May 22, 2023 | Electronic Billing, EZClaim, Medical Billing Software Blog
Price transparency is an increasingly popular trend in the world of healthcare. The term “price transparency” refers to the ease with which consumers can obtain detailed price and market information of different products. The Hospital Price Transparency rule
went into effect Jan. 1, 2021, requiring hospitals to post a comprehensive machine-readable list of their services and prices as well as a patient-friendly tool to help shop for 300 common services. Although it may not impact what medical billers do on a day-to-day basis, it is sure to have a large impact on the industry as a whole. So, why is price transparency becoming more common in healthcare?
Increasing Healthcare Costs
Healthcare costs have been rising steadily over the past few decades, and patients are increasingly bearing a larger portion of the financial burden. As a result, patients are demanding more transparency in healthcare pricing to better understand the costs associated with their care. Cost of care plays a massive role in whether someone seeks treatment or not. The rise of price transparency has already had a considerable impact on behavior in this regard. Before 2021, 44% of people avoiding obtaining health care were doing so because they didn’t know what it would cost. In 2021, only 25% of people reported avoiding care because of cost uncertainty.
Another trend fueling the price transparency wave is healthcare becoming more consumer-driven, meaning patients are taking a more active role in their healthcare decisions. Patients are increasingly seeking out information about healthcare prices and quality in order to make more informed decisions about their care. As mentioned previously, when information in regards to cost is readily available, people are more likely to seek out care.
Price transparency can also greatly improve the trust and overall relationships patients have with providers and ultimately promotes better outcomes and satisfaction.
Technology has made it easier to access and compare healthcare prices. Healthcare price transparency tools, such as online databases and apps, allow patients to compare prices across different providers and make more informed healthcare decisions.
How Will This Impact Medical Billing?
Fewer Phone Calls: Price transparency is important for promoting accountability and reducing the incidence of surprise medical bills, which can be a significant financial burden for patients and their families. Expect to get fewer calls to your practice about surprise charges.
Patient Responsibility After Insurance: As price transparency becomes more widespread and accessible there will most likely be more preservice collections of estimated patient balances. If patients are aware of their costs upfront and have more time to plan for those they are more likely to pay those either before or at the time of service. This will reduce the effort and time that medical billers would typically have to spend on collection efforts after services are already provided.
Efficiency: On the other hand, price transparency could also benefit medical billers by increasing their efficiency in billing and collections. With greater access to pricing information, medical billers can more easily identify and correct errors in billing and ensure that patients are being charged accurately.
New Tools: Clearinghouses are now offering comprehensive tools that help practices get data directly from payers in a very efficient manner. One such tool is TriZetto’s Patient Responsibility Estimator. This tool enables practices to generate real-time financial estimates for their patients. This creates complete transparency that empowers patients to be more proactive when managing their cost of care, making it more likely that your practice is able to collect payment.
If your practice is curious about how price transparency will continue to impact the industry, we’d love to speak with you. If you are looking to offset the cost of making pricing information available and improve your medical billing process at the same time, we can help. EZClaim is a low-cost medical billing software that has everything you need, and nothing you don’t. Our intuitive software helps practices and billers alike become more efficient. Schedule a consultation today to learn more!
May 15, 2023 | Electronic Billing, EZClaim, Medical Billing Software Blog
Data privacy is another prominent trend in the medical billing industry, and for good reason. With bad actors looking to steal data wherever they can, medical practices and billers can be prime targets. To combat an increased need to protect the data of their patients, practices and billers are implementing robust security measures, making changes to their data collection and storage practices, and being more accountable and transparent in their handling of patient information. More time and resources than ever are being invested into ensuring compliance with ever-changing and evolving regulations.
In this blog, we dive into why the issue of data privacy is so important to your business.
There are myriad rules and regulations regarding patient privacy for a reason. Non-compliance is a very serious matter. An organization that is not in compliance won’t simply be able to claim ignorance, and even if it does, there are potential criminal ramifications.
There are four tiers of HIPAA violations that range from small fines to ones of over $50,000 (minimum, per violation). An organization with several tier four violations can find itself on the hook for up to nearly 2 million dollars in fines in a single year. Very few businesses can withstand such a blow financially, let alone reputationally.
In some cases, a violation can be characterized as criminal, not civil, and even include penalties like jail time.
