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 | 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 | 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
Jul 3, 2022 | Partner, Trizetto Partner Solutions
It’s safe to say that healthcare practitioners are well aware of the importance of credentialing. Beyond the legalities required of practicing physicians, credentials are needed for a practice’s revenue cycle to function properly. If providers aren’t enrolled with payers, they can’t receive payment for submitted claims. It’s as simple as that.
New and existing providers are required to maintain credentials and it’s not an easy process, even for the most well-oiled office. In order to take on the most patients and collect optimal revenue, practices also need to accept a wide array of payers. In fact, there has been a 5 percent uptick in providers enrolled with 10-20 payers, according to VerityStream’s 2018 Provider Enrollment Survey. Gaining enrollment with these payers involves verifying qualifications in order to accept patients, submit claims and ensure a steady stream of cash. Administrators need to collect the educational history of providers, fill out forms and submit the applications. It sounds easy enough, right?
Think again. There are hours of administrative work needed and a high risk for human error, with any hiccup in the process likely causing delays. It’s been said that up to 85% of credentialing applications are incomplete, which could cause delayed billing, lost revenue or even audits.
When it comes to credentialing, time is money. A 2016 survey by Merritt Hawkins found that a non-credentialed doctor was losing approximately $6,600 a day. Multiply that by the total amount of physicians in a given practice, and the potential losses are staggering.
Credentialing is a necessary evil, so do you handle in house or outsource? That’s the million dollar question. Utilizing current staff resources sounds like the easy solution, but does your organization have a dedicated employee to focus on your credentialing needs? Probably not. Chances are, this employee is pulled in many directions and isn’t able to dedicate time solely to credentialing. And if you do plan to handle the process with current staff, are your employees well-versed in all payers and their processes? Factor in learning curves or potential staff turnover and the time associated with training new employees and the not-so obvious financial costs quickly add up.
So how does the average practice streamline the process and ensure that credentials are gained as painlessly as possible? The old adage “you get what you pay for” could easily apply to this scenario. Hiring an outside resource means you are essentially paying for expertise and efficiency, which will save time and money in the long run. Why wouldn’t you want to utilize expert resources with in-depth knowledge of payer and state nuances? However, before making a decision, you need to know how much your practice could save by using a third party. Knowledge is power and having an accurate picture of your potential revenue is the first step to determining the best option for your organization.
Access the credentialing ROI calculator from TriZetto Provider Solutions, a Cognizant Company, to receive an estimate of potential revenue savings. Discover the hidden costs associated with the credentialing process and see just how much revenue your practice could be leaving on the table. You’ll gain enrollments quickly and accurately, keep employee satisfaction levels high (since they won’t be burdened by the process) and ultimately, increase revenue.
Don’t allow the complicated payer credentialing and enrollment process to be a burden on your practice. The credentialing experts at TriZetto Provider Solutions have experience working with various payers and providers of all backgrounds. Our team will collect and submit information in a timely manner and perform all necessary follow-up tasks. Let us lighten your load so you can focus on patient care and growing your practice.
[Contribution by TriZetto Provider Solutions Editorial Team]
