Medical billing technology is always changing, and usually much quicker than one expects. While your current processes may be working for you, there just may be something better available to reduce staff time and increase your revenues. The thing is, technology has made huge strides in the medical billing industry in recent years, offering a number of ways to send and receive data faster, while still protecting sensitive patient information.
So, over the next several posts, we will explore different features technology can offer to increase your efficiency as well as your‘bottom line‘. We will consider how your Electronic Medical Record (EMR) can communicate with your Practice Management(billing) software, the key features to look for in your Practice Management software, and how it can communicate with other programs, such as Clearinghouses and statement vendors.
This Medical Billing Technology Series will include:
Validation vs. Scrubbing
Rejection vs. Denial
Integrating With an EMR
Integrating With a Clearinghouse
Basics of ANSI/EDI Reports
Patient Collection Policy/Credit Card Processing
Is Integrated Eligibility Worth It?
Selecting a Practice Management System (Ease of Use/Access; Training; and Support)
Now, not every office will benefit from the same “bells and whistles,” and there are so many options out there. It can be overwhelming. Chances are though, your office could benefit from considering some updates, and some may not even cost you at all!
EZClaim suggests that you take a fresh look at the workflows and processes that you have in place today, and start thinking about the tasks that are wasting time or that are causing delays in collecting payments (from both patients and insurance). These insights just may help you create a positive changeto your workflow and your revenues!
So, if you need some help getting started, consider working with a consultant. One of EZClaim’s partners, RCM Insight, offers an annual fee schedule review, and during the month of February 2021, they will be offering four practices a FREE fee schedule review. So, visit their CONTACT US page for your chance to win! [ Note: RCM Insight uses EZClaim’s medical billing software for their billing services, so it could be a ‘win-win’ if you are—or will be—using EZClaim’s medical billing solution ].
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, visitEZClaim’s website,e-mail them, or call them today at 877.650.0904.
[ Contribution: Stephanie Cremeans with RCM Insight ]
It IS POSSIBLE to improve medical billing revenues, and here are a few ways to do just that.
Healthcare practitioners, whether established or just starting out, have many overwhelming tasks: Managing a practice; Seeing patients; Working to staying up-to-date on administrative tasks; The whole host of compliance at the federal, state, and local level; and Overseeing the billing.
One of these that can lead to loss of revenue is not properly managing the medical billing, which can also lead to HIPAA fines and rejected claims. However, there is a solution: a medical billing system that balances the budget and optimizes revenues of medical practice.
EZClaim, an expert in the medical billing software market since 1997, provides a solution that improves the efficiency of an office’s billing process in many ways. The following are the primary reasons.
Reduce Coding Errors Medical procedures become codes, codes become claims, and claims become revenue. Any error in this process can make claims to be denied, your workload can be increased, and revenue can be lost. To help in avoiding errors, it is essential to use billing software that offers the easiest implementation and access to descriptive diagnosis and treatment codes. EZClaim’s medical billing solution offers ease-of-use in coding, billing, and strong partnerships with Clearinghouses which act as an additional ‘safety net’ for catching errors.
Administrative Support Most medical practices are a small team of people tackling a wide range of tasks, so when one cannot understand the function of the billing software, accessing reliable support is very important. EZClaim prides itself on having dedicated support experts available, and that was how the company was established. Founder and President Al Nagy has said, since day one, “We are a support company that happens to sell medical billing software.”
Maintain Industry Compliance It is important to recognize that industry compliance and a practice’s revenue go hand-in-hand. Filing and batching inaccurate and non-HIPAA compliant claims can often be traced back to an outdated healthcare revenue management system. Conquering these tasks requires a focus on multiple fronts: A properly trained billing team, clear office procedures, patient payment policies, and a reliable medical billing company. These are all ways to help buttress against non-compliance and rejected claims.