It is pivotal that your business remains in compliance, as falling out of line can mean the end of your business, or worse.
Preventing Data Breaches
Cybercriminals are becoming more sophisticated, and you need to be sure your systems and security can keep up. Medical billing systems are a prime target for cybercriminals because of the valuable patient information they contain, from credit cards, to medical history, to social security numbers. A data breach can result in the theft or exposure of patient data, leading to identity theft, fraud, and other serious consequences.
Moreover, a breach can be catastrophic to your business’ reputation. No practice or biller wants the reputational damage associated with its patient’s personal information being leaked.
To prevent data breaches, medical billing systems must have robust security measures, such as firewalls, encryption, and access controls. Your business should spare no expense on ensuring you have best-in-class technology and minds behind your security.
Your relationship with patients is the most important aspect of your practice. Your patients share confidential information that they likely wouldn’t share with others. It is pivotal that you take care of this information, and keep it private.
Your patients need to be certain that their medical information, including test results and diagnoses are safe in your hands. If this is not the case, they will take their business elsewhere.
It is critical that you do not undervalue how important data privacy is to your patients. Remember, you are one breach away from disaster, and decades of good-will being torn to shreds instantly.
How to Promote Compliance
There are two primary ways your business can promote compliance with all data privacy/security requirements:
1. Protecting Your Systems: There are countless productive steps your practice or billing (RCM) organization can take to ensure you are taking proper care of patient data
Some of these include
-Extensive password protection
-Regularly updated firewalls and antivirus software
-Access to a secure data-backup source
-Encryption for transferred files
-Information access control/authorization protocol
-Regular technical evaluations to assess threats and potential issues
2. Training Your Employees: When it comes to training your employees, there are two primary buckets you should be focusing on:
Training on your organization’s policies and procedures: General, low-cost training that answers basic questions like “what is HIPAA” is not going to go very far in ensuring compliance. Your employees need to participate in comprehensive, ongoing training specific to your organization and its procedures. This should contain a thorough exam that team members must pass to demonstrate their understanding.
Remember: your organization can have the best compliance program in the industry, but if your employees don’t know about it, it is very easy to slip into non-compliance and encounter major issues that can sink your business.
Training regarding privacy and security as it relates to HIPAA: In addition to company policies and procedures they’ll encounter in their day-to-day, your team should also have a robust understanding of HIPAA itself, and what is and is not compliant.
If you are curious how your organization can improve its compliance, Live Compliance is an exceptional resource and partner for getting you where you need to be.
Are you sure your medical billing system is safe and secure? If you have any doubts, your business is likely in a compromising position. EZClaim is a cloud-based, secure medical billing software that you can access from anywhere, but only with the right permissions. Our top priority is keeping your data secure, and ensuring your business runs as smoothly as possible. Schedule a free consultation to learn more about how EZClaim can transform your business!
May 4, 2023 | Electronic Billing, EZClaim, Medical Billing Software Blog
In the modern day and age, bills are paid online. From car insurance to college tuition, online payment portals have become the best way to facilitate bill pay options. Even stodgy old landlords have allowed their property managers to set up online payment portals. However, in the medical industry where receiving payment is a primary pain point, many patients struggle to pay bills simply because there is no 24/7 bill pay option.
Most people pay their bills at home, after work, and often late at night during their final to-do checklist. Others pay their bills at work between other online tasks. Coming into the doctor’s office or medical facility to write a check is just not on the menu. Many don’t have the time, and for most, it’s now a complete detour from every other life routine.
If your medical practice does not yet have a 24/7 online bill payment option, it’s time. Let’s take a deeper look at the many reasons why medical procedures need this essential billing upgrade.
Digital Accessibility: Patients Who Can’t Make It In
Accessibility is a medically profound reason to switch to anytime online and phone bill payments. However, not everyone can make it into the doctor’s office to pay their bill. It is likely that not all your patients are fully mobile, can drive themselves, or can schedule a quick trip to the office to pay their bills. Supportive families and caregivers may not have the time, or the scope, to take care of in-person bill payments for them. Requiring patients to pay in person is a reliable way to ensure that some payments will be late or missed due to accessibility issues alone.
