a company and at the time the state of Illinois in 2010 transitioned to manage care programs, and no one was really prepared for that. I was then asked to take on the role of billing manager. It grew so large that doing HCFA 1500 forms was not efficient, so I started looking for electronic billing solutions. What I enjoy most about the billing industry is closing the claims entirely. Getting that amount to zero dollars. Most people wouldn’t say it’s the money coming in, but for me, it’s the gratification for the end-to-end process of the revenue cycle. It’s all about getting the receivables closed.”


EZCLAIM: Final thoughts?                                                                                                                                                                                         

GRAVEN:With EZClaim, the value is beyond just the software. Yes, it’s easy to work with, but the IT team and all the people involved make the experience favorable.”

 [ The above answers were paraphrased as closely as possible to the original answers given by Chelsea Graven on October 22nd, 2021. ]

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.




No Surprise Act Tackles Unexpected Medical Bills

No Surprise Act Tackles Unexpected Medical Bills

New No Surprise Act Tackles Unexpected Medical Bills

Two-thirds of bankruptcies filed in the United States are a result of medical expenses. It’s an alarming statistic, but probably not surprising. It’s no secret that many people have trouble paying out-of-pocket medical costs, so much so that a recent survey from The Commonwealth Fund found that 72 million Americans have some sort of trouble with medical debt.

It’s a common problem, but why? Let’s say a person visits a hospital, perhaps an emergency room, and receives a myriad of services. Maybe they arrived via ambulance or required treatment from an anesthesiologist. Although they may inquire about an estimate at the time of service or have an idea of their coverage, the exact financial responsibility is often a mystery. But what’s a person to do? They need medical assistance, and they need it at that moment. Then a surprise arrives in the mail in the form of an outrageously high medical bill. It’s something many of us have likely experienced.

What’s the cause of such an expense? Often the charge stems from using an out-of-network provider. Basically, this means that the hospital may have been in-network, but the physicians were not. Additionally, patients are often confused about medical coverage. Even with a good understanding of their benefits, situations may arise that are out of their control, and there may be unintended outcomes. Patients may (falsely) believe that all services rendered will be considered in-network when they go to an in-network facility. However, this isn’t always the case. In some instances, even though their physician is in-network, patients referred to specialists (such as a pathologist or radiologist) may discover the ancillary services were out of network. It is only after the patient receives a bill that they discover the issue. In the case of an emergency visit, patients don’t have the luxury of researching for in-network hospitals and typically go to the nearest hospitals. Patients may also be taken to out-of-network hospitals by ambulance. Researchers estimate that 1 in 6 emergency room visits and inpatient stays involve care from at least one out-of-network provider. The cost of out-of-network visits can have devastating financial consequences for the patient.

2019 study by the Government Accountability Office (GAO) found that the cost for air ambulance services clocked in at approximately $40,000. A large portion of this cost (over 70 percent) often fell out-of-network, meaning that the balance usually was placed on the consumer. When such a service is needed, it’s understandable to not have the option to “shop around” for a cheaper, in-network alternative.

Thankfully, help is on the way. Leaders and policymakers at the federal level have taken steps to tackle the issue. On July 1, 2021, the Biden Administration announced a new rule aimed at protecting consumers from surprise medical bills. In conjunction with the Department of Health and Human Services (HHS), together with the Departments of Labor and Treasury and the Office of Personnel Management, debuted “Requirements Related to Surprise Billing; Part I.”

This announcement, the first in a series, will go into effect on January 1, 2022, and protect patients from those all-too-common surprise medical bills. It’s an important step forward in protecting patients.

“No patient should forgo care for fear of surprise billing,” stated HHS Secretary Xavier Becerra. “With this rule, Americans will get the assurance of no surprises.”

Let’s dive into the new regulation. Among other provisions, the rule:

    • Protects patients from surprise billing in emergency services. These provisions will safeguard patients in emergency care situations from unknowingly accepting out-of-network care and incurring unexpected expenses.
    • Limits out-of-network cost-sharing. Patient cost-sharing for emergency and non-emergency services, such as a deductible, cannot be higher than if provided by an in-network provider. Simply put, co-insurance or deductibles must be based on in-network rates.
    • Bans out-of-network charges for ancillary care. Previously, out-of-network providers like anesthesiologists could have been assigned, even though the facility or physician was in-network.
    • Requires that providers and facilities provide patients with accurate cost information and advance notice of any out-of-network charges for non-emergency services. A consumer notice must explain that patient consent is required to receive care on an out-of-network basis before that provider can bill at the higher out-of-network rate.
    • Allows providers and insurers access to a dispute resolution process should reimbursement issues arise around reimbursement.

With the increase in high deductible health plans and increased out-of-pocket costs, finances are top of mind. From the consumer’s standpoint, gaining healthcare services will be less stressful. On the simplest level, this ruling will hopefully eliminate those hefty surprise bills, which can only be seen as a positive. Moving forward, patients can rest assured that they will be more aware of expenses and will avoid out-of-network charges for emergency care.

So can consumers finally say goodbye to surprise medical bills? Hopefully, they become a thing of the past. And how will this bill affect the future of the industry? Advocates are hoping these regulations and newfound transparency will eventually lower costs, for one. More importantly, it shines a light on the need to improve the overall patient experience. It’s a step in the right direction and has the potential to improve healthcare policies going forward for years to come.

For more information on solutions that equip you to have informed conversations about financial responsibility and eligibility, contact a TriZetto Provider Solutions representative today.

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.