After Pandemic Impact on Outsourcing RCM

After Pandemic Impact on Outsourcing RCM

After Pandemic Impact and Outsourcing Revenue Cycle Management

The impact of the COVID-19 pandemic will be felt in every industry for many months to come. For medical providers, they are facing some of the most challenging financial times they will or have known. Therefore, we understand that it is crucial for providers to re-access their business and look for ways to cut costs with minimal impact on their practice or their patients.

To compound the issues providers are facing, there has been a wave of changes in recent years with new coding and telemedicine requirements that are making it difficult for provider offices to remain independent. Add on the constant rise in the cost of living and expenses while insurance reimbursements continue to decrease, and the issues get worse and worse.

Many have decided that outsourcing to a complete revenue cycle management company could help alleviate some of the undue burdens, cut costs, and keep providers compliant with their coding and billing. Ultimately this allows providers to continue to focus on patient care, which is their goal. As providers, you understand that revenue cycle management is a crucial part of your physician’s office. If not managed properly, it could result in an office leaving thousands of dollars on the table in unclaimed revenue. Over the years, our free audit services have allowed providers to have a free, transparent, and unbiased assessment of how their accounts receivable department functions. We are always amazed at how many providers do their billing in-house, and sometimes even when they outsource,  are not aware of how much money they have sitting in their accounts receivables.  Getting this knowledge is the first step to increasing revenue and efficiency.

In-house medical billers and third-party outsourced revenue cycle management companies should be giving provider offices monthly aging reports to assess their financial forecast. Each accounts receivable bucket over 60 days should hover at approximately 1 0% or less of the entire revenue balance. If account receivable buckets are higher than 10%, providers may be leaving money on the table, and the account may not be getting worked as providers think they are. In efforts to avoid unpaid claims and a spike in accounts receivable, outsourcing your revenue cycle management to a third-party medical billing company, such as BC Medical Billing, could help providers in countless ways. Many practices recognize that keeping their revenue cycle management optimized is key in delivering regular practice operations; however, they are not always sure how to achieve that. Outsourcing may be the solution!

Outsourcing alleviates the practice from managing a new medical billing employee, paying a salary and benefits, completing training and onboarding protocols, and managing the lost time from a learning curve. Many providers feel that it is not a wise use of the back office executive personnel’s time to worry about finding coders in-house and then wondering if the charges are captured and billed correctly. Instead, the business office should be focusing on how to grow the providers and the physician practice.

Our free audits will help you determine if you have found the right solution for you. If not, we are always there to assist and always increase the provider’s revenue.


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 BC Medical Billing ]

Integrating an EHR and PM – RCM Insight

Integrating an EHR and PM – RCM Insight

Have you ever been a bit overwhelmed when shopping around for all your medical practice needs?  Of course!  There are so many pieces required to meet all the HIPAA and reporting requirements, but it’s also about efficiency and ease of sharing information between clinicians to administrators.  This can make the all-in-one Electronic Health Record (EHR) and Practice Management (PM) systems very tempting.  Keep in mind, you will pay a hefty price for an all-in-one, which makes this a very simple decision for some practices.  The good news:  You have alternatives that still provide the same ease of sharing data through integration.  I recently interviewed Dan Loch, President of EZClaim Software, LLC.  EZClaim offers a stand-alone billing platform that offers several options for integration with clearinghouses and EHR’s.  I asked Dan what he felt the biggest advantages were to using stand-along programs.

    1. Your practice will get the best of both worlds! Often practices will find a great EHR, but the billing side is not the best, or vice-versa.  Using stand-alone programs that can talk to each other allows a practice to choose an EHR solution that is best for their clinicians AND a PM solution that is best for the billers and administrators.
    2. Typically, stand-alone systems are more ‘nimble’ in responding to industry and regulatory changes.
    3. Integrating multiple ‘best-in-class’ software packages creates an offering with much more in-depth capability.

If you are currently using separate EHR and PM solutions but the programs are not integrated – consider looking into this feature.  This will relieve the burden of entering data twice.  Start by verifying if the programs have an existing integration.

    • If so, the hard part is done! Just ask what the process is to get set up and if there are any fees associated.
    • If not, consider contacting your PM software vendor to inquire what formats they accept for EHR integrations. Once they provide the specs, work with your EHR to determine if you can export in the required format.

There is no single solution that works for every practice.  If you’d like to learn more, check out this article from EZClaim ‘All-in-One’ or ‘Specialized’ Medical Billing Software?  Which is Best?  I hope that this information will help you weigh your options and find the right fit for your specific situation.  If you have questions or would like some help determining what would be best, RCM Insight is here to help!  Visit us at www.rcminsight.com and submit a request to chat on the Contact Us page.

 

Pandemic Impact and Outsourcing Revenue Cycle Management

Pandemic Impact and Outsourcing Revenue Cycle Management

The impact of the COVID-19 pandemic will be felt in every industry for many months to come. For medical providers, they are facing some of the most challenging financial times they will ever know. Therefore, we understand that is it crucial for providers to re-assess their business and look for ways to cut costs with minimal impact on their practice of their patients.

To compound the issues providers are facing, there has been a wave of changes in recent years with new coding and telemedicine requirements that are making it difficult for provider offices to remain independent. Add on the constant rise in the cost of living while insurance reimbursements continue to decrease, and the issues get worse and worse.