However, even if you have online or phone bills pays within office hours, this can also be an accessibility issue. You must include patients who work the night shift or whose work hours 100% exclude your office hours. People lose enough of their work hours to medical appointments without needing a second appointment to pay their bills.
The Medical Industry is Behind the Curve
The medical industry is notorious for technological lag, using tried-and-true methods long after the world has adopted the next big thing. But this one upgrade is no longer an option and does not require a huge data migration of secure files. Allowing online and phone 24/7 bill payment has become the industry standard – and has been for over a decade.
According to Insider Intelligence, 85% of patients prefer electronic payments for medical bills, while 65% of patients would consider switching medical providers if paying bills was easier. Medical billing is struggling to get payments from patients who can and are willing to pay. This is because payment has become inaccessible compared to the way all other modern bills are handled. Medical bills are now ranked with traffic tickets as difficult to get paid even when patients desire to pay the bills.
Increase Immediately Available Revenue for Your Medical Practice
Of course, it’s not just about customer satisfaction, or being behind on the digital transformation. It is always about collecting enough revenue to keep the lights on and your staff paid. Medical practices often struggle with finances and billing. Insurance companies like to reject claims and many patients have genuine financial troubles. Online bill payment takes one very important block out of the path to your team getting paid for medical services you work hard to provide to the community.
When patients can easily log in and pay their medical bills, often as soon as they get the statement, their immediate access to revenue goes up. These are bills that are paid promptly instead of waiting for months. They don’t get forgotten, they don’t go into collections. You just cross one payment off your list, mark the patient as paid in full, and enjoy the revenue as it arrives.
Hop on the Gravy Train: Inclusion in Monthly Bill Pay Routines
Another great reason to upgrade your medical practice to 24/7 and online bill payment is the “gravy train” effect. Many people sit down and pay all their accumulated bills at once. It simplifies the bill pay process and can be done just by sitting at the computer for 15-90 minutes once or twice a month. They pull out their payment cards, type in the information, balance the household budget, and call it done.
Your medical practice’s bills should be included in that routine. They could be. Every patient who routinely pays all their bills online would just as easily pay for the services provided by your practice – if it were that easy. However, setting aside an envelope or email to pay in person or during office hours drastically decreases the likelihood that this bill will be paid – on time or otherwise. It’s just not included in the usual to-do routine. However, with online payments, your practice could easily hop on the gravy train of routine, responsible bill payers.
Automated Online Bill Pay
Many medical facilities are also missing out on the opportunity to set up automated medical payments. Financially stable patients often have no problem setting up yet another automatic monthly bill to pay off significant procedures or accumulated medical expenses slowly. In fact, even patients who struggle financially may appreciate automating their payment plans. Not only are you making payment easier (the easiest possible) for patients, but you are also creating a reliable and assured revenue stream for your medical practice.
Payment Options Decrease Technical Roadblocks
Most medical practices have faced more than a few billing roadblocks. Technical difficulties, bureaucratic slowdowns, phone system failures, and in-office computer errors can all prevent patients from paying their bills, even if they come in during office hours.
However, the more payment options available, the more likely your patients to find a workaround to pay medical bills anyway. For example, if the office system is down, paying by phone might work. If the phone system is down, paying online might work. If paying by card doesn’t work, PayPal and separate digital payment providers may come through. The more options available, the more payments make it through technical roadblocks. Then, many patients will do the troubleshooting for themselves with at-home access to payment methods.
Payment Options Decrease Technical Roadblocks
The good news is that upgrading your medical practice’s bill payment options doesn’t have to be a big ordeal. With convenient and swiftly integrated systems like BillFlash Pay Services powered by EZClaim, you can add easy online and mobile bill payment, automated payments, an integrated in-office payment system, and a gateway for merchants as well.
Give your patients the 24/7 online, mobile, and automated bill payment access they have come to expect. Then, reap the rewards in more reliable and timely revenue for your medical practice. Schedule a consultation today to discover how BillFlash Pay Services powered by EZClaim can work for your practice, facility, and revenue stream.
May 1, 2023 | Electronic Billing, EZClaim, Medical Billing Software Blog
Another rapidly growing trend in the medical billing industry is the emergence of web-based or “cloud-based” software. As practices and billing firms (RCMs) alike look to become more efficient and better control the billing process, organizations are switching to web-based softwares as an integral part of that mission. Let’s dive into some of the key factors fueling the rise of web-based medical billing software.
