If you’re thinking of investing in medical billing software, there’s no better person to give you the answers you need than Chelsea Graven, a revenue cycle director for Alert Medical Alarms. With over ten years in the medical billing industry, she’s been in numerous roles including billing and claims submissions. A longtime customer and champion of EZClaim since 2013, Chelsea has referred the software to many other partners because she knows firsthand not only how simple it is to use, but how effective the software is.
Recently, we found time to interview Chelsea about her start in the industry, why she continues to recommend EZClaim, and her advice on anyone starting out in medical billing.
EZCLAIM: Working with EZClaim’s medical billing software platform, what role does their software impact your work?
GRAVEN:“The company I currently work for was originally either submitting paper claims or billing through portals. EZClaim has allowed us to transition to electronic billing and it cuts the amount of time we spend in provider portals or filling out those forms. I would say seventy-five percent of the workload has been cut using EZClaim. Previously, it took one person three weeks to bill 6,000 claims. Now, we are billing 7,000 claims in a matter of minutes just by submitting and using the features within EZClaim, such as the recurring claim option.”
EZCLAIM: If you were going to share something with your colleagues about EZClaim, what would it be?
GRAVEN: “How spot on the name ‘EZClaim’ is. It’s exactly what it’s called, EASY. Other software programs do not accommodate the simple recurring billing that we need. EZClaim is the only software I have used that does that and makes it easy. Of all the billing software platforms I have used, EZClaim is the simplest to use and the most user-friendly.”
EZCLAIM: What would you say are some strengths needed to be an effective medical biller?
GRAVEN:“Analyzing, troubleshooting, and resolving. There is a lot of that involved. You must be able to troubleshoot and independently find resolutions in order to be effective at billing. I think EzClaim has customized reporting capabilities that allow the companies to better follow current trends that they are seeing in claims, denials, and payments. Tracking the trends is what will lead to the troubleshooting, analyzing, and resolving of any issues, having customizable reporting makes all the difference to successful billers. You can’t fix something if you don’t know it’s wrong, EzClaim reporting brings all of that to the biller, so you don’t have to go looking for problems/solutions on top of your daily billing processes.”
EZCLAIM: Do you have any advice for anyone who is starting out in the medical billing industry?
GRAVEN:“EZClaim is my go-to for anyone who is doing medical billing and is wanting to learn and get into the industry because it is the simplestsoftware to use. EZClaim makes it easy to grasp the electronic billing end-to-end process without feeling overwhelmed by the complexity of the software. I would say for anyone starting out the first thing I would do is find an electronic billing solution and a clearinghouse.”
EZCLAIM: Why did you get into the medical billing industry?
GRAVEN:“I actually fell into this industry by default. I was working on private pay collections for a company and at the time the state of Illinois in 2010 transitioned to manage care programs, and no one was really prepared for that. I was then asked to take on the role of billing manager. It grew so large that doing HCFA 1500 forms was not efficient, so I started looking for electronic billing solutions. What I enjoy most about the billing industry is closingthe claims entirely. Getting that amount to zero dollars. Most people wouldn’t say it’s the money coming in, but for me, it’s the gratification for the end-to-end process of the revenue cycle. It’s all about getting the receivables closed.”
EZCLAIM: Final thoughts?
GRAVEN: “With EZClaim, the value is beyond just the software. Yes, it’s easy to work with, but the IT team and all the people involved make the experience favorable.”
[ The above answers were paraphrased as closely as possible to the original answers given by Chelsea Graven on October 22nd, 2021. ]
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.
We see it all the time, a patient visits their doctor’s office to seek treatment and then receives a bill in the mail for their portion of the medical expenses. When a patient receives the bill, they are often alarmed at the amount that is due and may not have the funding to pay the balance in full. In a recent study conducted by UCLA, it is estimated that there is $140 billion in medical debt that has been reported on credit reports (VeryWellHealth, 2021). In fact, this research study found that one in every five consumers was already in collections prior to the COVID-19 pandemic.
As cases of COVID-19 increased in 2020, many consumers feared visiting their doctor’s office that they avoided their routine office visits, and/or lost their employment further impacting a patient’s ability to pay for any medical expenses. As providers continued to keep their offices open, many providers witnessed a decrease in patient volume while also seeing a reduction in revenue. According to a recent article published in Medical Economics (2021), 55% of practices were impacted by a decrease in revenue while 60% were impacted by a decrease in overall patient volume. Combined with the number of patients that were already in medical debt and/or collections, many practices faced a financial crisis as a result of the COVID-19 pandemic.
