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.
1. Specialization
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.
4. Compliance
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:
Enhanced Security
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
(PCI DSS).
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.
Improved Compliance
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.
Mar 17, 2023 | Electronic Billing, EZClaim, Medical Billing Software Blog
Looking to grow your medical practice or RCM organization? Taking steps towards automating the billing process is an excellent place to start. From improving the efficiency of your claim processing, to making life easier for patients, the results of nuanced automation of the medical billing process are extremely impactful on your business’s day-to-day operations. Let’s take a look at some of the key benefits of medical billing automation.
Faster Claim Processing
Many medical practices and billing companies constantly struggle with perfecting their revenue cycle management and ensuring they receive reimbursement on time, with optimal accuracy. Automation enables claims to be processed more efficiently than with manual billing methods that take a considerable amount of staff time and effort that could then be refocused onto patient care and satisfaction. Faster claim processing leads to quicker reimbursement and improved cash flow for your practice.
Reduced Errors
One of the great things about medical billing automation is that it helps improve accuracy by minimizing the human element and increasing the probability that all necessary information is properly entered into the billing system. This can help prevent claims from being denied or delayed, which can save your team substantial time on rectifying incorrect or denied claims, as well as increasing revenue.
Increased Productivity
You have a business to run. Automating troublesome, manual parts of the medical billing process helps reduce the time and effort required to process claims, allowing staff to focus on patient care or organizational growth initiatives. When you’re spending less time on tedious manual tasks, you can spend more time on ensuring your business is the best it can be.
Ensure Patient Satisfaction
A practice whose patients are repeatedly enduring billing errors and delays is doomed to fail. For many, going to the doctor is already stressful enough without layering on issues in the medical billing process.
By reducing the amount of time it takes to process claims and reducing errors, medical billing automation can help improve patient satisfaction and take some stress out of the process. Your goal should be to make life as easy as possible for patients. Automating the medical billing process is an important step towards getting there.
Improved Financial Management
You should be using nothing but the most accurate, up-to-date information when making important strategic decisions for your business. Billing automation can provide real-time, accurate insights into revenue and financial performance. This can help owners and managers make informed decisions about how to grow and improve their business.
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.
May 5, 2022 | HIPAA, Live Compliance, Medical Billing Software Blog, Support and Training
Your organization’s annual HIPAA Security Risk Assessment and Analysis are only one element of the compliance process, and whether you’re a Business Associate or Covered Entity, your organization must also “implement security updates as necessary and correct identified security deficiencies”. In other words, you must act via a Corrective Action Plan (CAP) following the required risk assessment process.
Here are a few common Corrective Action Plan steps:
- Implement technical policies and procedures to allow access only to those persons or software programs that have been granted access rights to information systems maintained.
- Implement procedures to regularly review records of information system activity, such as audit logs, access reports, and security incident tracking reports.
- Conduct accurate and thorough assessments of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of ePHI.
- Develop a complete inventory of all its categories of electronic equipment, data systems, and applications that contain or store ePHI, which will then be incorporated into its Risk Analysis, and must complete a Risk Management plan.
What happens if I fail to complete my Security Risk Assessment?
Failing to complete your annual Risk Assessment oftentimes means the organization will be required to complete a “robust” Corrective Action Plan (CAP) and often with at least two years of monitoring activity.
Have you ever doubted whether a small billing company or independent physician practice actually ever face penalties?
Well, keep in mind, a Business Associate is a ‘person’ or ‘entity’. This means that there is no billing company too small to have to comply with the Federal HIPAA regulations. Again, if you have not completed an accurate and thorough security risk assessment prior to that, you could also be penalized under ‘willful neglect’. This category alone is $50,000 per violation!
It is important for you to understand that every complaint or potential breach must be investigated by HHS/OCR. If you, a billing company, or another vendor suspects a breach, you must inform the covered entity (your client) and have a breach risk assessment completed to determine key factors and take action.
An EZClaim partner, Live Compliance, will help you to make checking off your compliance requirements extremely simple. They provide:
- 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.
- Complete set of HIPAA Policies and procedures built directly into your portal. Includes actionability, change management documentation, and Incident Response Policy to assist with your Corrective Action Planning. Easily share policies with staff with one click.
- Built directly into your portal, easily monitor where your workforce may be vulnerable with our Dark Web Breach Searches. Easily expose breach sources with ongoing searching of active employee email or domain ensuring continued awareness of potential breach exposure. Weekly automatic email notifications if new breaches are discovered.
- Short, informative, privacy awareness videos covering technical, administrative, and physical safeguards with topics such as ransomware, phishing, the Dark Web, password protection, and more. All delivered monthly with no logins required, they empower your workforce to make conscious decisions when it comes to your organization’s privacy and security.
So, don’t risk your company’s future, especially when Live Compliance is offering a FREE Organization Assessment to help determine your company’s status. For more information, visit their website, e-mail them, or give them a call at 980.999.1585.
ABOUT EZCLAIM:
EZClaim is a medical billing and scheduling software company that provides a best-in-class product, with correspondingly exceptional service and support. Combined, they help improve medical billing revenues. To learn more, visit EZClaim’s website, e-mail them, or call them today at 877.650.0904.
[ Contribution by Jim Johnson with Live Compliance ]
Oct 28, 2021 | EZClaim, Medical Billing Software Blog
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. ]
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 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 ]