A major draw of web-based medical billing software is that it can be accessed from anywhere with an internet connection, allowing practitioners to work remotely or from multiple locations. This enables quick connection for everyone involved in the medical billing process. As you have access to the internet, you are connected to your billing process, whether you’re at home, at the office, or on a tropical island.
This visibility is remarkably valuable to businesses, and also allows for improved patient treatment. Clinicians can access patient health data from anywhere, and can rest assured that all the information they are looking at is up to date. It is in the best interest of any practice looking to improve the patient experience and effectiveness of care to ensure their software makes information as readily available as possible.
Using a web-based software also enables you to hire billers from anywhere in the world. Since your data can be easily accessed, you aren’t limited in terms of who you can hire (from a geographical perspective).
2. Automatic Updates
Web-based medical billing software is updated automatically, eliminating the need for manual updates and ensuring that practitioners are always using the latest version. As the software evolves and receives a more robust feature set, your organization will reap the benefits without any cumbersome steps needed.
Web-based medical billing software can easily be scaled up or down depending on the needs of your practice/RCM, making it more flexible and adaptable than traditional software. If you intend on growing and processing more claims, you need a software solution that is able to grow with you. Using a web-based software ensures your practice won’t be held back by its software.
Additionally, your business won’t need to spend money up-front on servers, an IT department, and hardware. A cloud-based solution simplifies your operations, and makes it easier to scale.
Web-based software tends to be easier to use and more intuitive than traditional software. You won’t need highly-specialized training in-person training from an in-house team member, as cloud-based software typically provides comprehensive onboarding to ensure you’re ready to go as quickly as possible.
Web-based medical billing software allows multiple users to work on the same project simultaneously, facilitating collaboration and improving communication among team members. This improves overall operational efficiency, and allows you to process more claims in less time.
Web-based medical billing software providers typically offer data encryption and other security measures to ensure patient information is kept confidential and secure.
Another key security benefit of web-based software is the peace of mind it provides from a data backup perspective. If you are using a traditional software, and are faced with an unfortunate situation like a fire or other disaster that damages your office or hardware, you are at risk of losing all of your records. Storing your data on the cloud ensures it cannot be lost, and is with you wherever you have internet connection.
If your business is exploring the possibility of switching to a web-based software, we’d love to chat with you. Schedule time to meet with our team so we can discuss your needs and how EZClaim can help.
Apr 24, 2023 | Electronic Billing, EZClaim, Medical Billing Software Blog
Welcome to the start of a new series, where we discuss some prevalent medical billing trends, and what they mean for your organization! Let’s start off this discussion with the concept of practices outsourcing their medical billing. This trend has skyrocketed in popularity over the last decade or so, and isn’t going away anytime soon. So, why do practices outsource their billing function? Let’s analyze a few key reasons.
Medical billing requires extremely specialized knowledge of complex billing codes, regulations, and compliance requirements. Outsourcing to a dedicated revenue cycle management firm ensures you have the most highly-trained professionals in your corner handling your practice’s billing, and is a good way to promote more accurate billing and timely revenue cycle management. Many practices try to get by with novice billers, and the results are often disastrous. By outsourcing revenue cycle management, you delegate your billing to the most qualified experts, which is quite attractive to many practices.
2. Potential Cost Savings
Another major reason practices look to outsource medical billing is to take advantage of potential cost savings. By outsourcing your revenue cycle management, healthcare providers can avoid the costs of hiring and training a high-level in-house billing staff, purchasing billing software and equipment, and maintaining an infrastructure to support billing operations.
However, it is important to note that when you outsource, you tend to get what you pay for. If you choose a lower-cost outsourcing provider, you will likely receive lower-quality services, which can cause substantial problems downstream. If you partner with a top-of-the-market provider, you may not be realizing any up-front cost savings at all, but will have a better team in your corner. It is critical that you keep this calculus in mind when deciding whether outsourcing is the right choice for you.
3. Increased Efficiency
The opportunity for increased efficiency is another major reason practices look to partner with outsourced revenue cycle management companies. Outsourced billers often have more streamlined processes and technology than individual healthcare providers. This can result in more timely claims processing and payments, reducing the time and effort required to manage billing operations. Better processes also means increased accuracy, and helps you increase revenue.