As the COVID-19 pandemic seemed to become more stable in early 2021, many patients felt comfortable returning to visit their doctor and/or were able to secure employment, providing patients with employer-sponsored insurance coverage. With the current rise of COVID-19 cases increasing again, practices are left with the ongoing challenges of attempting to maximize revenue collection with the risk of history repeating itself and the patient’s inability to pay their medical bills or avoiding their office visits.
Contrary to belief, consumers actually want to pay their medical bills and are seeking more payment options. According to the 2020 Trends in Healthcare Annual Report, providers and consumers must adapt to a new payment experience in order to enhance how they interact with one another. In addition, more than half of consumers would consider changing their provider for a better payment experience. One may ask, what constitutes a better payment experience? Consumers are showing a higher demand for contactless payments and the ability to work with their providers to create a payment plan or auto-payment options. Unfortunately, many providers have not adapted to their consumer’s needs and continue to operate with traditional methods creating dissatisfaction amongst their consumers
How can providers change their operations to facilitate a more consumer-friendly experience for their patients? Front-office staff play a pivotal role when interacting with patients and should be collecting up-to-date contact information to ensure patients are communicated with effectively, have the most recent insurance data to avoid any processing delays, and should collect a patient’s consent ahead of time for new features such as eBills, texting, and payment preferences. EZ Claim customers can streamline their revenue collection opportunities by partnering with BillFlash for innovative billing opportunities and various payment collection features that consumers highly desire. While nobody can predict if this recent wave of COVID-19 cases will lead to another quarantine phase or not, it is important for providers and consumers to enhance how they interact with one another to create solutions for healthcare needs.
EZClaim has been at the forefront of the medical billing software industry since 1997 with one goal in mind: to simplify the billing challenges for all providers. We at EZClaim understand that the healthcare billing process can be time-consuming and arduous, which is why we offer software that is easy to use, will focus on customer’s needs and can be specifically tailored to your practice.
Here are three essential reasons why you should be using medical billing software in your practice.
Improve Your Practice’s Billing Revenues
Did you know thatthe Academy of Healthcare Revenue estimates that providers have a 70 percent chance of collecting patient responsibility either prior to or at the point of service, compared to a 30 percent chance after the patient leaves? EZClaimPay not only saves you and your team time but makes it easier to collect and record payments.
EZClaimPay allows your patient to make a payment at the point of service, and if they owe less than what they paid, you can offer a partial refund right from EZClaimPay. You can also keep a patient’s credit card on file, so if they owe more, you can get consent to charge the card on file. Additionally, there is no need to send out a statement; you can text or email the patient directly.
Useful in Processing and Tracking Medical Claims
There is no question that medical billing software is helpful for tracking and processing medical claims. If you are currently not utilizing a PM system, it is probably difficult to keep track of patient and insurance balances and claims that are under and overpaid, which means your practice could be losing money. With EZClaim, you will have much better control of your billing data.
Check out the video with real customer’s firsthand experiences on how easy and flexible EZClaim software really is:
Ease of Access
Using medical billing software allows your practice greater and easier access to all your patient data. By only logging into one program vs. numerous programs, you and your team will find it easier to answer questions for your patients. In addition, having your data seamlessly accessible will make processing payments more efficient.
Here at EZClaim, we understand that not all provider offices work the same. EZClaim software allows you to choose the additional tools and services that work best for how your practice operates. You can utilize the software as simple as you want or customize it to fit your practice’s specific objectives. With EZClaim Billing, you always have the option to grow.
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.
As a medical billing software company, EZClaim has worked and built relationships with thousands of billing experts across the country. With the aim of helping establish a standard of best practices, we have come up with 3 keys to being a medical billing expert. If you own a medical billing company or are studying to be a medical biller, then you will not want to miss these.
1. Strong Communication Skills
Medical billers must interact with a variety of individuals in their roles.
One of the most important people a medical biller must learn to communicate with is the patient. It is a biller’s job to be courteous, transparent, and offer up solutions to problems. Clearly communicating to patients their financial responsibilities will allow for the medical biller to complete the claim. It is also crucial for a medical biller to communicate well with their provider. If a patient’s claim is not complete, the biller must feel comfortable reaching out to the health care provider to find the missing pieces. Proper classification and correct billing methods is a critical component to getting paid.
