May 12, 2020 | BillFlash, Features, Medical Billing Software Blog
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
Telehealth visits:
- 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 support@ezclaim.com.
[Contributed by James Easley VP, Marketing NexTrust Inc.]
Apr 13, 2020 | Live Compliance, Medical Billing Software Blog, Partner
Since CMS HHS just updated their Telehealth regulations to adjust to the COVID-19 environment—including having a remote workforce—we wanted to provide a clear update to independent physicians and billers to advise them of the fast-moving changes of many regulations, and what to expect in the near future.
It is important to note that CMS has recently announced that new and established patients have availability to Telehealth, and HHS OIG is providing flexibility for healthcare providers to reduce or waive cost-sharing for Telehealth visits paid by federal healthcare programs. CMS is also expanding Telehealth services to people with medicare.
As a result, please see the below video from CMS which highlights the Medicare Coverage and Payment of Virtual Services and Telehealth.
In addition, we’ve included a few key questions and answers below. If you have further questions about Telehealth and your compliance, contact Jim Johnson with Live Compliance at Jim@LiveCompliance.com or (980) 999-1585.
1. Who can provide Telehealth services?
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- Physicians
- Nurse Practitioners
- Physician assistants
- Nurse-midwives
- Certified nurse anesthetists
- Clinical psychologists
- Registered dietitians
- Nutrition professionals
2. What services can a medicare beneficiary receive through Telehealth?
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- Evaluation and management visits (common office visits)
- Mental health counseling
- Preventive health screenings
- More than 80 additional services
3. What are the types of virtual services?
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- Medicare Telehealth visits
- Virtual check-ins
- E-visits
- Telephone services
Live Compliance is an EZclaim premier partner for HIPAA compliance and is integrated into EZclaim’s billing solution.
If you have any further questions about Telehealth regulations and your compliance, e-mail Jim Johnson at Live Compliance at Jim@LiveCompliance.com, or phone him at (980) 999-1585.
[ Contribution by Jim Johnson with the Live Compliance ]
Apr 13, 2020 | Medical Billing Software Blog, Trizetto Partner Solutions
On January 13th we posted part one on this topic of Eligibility in healthcare, in that, we touched on deductibles, co-pay, and max out-of-pocket pay. Now in part two, we review the impact of price transparency in healthcare and its importance to the healthcare team decisions.
Consumers are the most important member of the healthcare team and are better collaborators in their care when they know all the variables and their required responsibilities in the process.
The individual consumer’s healthcare team includes, along with themselves, the physician and their staff, the pharmacist, an insurance adviser, and possibly some gatekeepers as well. The communication of clear symptoms when a patient is diagnosed is the responsibility of that team along with building an understanding of the financial responsibility that goes with any medical solution. While providing answers, options and solutions is a provider’s responsibility, so is providing a cost for the provided care. Therefore, price transparency can be achieved when the cost for that care is presented in a clear and concise fashion so the patient can understand what they owe, why they owe it, and when it is due.
Ensuring your staff is educated on discussing the financial responsibility with the patient from the first appointment and forward will strengthen the healthcare partnership and assist in the collection process. Understanding the steps that occur post the upfront estimate can be beneficial to the team. This discussion can be bolstered by ensuring bills are clearly marked with the statement, “this is a bill”, also clearly listing what the patient is being charged for when the bill is due and offering details on the methods of payment that are accepted. This clarifies what insurance will cover for the patient and their own out-of-pocket cost, prompting them to share any concerns and constraints with payments upfront.
Estimating patient responsibility is one part of the reimbursement process that is used for transparency for patient billing. The estimates can be provided using a spreadsheet of prior reimbursement and your most commonly billed CPT codes. If you would like an automated and more accurate option then look into a software tool like the Patient Responsibility Estimator by our solutions partner, TriZetto Provider Solutions (TPS). Giving this to the patient at the time of checking in will assure they have a rough idea of the costs and allow the office to collect upfront if needed.
For more information on how EZClaim can help you with this journey, schedule time with our sales team. Ready to get started? Download your FREE 30-day Trial today!
[ Contribution by Brenda Smelser with the DMC ]
Apr 13, 2020 | Medical Billing Software Blog, Revenue, Trizetto Partner Solutions
Because of COVID-19, some practices are doing triage from the car before they will allow a patient into their offices. Practices should also take a ‘cue’ from this by instituting protective measures for their finances.
I went to the doctor for a regular visit last week, which seemed anything but regular. I sat in the car and called to let them know I had arrived. They verified my demographics and insurance information over the phone; me in the parking lot, them in the office. The MA came out with her PPE and took my temperature, found me to be fever free so I could enter the building.
My nurse practitioner came in for our visit. We went about our appointment as usual except this time she took my superbill upfront herself and handed it to the check-out staff member. We scheduled a Telehealth visit instead of a traditional office visit. At the checkout desk, I said “I’m pretty sure I have a balance from the last visit, can I take care of that today?”. I loved where their heart is at, but I was sad to hear her say “You do, but we aren’t worried about that today. Just pay when you get the next statement.”
With so many things in chaos right now, so much thrown at you, and out of your control – let us not forget about the protective measures you can put in place for your practice. This is the time to get some vitals and triage from the car, before blindly allowing the chaos into your business. So, what should you be tracking?
Start with basics – look at the aging balances. More than likely, you have money on the table! In EZClaim, you have the option to run full aging, but the more efficient option is running the Insurance Follow Up report and the Patient Follow Up report. Just running these reports will let you know where there is money that needs to be collected. In addition – it just may show you that it is time to reevaluate policies and procedures in your office related to patient balances and insurance follow-up. Here is a peek at what these two reports can do for you.