Many have decided that outsourcing to a complete revenue cycle management company could:

    • help alleviate some of the undue burdens
    • cut costs
    • keep providers compliant with their coding and billing

Ultimately, this allows providers to continue to focus on patient care which is their goal. As providers, you understand that revenue cycle management is a crucial part of your physician’s office. If not managed properly, it could result in an office leaving thousands of dollars on the table in unclaimed revenue. Over the years, our free audit services have allowed providers to have a free, transparent, and unbiased assessment of how their accounts receivable department functions. We are always amazed at how many providers do their billing in-house, and sometimes even when they outsource, are not aware of how much money they have sitting in their accounts receivables. Getting this knowledge is the first step to increasing revenue and efficiency.

In-house medical billers and third-party outsourced revenue cycle management companies should be giving provider offices monthly aging reports to assess their financial forecast. Each accounts receivable buckets over 60 days should hover at approximately 10% or less of the entire revenue balance. If account receivable buckets are higher than 10%, providers may be leaving money on the table, and the account may not be getting worked as providers think they are. In an effort to avoid unpaid claims and a spike in accounts receivable, outsourcing your revenue cycle management to a third-party medical billing company, such as BC Medical Billing, could help providers in countless ways. Many practices recognize that keeping their revenue cycle management optimized is key in delivering regular practice operations; however, they are not always sure how to achieve that. Outsourcing may be the solution!

Outsourcing alleviates the practice from managing a new medical billing employee, paying a salary and benefits, completing training, and onboarding protocols, and managing the lost time from a learning curve. Many providers feel that it is not a wise use of the back office executive personnel’s time to worry about finding coders in-house and then wondering if the charges are captures and billed correctly. Instead, the business office should be focusing on how to grow the providers and the physician practice.

Our free audits will help you determine if you have found the right solution for you. If not, we are always there to assist and increase the provider’s revenue.

 

 

 

Integrating Your EHR with EZClaim

Integrating Your EHR with EZClaim

Are you or your staff having to enter every patient into your EHR program and then again into EZClaim?  There is an easier way!  Integrating your programs will put an end to duplicate data entry, saving your practice time and money!

So, what exactly is an interface and how does it work?  An interface is a way for two programs to share information.  For EZClaim clients, the interface can be set up to share data from your EHR program to EZClaim.  Your EHR can give you specifics on how to send the data to EZClaim.

In EZClaim you will have an opportunity to review the file prior to saving the data.  When you complete the import process, your claims will be created, and libraries will be updated.  In addition to creating your claims for each visit, an interface can also create Physician/Facility library entries, as well as Payer library entries, and create new or update existing patient accounts.

If you are working with one of our partner EHRs (Visit our Partner List) the integration between programs can be set up quickly and easily.  Since the process varies slightly depending on the EHR you are using, time to complete the integration request will vary.

If you are not using a partner EHR, you may still be able to integrate with EZClaim.

Following are some options:

  • In our Online Help File the format types and specifications are available for you to share with your EHR vendor.  If they can provide a file in one of the required formats you will be able to import your data.
  • You may consider using a third party to write a custom interface for you.  If you would like more information on this, contact EZClaim and we will be happy to provide information on consultants who are familiar with the EZClaim platform.

If you have questions, please submit them via email to support@ezclaim.com so a technician can review them and get back with you.

How to Set Up Validation Rules in EZClaim

How to Set Up Validation Rules in EZClaim

EZClaim medical billing software has many features built into the program to help you submit clean claims for quick payment and some that can be customized to fit your specific needs. This post will look at the ability to create customized validation rules.

Your EZClaim program already includes standard validation rules. To access these rules and create your own, press CTRL-ALT-V.  This will open the Rule Library.

Here you will find four different types of rules to work with, rules related to:

  • Sending claims
  • Saving a patient
  • Saving a payer library entry
  • Saving a physician library entry

 

Now, click on the rule type you would like to work with and click Edit Rules. A list of rules that are already in the program will appear, along with the option at the top to “Add new validation rule“.

To get started, you will fill in the fields on the bottom left side of the screen:

Name: Name the rule anything you would like
Field: This is the field in Premier that you want to validate
Message:  This is the message that will show when the error is encountered (consider using casual wording or extra punctuation so it is easily identified as a custom rule rather than a default rule)
Severity: Do you want the program to simply warn you that there may be an error or stop you from completing the task?

 

Next, you will build the logic for the validation of the field you have named above.  In the example below, the rule has been created to warn users if ALL the following statements are true:

  • Authorization Number is blank
  • Procedure Code is 90876
  • Payer is Blue Cross

 

Before you begin working with your validation rules it is extremely important to keep the following in mind:

  • Rules are created to check for bad or missing data, not to confirm good data.
  • Rules in the Sending Claims area may prevent batches from being created.
  • If you wish to bypass a built-in validation rule you may disable it, if you want to customize it you can Copy the rule, update, and disable the original rule.
  • Rules are the sole responsibility of the practice, EZClaim cannot troubleshoot custom validation rules.

 

As you can see, custom rules allow you to be very specific and can include multiple data points. Learning to use validation rules can be tricky and may take a few tries to get the rule built correctly. However, once you have the rule in place you can avoid payment delays and needing to resubmit claims.


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, email them, or call them today at 877.650.0904.