Sep 5, 2022 | Partner, Waystar
Switching to Electronic Claim Attachments
One of the biggest strains on the healthcare industry remains its reliance on paper and manual processes. The combination often adds up to human errors and costly denials, which require exponentially more time and resources to resolve, if left unchecked.
Among the manual processes most challenging to manage is claim attachments, which demand considerable time for teams to review requirements, collect and send necessary documentation, and complete follow-up procedures. According to the CAQH Index, the medical industry spent $590M annually exchanging attachments, with some providers spending anywhere between 10-30 minutes manually submitting an attachment to a payer.
An electronic claim attachments solution bolsters efficiency, strengthens cash flow, and significantly reduces AR days. If you’re considering how such a solution could benefit your healthcare organization, read on to learn about three key areas it can improve.
- Simplify document + data exchange with payers
Despite technological advancements, providers still face a complex, manual environment for payer document and data exchange. Electronic claim attachments can help ease long-standing friction points between providers and payers by automating supporting documentation submission. It’s a win-win for providers and payers as workflow efficiency can be maximized and claims adjudicated more swiftly and correctly.
- Support frictionless and remote workflow
Processing claim attachments becomes exponentially more time-consuming and expensive because of its paper-based nature and the need to keep up with ever-changing payer rules and requirements. Shifting to electronic claim attachments can provide flexibility to ensure your billing team can continue to operate effectively even in disruptive times. It not only saves time and money each day but it’s also proved critical during events like Covid-19, allowing a divided workforce to still get the job done.
- Reduce cost to collect
Not all clearinghouses are created equal—the right partner fervently seeks opportunities for staff to work smarter, not harder. Automation and scale are key elements to not only maximize efficiency and accuracy but also reduce a provider’s cost to collect.
Although electronic attachment adoption remains low, there’s considerable benefit to implementation. While electronic transaction for claim attachments has not yet been federally mandated, the 2020 CAQH Index found the medical industry could save over $377M per year, helping organizations protect their bottom lines and provide more affordable care to their patients and communities.
Wrapping it up: taking the smarter approach to submitting attachments
Providers are all under cost and reimbursement pressure and the need for smarter, purpose-built automation is the secret ingredient for remaining in the black. Electronic claim attachments are a simple way to take the administrative waste out of your processes, prevent costly denials and accelerate cash flow, all the while supporting a remote workforce.
Looking for a smarter, simpler way to manage claim attachments and streamline workflows? Find out how Waystar can help automate the process, reduce denials and accelerate reimbursement. Visit Waystar.com.
ABOUT EZCLAIM:
As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.
Sep 4, 2022 | MedCycle Solutions, Partner
Collections aren’t the most glamorous part of running a practice. Perhaps the only thing worse than making collections calls is receiving them! Unfortunately, collections are necessary and if done correctly, it will allow you to collect on accounts that have sat stagnant for months, sometimes years.
In our years of experience managing collections for small and medium physician practices, we’ve identified seven best practices for optimizing your collections.
- Speak their language. There are so many ways to communicate these days. Routinely ask and record how your patients prefer to be contacted. Phone? Email? Text? Mail? Patient Portal? For best collections results, communicate with your patients using their preferred communication method.
- Allow multiple payment options. Similar to communication methods, there are several payment methods that different people prefer. For some, a payment plan might be their best option. For others, credit card payments. For yet others, cash or checks. Sometimes, patients want the ability to finance their medical procedures through a healthcare financing company like Care Credit. And with today’s ever-changing technology, look into text message billing reminders with links to pay from their phone – and even QR code-driven options! Make sure your practice can accept multiple forms of payment to optimize your collections.
- Coach your staff. We encourage you to train your patient-facing staff to implement some basic key principles: Be a good listener; Talk in terms of the other person’s interest; Make the other person feel important and do it sincerely. By implementing these simple practices, your patients will feel less attacked and more heard – which in turn will hopefully lead to increased payments.
- Optimize technology. Most practice management systems, patient portals, and/or EHR platforms have advanced notification settings where you’re able to reach out to the patient (via their preferred communication method, of course) with reminders, balances, past-due alerts, etc. Using technology to automate parts of the process can reduce the heavy lifting for your staff.
