The Top 5 Advantages of Electronic Medical Billing Services

The Top 5 Advantages of Electronic Medical Billing Services

Aug 7, 2023 | Uncategorized

Electronic medical billing (EMB) is a process whereby a healthcare provider or third-party billing company submits a bill or claim electronically to a patient or third-party payer (usually an insurance company). These services use electronic billing software to manage the billing process, including coding, submitting claims, tracking claims status, and collecting payments.

Electronic medical billing services offer numerous advantages to providers, including improved payment accuracy and speed, cost savings, and improved security, enhancing the overall financial management of a healthcare practice.

5 Benefits of Electronic Medical Billing Services

Electronic medical billing services offer numerous benefits to healthcare providers, insurance companies, and patients. Some of the key advantages include the following:

1. Increased Efficiency

Electronic medical billing services offer increased efficiency in the following ways:

●      Automation: Electronic medical billing systems automate many of the manual steps involved in traditional billing methods and payment processing. This process reduces the risk of errors and leads to faster processing times, improved cash flow, and reduced administrative burdens for healthcare providers.

●      Real-time updates: Electronic medical billing systems provide real-time updates to patient information, insurance information, and billing status. It reduces the time required to resolve billing issues and ensures everyone involved in the billing process has access to the latest information.

●      Electronic submissions: Electronic medical billing systems allow for the electronic submission of claims to insurance companies. Electronic submissions reduce the effort required to process claims, minimizing the risk of lost or delayed claims.

2. Get Paid Faster

Electronic medical billing services and Electronic Data Interchange (EDI) can help healthcare providers get paid faster by streamlining the billing process and reducing the time required to process payments.

Here are a few ways electronic medical billing services can help providers get paid faster:

●      Faster claim submissions: EDI enables the electronic submission of claims to insurance companies, reducing the effort required to process claims. It reduces the risk of lost or delayed claims, leading to faster processing and quicker payment for providers.

●      Notify patients of financial obligation faster: the sooner your patients receive their bill, the faster healthcare providers can get paid. EDI billing allows statement files to be sent to a billing organization electronically, meaning bills are sent out more quickly. Additionally, some billing software may provide the option of notifying patients of their responsibility by text and email in addition to mailed statements, meaning the patient knows their financial responsibility even faster.

●      Electronic payments: Electronic medical billing systems and EDI supports the electronic receipt of payments, reducing the duration required to process payments and leading to faster payment for providers and improved cash flow.

Electronic billing and EDI transactions help healthcare providers improve their cash flow by modernizing the billing process, reducing errors that can be introduced during manual processing, and increasing the speed of notifying patients of their financial obligation. This can positively impact the financial health of providers and allow them to focus on providing quality care to their patients.

3. Cost Savings

 

Electronic medical billing services allow healthcare providers to save costs in various ways:

●      Reduced administrative costs: By automating the billing process, EMB services reduce the labor required to process claims and payments, minimizing administrative costs and freeing up staff time to focus on other tasks.

●      Fewer errors and denied claims: EMB systems use standard codes and algorithms to accurately assign codes to procedures, reducing the risk of coding errors and denied claims. This can significantly save costs, as denied claims often require additional time and effort to resolve.

●      Increased productivity: EMB services increase the efficiency of transactions between providers and insurance companies and between provider billing and patients. In fact, according to a recent CPMG case study, practices that automate their daily workflows reduce bill processing time by an incredible 48%.

4. Improved Patient Satisfaction

Electronic Data Interchange (EDI) and electronic medical billing can improve patient satisfaction in the following ways:

●      Faster and more accurate billing: EDI and electronic medical billing systems can reduce the effort required by patients to resolve billing issues, improving their satisfaction with the billing process.

●      Improved transparency: As EDI and electronic medical billing systems provide real-time tracking of claims and payments, it enables patients to monitor their billing status and understand the details of their charges. This increases transparency and improves patient satisfaction with the billing process.

●      Reduced administrative costs: By reducing administrative costs, EDI and electronic medical billing systems can help healthcare providers reduce the cost of care. Patients can benefit from the lower prices and increased services, improving patient satisfaction and assisting providers in attracting and retaining patients.

5. Improved Security

Electronic medical billing and Electronic Data Interchange (EDI) can increase security in several ways, including:

●      Encryption: Electronic medical billing and EDI systems use secure encryption methods to protect sensitive patient information during transmission and storage, reducing the risk of data breaches and helping safeguard patient privacy.