Patient Follow Up Report: This report will show you balances that are outstanding with your patients. While this may not be the easiest time to ask patients to pay their balances, there are steps you want to consider:
- Consider what you will do with lingering patient balances. The Patient Follow Up report will show how many statements have been sent since the last patient payment. If you have sent several statements is it worth continued efforts?
- Contact your patients to see if they can pay with an HSA or FSA account
- Offer to set up a payment plan
- Write off the balance as a bad debt or a one-time professional courtesy
- Consider sending the account to collections
- Use technology to your advantage. Take this time to consider enabling online payment options.
- Create or revise patient payment policies and train your staff on these policies
Insurance Follow Up Report: This report will show your balances that are outstanding with insurance companies. Some of the useful features of this report include:
- Ability to see the aged balances by the payer. This lets you get the biggest bang for your buck. Look for payers that have a large percentage of balances in the oldest buckets and work those first.
- All the information you need for calling the insurance is right there on the report. You will have easy access to the date of birth, member ID number, and claim totals on the report.
- During your research, you will find common themes. Use these themes to update your office procedures and train your staff to eliminate errors so that claims get paid quicker.
EZclaim billing software can help you manage your office’s finances. Visit our website to find out more about our solutions: https://ezclaim.com/
[ Contribution by Stephanie Cremeans with EZClaim ]
Apr 13, 2020 | Alpha II, Medical Billing Software Blog, Partner
One of our partners, Alpha II, is presenting a special webinar on COVID-19 billing changes on April 16, 2020, “COVID-19: Critical Coding and Regulatory Updates,” to provide the most up-to-date information on the coming changes to new procedures, diagnosis codes, telehealth updates, and changes to regulatory policies.
As guidelines for coding and billing of COVID-19 services are revised almost daily, rest assured Alpha II is working to implement these critical changes to regulations and coding guidance as quickly as possible by conducting near-daily promotions.
Here is a very brief summary of some of the updates we’ve implemented:
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- Clarification of correct telehealth rendering POS and use of modifier -95
- Modification of diagnosis code edits for billing of COVID-19 symptoms from February 20 – March 31, 2020, and use of new diagnosis U07.1 for dates of service on or after April 1, 2020
- Addition of the new AMA CPT code 87635 effective March 13, 2020
- Addition of the new CMS CPT codes U0001 and U0002 retroactively effective February 4, 2020
- Modification for waiver of DME replacement requirements prior to March 1, 2020
- Modification for waiver of occurrence code 70 on SNF three-consecutive day stay validation prior to March 1, 2020
- Modification to LCD/NCD edits to relax rules related to respiratory-related devices and services
- Modification to Medicaid for the temporary suspension to prior authorization rules in PHE areas effective March 1, 2020
You can get all the latest COVID-19 specific updates here: https://www.alphaii.com/landing/covid19
Alpha II is an EZclaim partner that provides “Claim Scrubbing” for our medical billing software system. View our website for more details on this: https://ezclaim.com/partners/
Jan 13, 2020 | collections, Electronic Billing, Medical Billing Software Blog, Revenue
Patient Payments – Written by Stephanie Cremeans of EZClaim
Why do I have a balance? The golden question regarding patient payments every physician’s office staff member dreads beginning January 1st. Unfortunately, your patients are not usually savvy when it comes to the nuts and bolts of their contract, and they are frustrated. They thought their plan was good, but now they have a bill.
68% of patients failed to fully pay off medical bill balances in 2016, up from 53 percent in 2015, and 49 percent in 2014. This number is expected to climb to 95% by 2020
Source: Patients May be the New Payers, But Two in Three Do Not Pay Their Hospital Bills in Full, TransUnion Healthcare, June 26, 2017
So here we are, in 2020. Let’s make sure your office is equipped and able to collect patient payments for services rendered rather than becoming a part of this scary statistic.
Begin with the basics. Make sure that your staff understands these key terms and is comfortable explaining them to your patients.
Deductible – The deductible is the amount the patient has to pay for covered services before the insurance plan pays. Some insurance plans will apply an office visit to the deductible, others will not. Family plans typically have an individual and family deductible.
Copay & Coinsurance – These are both the portion the patient will be responsible for after their deductible has been met. Copays are a set, flat fee. Coinsurance is a set percentage that the patient will pay.
Max Out of Pocket – This is the limit of what a patient will pay for covered services within a plan year. Again, on family plans, there may be an individual max and a family max.
Keep in mind your staff will not know the details of your patients’ plans, nor should they be expected to! In the ever-changing world of health insurance, our patients need to become better consumers. So just being able to explain these key terms and why they create a patient balance will help them become better insurance plan shoppers!
Use your tools. Look into using Integrated Eligibility (available through your billing software and your clearinghouse). This will allow your staff to check remaining deductible balances, copay, and coinsurance amounts with the click of a button. These results allow practices to confidently collect at the time of service rather than spending time and money on sending statements and working collections after the visit.
Create a plan and stick to it. Use this time to review the efficiency of your patient collections plan. Are you using an outdated plan or policy? Have you considered offering payment plans to patients with an HSA card kept on file? Make sure that your employees understand how important patient collections are to the practice, educate them on the plan, and support them when they hold patients accountable to the patient collections policy.
For more information on how EZClaim can help you with this journey, schedule time with our sales team. Ready to get started? Download your free 30-day demo today!