- Discuss costs upfront. Being upfront about the costs of your patient’s care is one of the most effective ways to minimize collections. If you offer a limited number of services, consider listing the prices on your website or marketing collateral. If you’re a general practice, ensure your staff is communicating with patients before treatment regarding costs and how they plan on paying for their care. A shift we’ve seen over the past several years in healthcare is having a Patient Financial Counselor on the front end. This roles’ primary responsibility is to know what the patient is coming in for, verifying their benefits & coverage – and then reaching out to the patient before the appointment to provide them with an out-of-pocket estimate and payment options. That way, when the patient presents for the appointment, they are already aware of their financial obligations, and not surprised a few months later with a bill they were not expecting.
- Incentivize your collections staff. Collections can be tedious and tiresome. Consider offering incentives to help the task feel a little more exciting – small prizes can go a long way in motivating! Some incentives we’ve seen include PTO, cash, practice logo wear , and gift cards – based on the amount they’ve collected.
- Enlist expert help. Consider partnering with a healthcare-focused organization that specializes in collections. The tricks they’ve learned by working with other practices may decrease your outstanding balances in a shorter amount of time than doing so internally.
Implementing these tips can help reduce your collections timeline and increase the amount you’re collecting.
There are many great organizations that can help you in these areas – and MedCycle Solutions is one of them. If you’re wondering how partnering in these areas could work for your practice, let’s connect. Ranadene (Randi) Tapio, MBA, CMRS, CPCS is the Founder & CEO MedCycle Solutions, which provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com. You can reach Randi via email at Randi@MedCycleSolutions.com or call 320-290-6448.
EZClaim is a leading medical billing, scheduling, and payment software provider that combines a best-in-class product with exceptional service and support. For more information, schedule a consultation today, email our experts, or call at 877.650.0904.
Aug 15, 2022 | MedCycle Solutions, Partner
By Ann Knutson, CPC-A
The healthcare revenue cycle includes all administrative and clinical functions that involve capturing, managing, and collecting the provider’s/facilities revenue. The cycle includes three distinct parts of the practice/facility that’s referred to as the front-end, middle, and back end. Unfortunately, most of the time there is little coordination between the three areas which can lead to more claim denials and lost revenue for the practice/facility. Therefore, adding a revenue integrity team to your practice/facility dramatically improves operational efficiency, compliance measures, and reimbursement rates. Members of the team must have extensive knowledge of and be familiar with the complete healthcare revenue cycle.
In order to foster collaboration between all three areas of a practice/facility that affect the revenue cycle, specific training needs to be implemented for staff, along with coding and documentation education for providers.
Specific staff training includes:
- Keeping up to date on billing requirements, such as coding guidelines, billing regulations, and insurance payer policies.
- Reimbursement updates, such as data showing rate of reimbursement vs. denials/rejections.
- Key performance indicators, such as data regarding common billing or coding errors leading to claim denials and rejections.
- Job expectations, such as all billing employees must know every aspect and function of their job in detail.
Provider education involves:
- Chart reviews to verify proper documentation.
- Quarterly meetings regarding coding guidelines, payer rules, and the importance of medical necessity.
Furthermore, creating templates and tip sheets for billers, coders, and providers improves operational efficiencies, clean claim submission, and proper provider documentation. It also decreases claim denials and puts everyone in the practice/facility on the same page.
In addition, the collaboration between coders and the accounts receivable team is crucial to improving reimbursement rates, the outcome of claim appeals, and compliance with regulations. It can also help to reduce the number of claim denials and rejections. Plus, medical coders are able to share their expertise regarding regulations and proper coding with the Accounts Receivable (AR) team members. This helps the AR team with reconciling claim rejections and denials along with properly submitting appeals. On the other hand, the AR team can inform coders of the current codes or coding combinations that are being rejected or denied by payers. With this vital information, coders can make the required coding and billing changes as they enter the charges and submit the claims. This can greatly improve the rate of clean claims submission. (AAPC, 2021)
Therefore, it’s in the best interest of a practice/facility to implement a revenue cycle management team that is familiar with the entire revenue cycle, fosters collaboration between all areas of the practice/facility and providers, and maintains open communication between all departments in order to maximize revenue cycle efficiency and reimbursement. For assistance with maximizing your revenue cycle efficiency, please contact us at MedCycle Solutions.
For more information about maximizing revenue cycle efficiency, please visit www.aapc.com.
Ann Knutson, CPC-A is an Accounts Receivable Specialist at MedCycle Solutions, which provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com.