●      Access controls: Electronic medical billing and EDI systems use role-based access controls to ensure that only authorized personnel can access sensitive patient information. Access controls help to reduce the risk of unauthorized access to patient data.

●      Compliance with regulations: Electronic medical billing and EDI systems are designed to comply with the Health Insurance Portability and Accountability Act (HIPAA) regulations. Compliance with these regulations helps ensure patient data is protected and secure.

Electronic medical billing and EDI can also increase security through regular updates, patches, and audit trails. Improved security helps to reduce the risk of data breaches and ensure patient information is secure.

Revolutionizing Healthcare with NexTrust: Your all-in-one Financial Solution

In today’s rapidly evolving healthcare landscape, electronic medical billing services are critical in helping healthcare providers work efficiently, improve revenue cycle management, and, ultimately, provide a superior patient experience.

Merge your billing, payment, and collections under one roof with NexTrust’s end-to-end SaaS solution, BillFlash. BillFlash helps medical providers get paid faster at a total lower cost by providing Electronic Medical Billing solutions for sending patient statements via mail, email, and text, in addition to comprehensive payment processing solutions and Integrated Collection Services that work in harmony with your existing EZClaim practice management software.

Boost your revenue and streamline your billing process with BillFlash. Schedule a demo today!

The PROS and CONS of Credit Card Collections

The PROS and CONS of Credit Card Collections

Jul 14, 2020 | Administrative Safeguards, Uncategorized

Credit card collections are a BIG part of any successful medical practice, and there has been a shift, in the last decade, that more insurance policies are adding co-pays with higher deductibles—which makes getting paid even more challenging.1 One industry report said that “73% of physicians shared that it typically takes at least one month to collect a payment, and 12% of their patients wait more than three months to pay.”2 With the current trend, more medical practices and their billing departments (or outsourced billing firms) are going the route of processing payment via credit cards, which has its PROS and CONS.

In light of this new information, the following are a few pros and cons for credit card processing that we anticipate in the near future and some insights for choosing the best billing software that supports the credit card processing needs of medical practices:

  • PRO: To protect against the dangers of stolen data, fraud, or other compromises in security, practices should seek out medical billing software that has credit card processing built-in, which can help safeguard against these dangers.
  • CON: Security is a big risk, and a leak in data leading to stolen funds can end up in a physician paying out-of-pocket for the breach. It is also important to note that breach of credit card data is also considered a violation under the federal Health Insurance Portability and Accountability Act (HIPAA). 
  • PRO: Implementing credit card processing will reduce long waiting periods for payments from the majority of your patients, and will also reduce the additional effort your billing staff has to extend to collect on overdue notices.
  •  CON: Practices cannot require patients to share their credit card information to receive medical care, and even if patients do share their credit card information, physicians cannot continue to charge the credit card without a patient’s consent.
  • PRO: Physicians can end the process of being a “line of credit” to unpaid or underpaid claims, and collect on funds immediately.
  • CON: You will need to implement internal processes that include, but are not limited to proper personal information storage and security, establishing guidelines on maximum percentages charged per bill, and personal consent forms.

Overall, there are definitely MORE ‘PROS’ than cons for implementing credit card processing for your medical practice, and all the trends are pointing to this being the PREFERRED METHOD of payment in the near future.  EZClaim is proud to announce that it will release an integrated credit card processing solution, EZClaimPay, that is backed by a national merchant services vendor.  [ EZClaim will be sharing more details about EZClaimPay in the weeks to come, via their social media platforms, their monthly newsletter, direct communications, and more ]. 

 

In addition to the credit card collections PROS and CONS above, we reached out to one of our partners, Live Compliance, to gather some regulatory and security advice. They suggested the following:

  • When accessing, transmitting, storing, or receiving any Protected Health Information (PHI), the Health and Human Services (HHS) Office of Civil Rights (OCR) mandates that you are to maintain HIPAA compliance. 
  • When accepting, processing, or maintaining credit card information and debit card information, you must ensure that your organization is PCI DSS compliant (Payment Card Industry Data Security Standard).
  • In addition to the above Federal regulatory requirements, most states require privacy and security compliance requirements to be implemented, along with strict adherence to the privacy of Personally Identifiable Information (PII) and Breach Notification requirements.

For more information on your compliance requirements, visit Live Compliance for a Free Organization Assessment to identify and uncover your organization’s vulnerabilities.