Streamline Workflow Recently, a study was done that showed almost 80% of medical bills contain errors. These incorrect medical claims often end up as lost revenue originally, not to mention the additional cost of resubmissions and collections. One of the best ways to resolve this problem for your practice is to make use of both well-trained, experienced billers and coders, combined with a competent medical billing solution that aids in catching these errors. EZClaim software features a library of standard validation, the ability to add custom validation, and integrates with Alpha II for full claim scrubbing.
Follow up Errors will and do occur, so establishing a system for follow-up on all denials will close the loop and protect against lost revenue. Being consistent with the follow-up process, and having a medical billing solution that tracks these things will help close that gap.
Collections Finally, probably the most important aspect that optimizes a practice’s revenue is to get paid. Portals and payment collection systems definitely help with this, but having collections integrated into the medical billing system is, of course, the best. EZClaim has pain-free payment processing integrated into their solution, called EZClaimPay. It solves all the problems associated with payment processing: Bank deposits, reconciliation, statements, changing fees, and ‘finger-pointing’ when there is a problem. EZClaimPay’s robust platform will greatly increase a practice’s collections success, and improve their revenue.
ABOUT EZCLAIM: EZClaim is a medical billing and scheduling software company that provides a best-in-class product, with correspondingly exceptional service and support, and can help improve medical billing revenues. To learn more, visit their website, e-mail them at firstname.lastname@example.org, or call a representative today at 877.650.0904.
Written by Stephanie Cremeans of EZClaim – AMBA 2019 National Conference Session Recap
I recently attended a breakout session of a seminar with a slide titled: “Clearinghouses are not Simply a ‘Pass-Through’ Portal.” With my role as a software support specialist, I immediately tensed up and thought about how inaccurate this statement is – I hear from clients that think that the software or the clearinghouse has changed their data, but that simply isn’t how it works. Well, kind of not how it works. You know that nothing in medical billing is as simple as it seems! Depending on how your practice management system works and depending on your understanding of how electronic claims are filed this may or may not be a valid statement. While I’ve always described a clearinghouse as simply a “pass-through” for your claims this seminar got me thinking about how much more a clearinghouse is! Let’s explore a little, starting from entering your claim into your PM system and clicking send.
The first piece of the puzzle is understanding what your PM system is (or isn’t) doing with the data. You’ve entered the claim data and you are ready to send your claims to the clearinghouse, but how is that data transferred? There are 2 typical formats – Print Image or ANSI 837. All claims being sent to payers must be in the ANSI 837 format, following specific guidelines for submissions. Although some clearinghouses are no longer accepting Print Image files, some do. In this instance, the PM system creates a snapshot of a claim form which requires the clearinghouse to move data into the correct fields for claim submission to the payer via the ANSI 837. Preferably, your PM system can create the ANSI 837 file for submission to the clearinghouse. The biggest advantage here is that you can typically view the file and the clearinghouse will not be changing anything before submission to your payer. If your PM system cannot create an ANSI 837 file I would consider upgrading or find a new solution.
So that’s it, right? If you have a system that creates a Print Image the clearinghouse is more than a pass-through and they “change” your data. If you send an ANSI 837 file, it simply passes your file along. Well … while this may be true, it’s really only part of the story, and you are potentially missing out on some pretty amazing resources that are at your fingertips! In addition to submitting the claims to your payers, they can scrub claims for common errors, confirm batch receipt and acceptance, provide claim level updates of accepted/rejected claims, and provide electronic remittance advice for auto-posting insurance payments. In addition, many offer additional services (for an additional fee) that can integrate with many practice management systems like integrated eligibility, determine deductibles and co-pays, patient cost estimators, claim status inquiry, patient statement processing, and printing services for your paper claims.
I’m working hard to remove the phrase “just a pass-through” from my definition of a clearinghouse. Once you have submitted an 837 file, they are still doing so much more than simply passing along the file.
EZClaim partners with TriZetto Provider Solutions but is designed in such a way that it will work with any clearinghouse a customer would like to use. The white-glove support team is even there to help set up the connection if needed.
We hope you enjoyed this AMBA 2019 National Conference Session Recap by EZClaim. Click here to view our blog page for more interesting and useful articles.
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