Aug 15, 2022 | Live Compliance, Partner
HIPAA Training Standards Every Business Associate Needs to Know
Per the HIPAA Privacy Rule and HIPAA Security Rule, both Covered Entities and Business Associates, must require HIPAA training for all workforce members that access protected health information (PHI) or electronically protected health information (e-PHI) in any of its forms and should be provided “as necessary and appropriate for the members of the workforce to carry out their functions within the [organization].”
According to the Rule, training must be provided “to each new member of the workforce within a reasonable period of time after the person joins the [organization’s] workforce.” Along with all other annual compliance requirements, HIPAA training is arguably the most important. Your workforce members are your first line of defense in the event of a Breach and must be able to identify your organization’s designated HIPAA Security Officer, and have a firm understanding of the HIPAA Privacy and Security Rule. Training should also highlight the organization’s Technical, Administrative, and Physical Safeguard objective security requirements. It is best practice to provide ongoing security awareness training and, in addition to the mandatory annual training, the Privacy Rule also highlights what’s known as “periodic” training. The goal is to ensure workforce members’ knowledge of HIPAA compliance is not forgotten.
It’s advisable that HIPAA training is given to all employees as new hires during the new employee orientation period, and before new employees are exposed to or work with individually identifiable health information. This includes officers, agents, employees, temporary employees; like students, interns, volunteers, and salespeople. At a minimum, training should cover the basics of HIPAA, the basics of privacy and security requirements and restrictions, and policies and procedures. All new hires need to be provided HIPAA training and a post-test on the material covered within the training course to ensure comprehension of relevant and appropriate HIPAA policies and procedures. Security Officers should be trained on the Breach Notification Rule, Minimum Necessary Rule, and the Organization’s policies and procedures.
The HIPAA Privacy Rule states that “An [organization] must document that the training as described [in the HIPAA Text] has been provided.” Failing to do so will be seen as “willful neglect” and will result in HIPAA violations including monetary penalties as high as $1.5 million dollars. A minor violation may only result in a corrective action plan requirement, whereas a significant data breach attributable to a lack of training will be viewed more seriously.
At Live Compliance, we make checking off your compliance requirements extremely simple.
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- Completely online, our role-based courses make training easy for remote or in-office employees.
- Short informative video training to meet periodic training requirements
- Depending on the size of your organization training may start as low as $79
Call us at (980) 999-1585 or visit us online at www.LiveCompliance.com/ezclaim
ABOUT EZCLAIM:
EZClaim is a leading medical billing, scheduling, and payment software provider that combines a best-in-class product with exceptional service and support. For more information, schedule a consultation today, email our experts, or call at 877.650.0904.
Jul 12, 2022 | MedCycle Solutions, Partner
Have you increased the amount of Telehealth visits with your patients?
If not, you and your patients may be missing out.
Over the past two years, the COVID-19 pandemic has changed the landscape of patient care and increased the need for providers to utilize virtual healthcare services. Due to the Public Health Emergency (PHE) policy update, many healthcare practices had to shut down, pause or augment their services with telemedicine to provide flexibility in patient support.
Here are four ways Telehealthcare has been implemented to provide safe, necessary care for patients while augmenting revenue.
- Stop the Spread of Contagions
With the need to quarantine, social distance, and reduce the risk for clinic staff and patients, many health practices adapted ways of providing non-emergency services. For patients with (possible) highly contagious diseases, such as COVID-19, many clinics ask patients to schedule virtual appointments to avoid possible infections and further outbreaks. This allows for keeping both the staff and patients as safe as possible while still receiving necessary treatment.
- Provide Essential Health Services
For those patients that suffer from White Coat Syndrome going to the doctor’s office causes a great deal of stress and anxiety. By allowing patients to access care in the comfort of their own home for managing chronic health conditions, routine services, prescriptions, and referrals for testing and labs, this allows for greater patient access. Plus, it has the added benefit of reduced overhead costs associated with cleaning and turning exam rooms.
- Provide Physical and Occupational Therapy Healthcare
Accidents happen. Whether motor vehicle accidents, workplace injuries, or trips and falls – PT and OT is imperative to keep patients mobile and progressing. Many providers offer hybrid services with virtual appointments for patients to keep them mobile while supervising and adapting exercises in their home environments.
- Provide Mental and Behavioral Healthcare
Mental and behavioral healthcare is one of many patient-care needs. This is especially true for long-term residential care. Many nursing home facilities transitioned to telemedicine during the COVID-19 pandemic.