 

If you are not a current customer of EZClaim, we would very much like to connect with you.  You can either schedule a one-on-one consultation with our sales team, view a recorded demo, or download a FREE 30-day trial right now. For detailed product features or general information about EZClaim, visit our website at ezclaim.com.

 

[ NOTE: If you would like a quote on the upcoming merchant services, please e-mail sales@ezclaim.com your last three merchant statements.  For more on our ongoing updates and industry news, you can follow EZClaim on Facebook and LinkedIn ].

Source Material:
1 – America’s Health Insurance Plans” report that there were 20.2 million co-pays in 2017, which was up tremendously from just over 1 million in 2005.
2 – Source: From InstaMed’s annual “Trends in Healthcare Payments” report.

> For more on this topic, read a previous article, “Why Do I Have A Balance? – Patient Payments”

EZClaim Is Monitoring Coronavirus

EZClaim Is Monitoring Coronavirus

Mar 23, 2020 | Uncategorized

During these unprecedented times, EZclaim is monitoring Coronavirus (COVID-19) developments, and are working to maintain the safety of our customers and employees. We are doing this by following the guidelines set forth by our state and local governments, and the recommendations from the CDC.

To enhance the safety of our employees, families, and communities, EZClaim is transitioning to a remote workforce to continue to serve our clients during this difficult period.  We will remain available and anticipate no disruption to our service or support.

Feel free to e-mail us or visit the contact page on our website to issue any questions or concerns.

Thank you for your patience, and please be safe!

Sincerely,
EZclaim

 

Office for Civil Rights is Looking at Business Associates

Office for Civil Rights is Looking at Business Associates

Feb 10, 2020 | Uncategorized

Live Compliance – EZClaim’s trusted HIPAA Compliance Experts

It is often, small companies who work in healthcare falsely assume that HIPAA pertains to large organizations and hospitals, when in fact, a Business Associate, is a person or entity that works with Protected Health Information. Many organizations don’t realize that the fundamentals of a compliance program are Business Associate Agreements, and performing Security Risk Assessments. 

In fact, an Indiana-based Business Associate, Medical Informatics Engineering, was recently fined $100,000 for “failing to perform a comprehensive risk assessment before its server was hacked in May 2015” resulting in what was concluded to be “one of the largest breaches in recent healthcare history!” According to the Resolution Agreement, MIE must assess whether its existing security measures are sufficient to protect its ePHI, and must revise its Corrective Action Plan, Policies and Procedures, and training materials, as needed. 

In May of 2019, in an effort to make the HIPAA Privacy Rule as easy to understand as possible, the Office for Civil Rights (OCR) has come up with a list of rules that clearly explain what Business Associates are now “directly liable” for. As OCR Director Roger Severino explains, “We want to make it as easy as possible for regulated entities to understand, and comply with, their obligations under the law.” 

The list consists of ten rules that, if failed to follow, can result in penalties and monetary fines. 

The OCR has made it very clear that even so much as simply “[failing] to comply with the requirements of the Security Rule” can result in immediate penalties as well. 

To this end, one of the most important rules also includes information about Business Associate Agreements and their need for proof of Satisfactory Assurance when the Covered Entity requests this of them. 

Satisfactory Assurance is crucial because it ensures the Business Associate is HIPAA Compliant and therefore, must also be in the form of a contract. Because it is so often overlooked, the fact 

sheet points out that there would be penalties associated with “Failure to enter into business associate agreements.” 

Are you ready when asked by your clients to provide your statement of Satisfactory Assurances? 

Checking off your Business Associate requirements, including those listed in the OCR’s fact sheet, is very easy with EZClaim’s trusted HIPAA Compliance Experts, Live Compliance. 

First, it is most important that all Business Associates and Vendors have proof of Satisfactory Assurance at least annually, as well as a Business Associate Agreement outlining their roles, functions, and notification requirements. 

Second, Business Associates and Vendors must complete an accurate and thorough Security Risk Assessment. A Security Risk Assessment will target vulnerabilities related to what is potentially exposing Protected Health Information. Failing to do so could also result in a penalty under ‘willful neglect’. This category alone is $50,000 per violation! These fines are huge, but the reputational damage to your billing company and the covered entity is expensive and difficult to overcome. (Live Compliance has a 100% audit pass rate!) 