Additionally, when you take RCM off your practice’s plate, you also reduce incoming calls to your office, freeing up your staff to handle other tasks that more directly affect patient care and improving the patient experience. When outsourcing billing, you also won’t need to worry about any interruptions to billing if a member of your internal team calls in sick, goes on vacation, or resigns.
Lastly, the issue of compliance. Medical billing companies stay up-to-date with constantly changing healthcare regulations and compliance requirements. It can be easy for your staff to fall behind, especially if they have other tasks on their plate. By outsourcing, healthcare providers can often reduce their risk of non-compliance penalties and lawsuits.
Why Do Your Own Billing?
So, with all of this in mind, what’s the argument for doing your own billing?
First and foremost, control. If you outsource your billing, your RCM partner becomes an extension of your practice, and plays an integral role in the way in which your practice is perceived. If your billing partner starts missing the mark, that reflects negatively on your practice in a way you really cannot control.
There is also the issue of complete dependence. If a practice dissolves its RCM staff and completely outsources the function, it becomes completely reliant on its billing partner. What happens if your billing partner goes out of business, and you don’t have any in-house staff capable of overseeing billing?
Outsourcing the billing process also causes your practice to lose some visibility in regards to reporting and data, which can make the path to improvement considerably less clear. Make sure you are closely monitoring timely filing of claims, days in A/R, timely reimbursement, appropriate reimbursement, and ensuring timely follow-up on denials to ensure your billing partner is hitting the mark.
As we touched upon earlier, there is the issue of quality, as well. When organizations outsource, they are typically looking to realize cost efficiencies. However, when you choose lower-priced outsourcing options, you may recognize cost-savings up-front, but your billing quality may suffer, potentially damaging your relationship with your patients. Many outsourcing organizations also make use of overseas staff, and there can be a bit of a language barrier at times. This can occasionally frustrate patients calling in to check on their bills.
Lastly, there’s the issue of confidentiality and security. You are passing over protected health information or PHI to a third party that is not your practice, or insurance. You must be sure your patients are aware of this movement of data, and that your billing partner takes proper compliance measures to ensure your patients’ data is protected (signing a BAA is a must).
What Does This Mean For Your Business?
As a medical practice, you must carefully weigh the pros and cons of outsourcing billing. If you are struggling to tackle billing on your own, outsourcing may make sense (check out some of our partners)! However, if you are doing a good job billing internally, there is likely no need to outsource this process unless considerable cost savings can be realized, without seeing a dip in quality. Investing in your own team is never a bad decision. By equipping them with great software and providing expert training, you can get exceptional results from internal billing. Always keep your options open, and realize that outsourcing is not a fit for every practice.
If your organization is looking to get the most out of its medical billing process, we can help. EZClaim has been the medical billing software of choice for practices and RCM firms alike for over 25 years. If you are interested in learning more about how we can help your business improve its billing capabilities, schedule some time to meet with our team!
Apr 17, 2023 | Electronic Billing, EZClaim, Medical Billing Software Blog
The healthcare industry increasingly relies on electronic payment systems to process transactions in today’s digital age. This includes everything from automated medical billing systems to online patient payment portals. However, with the increased use of electronic payments comes a higher risk of security breaches and data theft. That’s where payment tokenization comes in.
What is Payment Tokenization?
Payment tokenization is a security measure that involves converting sensitive payment information (such as credit card numbers) into a secure token. This token is a unique, randomly generated string of characters that represents the original payment information. The tokenization process takes place on a secure server, which a payment tokenization provider manages. The importance of payment security in the healthcare industry cannot be overstated. Medical practices handle sensitive personal and financial information daily, and any breach of this information could have serious consequences for the practice and its patients. Payment tokenization helps to protect against these risks by providing an extra layer of security for electronic payments.
How Payment Tokenization Works
The payment tokenization process begins when patients provide payment information to a medical practice. This information is then sent to the tokenization server, which converts it into a secure token. The token is then used to process the payment rather than the original payment information. This helps to protect sensitive data from potential breaches or theft. The tokenization server plays a crucial role in the process, as it generates and manages the secure tokens. The server is also responsible for decrypting the tokens when it is time to process the payment. This ensures that the original payment information remains secure throughout the transaction.