The U.S. Department of Health and Human Services, via the Centers for Medicare & Medicaid Services (CMS) heavily promoted the switch to Telehealth as infection prevention and control measures. They’ve made digital resources available that offer behavioral health and best practice guides for long-term nursing homes, a telemedicine tool kit, as well as other guidance.
If you think your practice and patients can benefit from implementing telehealth visits stay tuned for our next article on 5 Resources for Implementing Telehealth & Telemedicine.
Mariellen Mezzacappa has a variety of experience in the medical field. She has worked for doctors, hospitals, pharmacies, and insurance companies. Her experience includes bill review and coding with a wide range from EAPG 3M, DRG, Workers Compensation to Appeals and coder Affidavits for Litigation. She provides verification of code selection for operation reports, documentation review, and credentialing. Additionally, she has worked on operation policies, compliance training, and project management.
MedCycle Solutions provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com.
Jul 12, 2022 | Live Compliance, Partner
Whether you’re a one-person billing company or a multi-location organization, it’s possible that you’ve seen or heard of Malware and the potential risks associated with it and how it can cause major downtime and potential HIPAA violations due to breached information.
Criminals use malware to steal personal information, send spam, and commit fraud. Malware includes viruses, spyware, and other unwanted software that gets installed on your computer or mobile device without your consent. These programs can cause your device to crash and can be used to monitor and control your online activity. They also can make your computer vulnerable to viruses and deliver unwanted or inappropriate ads.
Here are a few, high-level quick steps you can take to spot and avoid Malware.
First, let’s talk security software.
Install and update security software, and use a firewall. Set your security software, internet browser, and operating system (like Windows or Mac OS X) to update automatically, and don’t forget to Back up your data regularly. Strong security software can prevent a hack or scam before it happens. You should install well-known software directly from the source. Sites that offer lots of different browsers, PDF readers, and other popular software for free are more likely to include malware. Read each screen when installing new software. If you don’t recognize a program or are prompted to install additional “bundled” software, decline the additional program or exit the installation process.
Don’t change your browser’s security settings and pay attention to your browser’s security warnings. Many browsers come with built-in security scanners that warn you before you visit an infected webpage or download a malicious file.
Next, watch what you’re clicking on.
Instead of clicking on a link in an email, type the URL of a trusted site directly into your browser. Scammers send emails that appear to be from companies you know and trust. The links may look legitimate, but clicking on them could download malware or send you to a scam site. Don’t open attachments in emails unless you know who sent it and what it is. Opening the wrong attachment — even if it seems to be from friends or family — can install malware on your computer.
Avoid clicking on pop-ups or banner ads about your computer’s performance! Scammers insert unwanted software into banner ads that look legitimate, especially ads about your computer’s health. Avoid clicking on these ads if you don’t know the source.
Your computer may be infected with malware if it:
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- slows down, crashes or displays repeated error messages
- won’t shut down or restart
- serves a multitude of pop-ups
- serves inappropriate ads or ads that interfere with page content
- won’t let you remove unwanted software
- injects ads in places you typically wouldn’t see them, such as government websites
- displays web pages you didn’t intend to visit, or sends emails you didn’t write
Other warning signs of malware include:
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- new and unexpected toolbars or icons in your browser or on your desktop
- unexpected changes in your browser, like using a new default search engine or displaying new tabs you didn’t open
- a sudden or repeated change in your computer’s internet home page
- a laptop battery that drains quicker than it should
At Live Compliance, we make checking off your compliance requirements extremely simple.
- Reliable and Effective Compliance
- Completely online, our role-based courses make training easy for remote or in-office employees.
- Contact-free, accurate Security Risk Assessments are conducted remotely. All devices are thoroughly analyzed regardless of location. Conducting an accurate and thorough Security Risk Assessment is not only required but is a useful tool to expose potential vulnerabilities, including those such as Password Protection.
- Policies and Procedures curated to fit your organization ensuring employees are updated on all Workstation Use and Security Safeguards in the office, or out. Update in real-time.
- Electronic, prepared document sending and signing to employees and business associates.
Don’t risk your company’s future, especially when we are offering a free Organization Assessment to help determine your company’s status. Call us at (980) 999-1585, or email me, Jim Johnson at Jim@LiveCompliance.com or visit www.LiveCompliance.com
For more information about DarkWeb breaches please contact us at (980) 999-1585 or email us at support@livecompliance.com