Lastly, employees should be HIPAA trained with relevant course material to their role and your organization. Your workforce is your first line of defense. Completely built into your portal, Live Compliance training is custom, online, and role-based. Training is delivered and monitored within the Live Compliance portal, anytime and from anywhere.

If you enjoyed this article, please click here to stay up to date with our most recent blog posts! We thank you for reading.

Billing for Acupuncture and Chiropractors

Billing for Acupuncture and Chiropractors

Nov 18, 2019 | Uncategorized

AMBA 2019 National Conference Summary

Written by Stephanie Cremeans of EZClaim

Acupuncture and chiropractic medicine have faced stigma for some time in the medical field, often considered alternative treatments. As the opioid epidemic continues to grow patients are looking for alternatives and the US is starting to recognize the therapeutic value of both chiropractic and acupuncture treatments. Thanks to the internet, patients can educate themselves on alternatives and as more patients want the treatment, they also approach their self-funded employer plans for coverage of such treatment. As a result, we are seeing more and more insurance plans that will cover the cost of these services. 

Requirements for providers vary greatly by the state for licensure as well as the scope of practice but both acupuncturists and chiropractors can generally bill for Evaluation and Management (E&M) services, and both need to have a very clear understanding of patients’ benefits. Many insurance plans will combine the number of allowed visits for acupuncture and chiropractic services, and some even include physical therapy visits as well. Unfortunately, both specialties also lack in medical billing training, leaving providers to figure it out as they go.

For providers considering accepting insurance, it is important to familiarize yourself with the guidelines for the specific payers and plans that you would like to contract with as well as the diagnosis and procedure codes that are billable. If you are just getting started, consider working with a consultant to ensure that you are properly enrolled with payers and help you understand the specifics of acupuncture and chiropractic billing for your state.

One recommended consulting firm is RCM Insight.  

If you want to go about billing on your own, which we do not usually recommend unless you have the experience, then speak to AMBA so that you can learn the basics. They are a very good organization to get you started.

The EZClaim platform offers its customers a low-cost option that has all the functionality needed to get their claims paid.

The Importance of Selecting the Right Reporting Methodology

The Importance of Selecting the Right Reporting Methodology

Nov 11, 2019 | Uncategorized

2019 MIPS Reporting

2019 MIPS Reporting – Guest Author: Sarah Reiter of Health eFilings

The Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law on April 16, 2015, and is driving the transition in healthcare from a volume to a value-based care model. CMS programs such as MIPS require providers to transition to a value-based care model or else face significant financial risks and even reputational harm. The stakes have been raised every year and it is even more complex than it has been in the past, further increasing the stress, burden and financial risk to providers. For a provider, it is critical to understand the impact that the reporting methodology has on one’s MIPS score and to choose the best methodology and reporting partner.

Within this new framework of the MIPS program, all healthcare practices regardless of size or specialty must evolve their approach to reporting to assure their financial viability. However, most do not understand or have awareness of, the different reporting methods available to them. Many providers erroneously still think that a registry is the only reporting option available to them or that they are required to use a registry. Or, they think that their EHR covers their reporting obligation. This misperception and general lack of awareness of the other reporting methodology is detrimental to the financial interests of any practice. And, furthermore, for the 2019 Reporting Period, it is likely the first time that traditional, legacy reporting systems (registry or EHR) may be unable to fulfill enough of the reporting criteria to avoid the minimum score penalty.

The other reporting methodology, known as Certified EHR Technology or CEHRT, has emerged as the superior reporting methodology. Reporting through a CEHRT dramatically improves the efficiency and effectiveness of the MIPS reporting process especially when done using ONC certified software. Also, a CEHRT utilizes eCQMs (electronic Clinical Quality Measures), which are a better way to optimize the points that can be earned.  When the process utilizes ONC certified software and is, therefore, an end-to-end electronic solution, CMS awards significant bonus points toward the provider’s MIPS score.

Health eFilings, a CEHRT, is the best choice for a reporting partner. Our cloud-based ONC-certified software fully automates the process and does all the work with no IT resources, administrative support, and workflow changes. Health eFilings’ service is an end-to-end electronic solution that will save significant time, be a turn-key submission process and maximize the financial upside for providers.

And, finally, an important and timely addendum: While the 2019 reporting period is quickly coming to a close, Health eFilings can support you with reporting for 2019 so that you will avoid the automatic 7% penalty for not complying. But, time is of the essence, reach out NOW to connect with Health eFilings.

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