The Benefits of Payment Tokenization for Medical Offices
Payment tokenization offers several benefits for medical practices, including:
Payment tokenization is an effective way for medical practices to enhance the security of their electronic billing systems. By converting sensitive payment information into secure tokens, payment tokenization helps to protect against data breaches and theft. This is particularly important in the healthcare industry, where personal and financial information is often sensitive and at risk of being compromised. Tokenization helps to safeguard the information of both the medical practice and its patients by ensuring that sensitive data is not stored in a way that is easily accessible to unauthorized parties. This helps to reduce the risk of data breaches and can help medical practices to comply with industry regulations and standards, such as the Payment Card Industry Data Security Standard
Enhanced User Experience
Tokenization helps improve the overall payment experience for patients. This is because tokenization allows for automated billing, which can be particularly helpful for medical practices with high patient volumes. For example, if a medical practice uses a traditional payment system, patients may be required to fill out lengthy forms and provide sensitive payment information each time they make a payment. This can be time-consuming and inconvenient for patients. With payment tokenization, however, patients can make payments more quickly and easily by simply providing their payment information once and using a secure token for all future payments. This enhanced payment experience can be particularly beneficial for medical practices that rely heavily on electronic billing systems, as it can help to reduce the number of payment-related issues that arise and improve patient satisfaction.
Payment tokenization helps medical practices to comply with industry regulations and standards. For example, the PCI DSS requires that sensitive payment information be stored securely. Tokenization helps to meet this requirement by reducing the amount of sensitive payment information stored on the medical practice’s systems. Tokenization can also help medical practices comply with other regulations and standards relevant to their specific industry. For example, medical practices may be required to comply with HIPAA regulations, which outline requirements for protecting personal health information. By using payment tokenization, medical practices can help ensure that they comply with these regulations and standards.
Implementing Tokenization in a Medical Office
If you are a medical practice looking to implement payment tokenization, there are a few key steps you should follow:
– Choose a payment tokenization provider: The first step is to choose a payment tokenization provider that meets your needs. This should be a reputable provider with a proven track record in the healthcare industry.
– Integrate with existing payment systems: You will need to integrate the payment tokenization system with your existing payment systems. This will typically involve working with your tokenization provider to ensure that the integration process goes smoothly.
– Train staff: It’s important to ensure that your staff is familiar with the payment tokenization process, as they will be responsible for handling patient payments. This may include training on how to use the new system and any relevant industry regulations.
Best Practices for Using Payment Tokenization in a Medical Office
To ensure the security and effectiveness of payment tokenization in your medical practice, it’s important to follow a few best practices:
– Keep tokens secure: It’s essential to keep the tokens generated by the tokenization server secure at all times. This includes properly storing and handling tokens and regularly updating your tokenization system to ensure it is up to date with the latest security measures.
– Complying with industry regulations and standards: Payment tokenization can help medical practices comply with industry regulations and standards. It’s important to stay up to date with these requirements and ensure that your payment tokenization system meets all necessary requirements.
– Provide a seamless payment experience for patients: Finally, it’s important to ensure that the payment experience for patients is seamless and efficient. This may involve integrating the payment tokenization system with your patient portal or other online payment portals and offering multiple payment options (such as credit card, debit card, or electronic check).
Unlock the Power of Tokenization with EZClaim & BillFlash
Payment tokenization offers several benefits for medical practices, including enhanced security, improved compliance, and enhanced user experience. If you are a medical practice looking to streamline your payment processing procedures and increase efficiency, consider implementing payment tokenization with reputable providers such as EZClaim and BillFlash, a NexTrust service. EZClaim integrates with BillFlash to provide a powerful end-to-end suite of billing and payment solutions for medical practices, including BillFlash Pay Services powered by EZClaimPay. Schedule a free consultation today to discover how together EZClaim and BillFlash can streamline your billing process, increase revenue, and improve patient satisfaction.
The medical billing process is as important to your business as it is tedious for those who aren’t making proper use of automation. Automating parts of the medical billing process not only makes your process more efficient but more accurate, resulting in smoother operations for your entire business.
At EZClaim, our goal is to help your business reach its full potential with medical billing software. We make automation easy and provide a centralized home for all of the critical information you need to run your business that seamlessly integrates with your other tools and technology. Request a free consultation today to learn more about how EZClaim can help your business grow.