How to Improve Medical Billing Revenues

Improving Medical Billing RevenuesIt 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 Filing and batching inaccurate and non-HIPAA compliant claims can often be traced back to an outdated healthcare revenue management system.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.

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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 sales@ezclaim.com, or call a representative today at 877.650.0904.

[ Photo credit: Studioarz ]

Clearinghouses – Simply a Pass-Through Portal?

AMBA 2019 National Conference Session Recap

Written by Stephanie Cremeans of EZClaim – AMBA 2019 National Conference Session Recap

AMBA 2019 National Conference Session RecapI 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.