2. Be Proactive
Be proactive in furthering your knowledge, the medical billing industry is continuously changing, and it benefits a biller to remain on top of the industry standards. There are billing associations you can join such as the American Medical Billers Association. Taking classes at a local community college or attending a billing school will help hone your skills. If a medical biller has gone through certification, these should be kept current.
3. Strong Follow-Up Skills
A good medical biller understands that having a strong follow-up and watching their dates is a critical component of revenue collecting. Identifying and correcting time management issues will increase productivity. An effective medical biller will set follow-up dates to track claims and set reminders in their billing program.
EZClaim offers many tools to assist billers with follow-up tasks. Between customized grids, follow-up reports, tasks, and reminders there’s a tool that will work for you and your workflow process.
In conclusion, a thorough knowledge of billing software, processes, and practices, is just one component to becoming an effective biller. Building strong relationships with patients, providers, and insurance companies through excellent communications and strong follow-up skills will ensure that patients stay satisfied with the medical practice and that providers are paid in a timely manner.
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.
Waystar’s newest guide investigates the state of denials and appeals in today’s healthcare landscape and explores how today’s most successful providers are redefining the core components of their denial and appeal process to grow revenue, streamline workflows and revitalize their approach to the process.
Denial and appeal management today
Like many administrative tasks further burdened by the impacts of the COVID-19 pandemic, denial and appeal management workflows dependent on manual processes are experiencing new strains on accuracy and productivity.
Last year a survey investigated how billing and administrative tasks were impacted by COVID-19, with 37% of surveyed providers reporting an increase in workloads due to issues with coding and requirements. An assessment of the general industry outlook found claim denial rates are at an all-time high, with 33% of surveyed hospital execs reporting concerns they are entering a “denials danger zone,” where rates grow to 10% or more.
Estimates put the cost of reworking denials as high as 20% of rev cycle expenses because on average they cost 4x as much to process than the initial claim. With so much strain already present on providers’ resources, many are turning to automation to ease the burden.
How automation elevates the process
Once a provider has been notified of a denied claim, steps are taken to identify whether or not it can be appealed. Many of the errors that cause denials come down to administrative issues that took place at the start of the claim lifecycle.
A recent analysis found 86% of the denials processed between July 2019 and June 2020 were avoidable. Analysis indicated that many of those issues stemmed from front-end errors related to benefit information, coverage detail, and shortcoming related to missing or invalid claim data.
While there’s a wide mix of problems that could cause a denial, with different providers experiencing a diversity of challenges depending on their location and patient population, they all face a common hurdle: the burden of manual denial management and appeal procedures put on administrative staff.
Like many other administrative processes, providers for the most part rely on a mix of manual and electronic procedures to handle denial and appeal management. But the industry’s continued reliance on manual procedures is beginning to have a negative effect.
How providers are transforming their approach to denial + appeal management
Studies have found that it costs about $118 in reworking fees to appeal a denied claim. These costs are exacerbated by the industry’s overall reliance on manual processes—a systemic issue many recognize yet fail to capitalize on. Indeed, while many providers see the promise automation can deliver on, they still face a number of considerations before pushing forward with implementing an automated solution.
And automation is a hot topic for providers for a very good reason—studies have demonstrated the US healthcare system could save as much as $16.3B by automating old or outdated processes. When it comes to denial and appeal management, the benefits are far-reaching, from improvements to productivity and a reduced strain on resources to huge boosts to claim accuracy and revenue recovery.
What to look for in a denial + appeal management solution
Leading-class solutions offer a wide selection of tools to provide a comprehensive approach to denial and appeal management, using customized, exception-based workflows to streamline the entire process and overturn a sizable increase in denials.
The appeal toolset a solution offers should make it easier to coordinate and use the info and data necessary to automatically process appeals and recover cash that would otherwise create productivity issues or unnecessary fees.
The solution’s ability to prioritize appeals based on cash value automatically lets staff concentrate on tasks that actually demand their attention, supporting them with additional tools like automatically generated payer-specific appeal forms and robust analytics capabilities that allow you to track and measure progress and problem areas.
Keeping disruptions at a minimum is key when considering your solution as well, so consider its ability to work efficiently with your existing systems and look for a partner that can demonstrate a strong history of seamless integrations.
Wrapping it up: why denial + appeal management solutions matters
A recent Waystar survey found 76% of providers categorized denials as their biggest RCM challenge. And the wider picture of healthcare reflects an industry struggling to solve a long-standing problem with manual processes and few answers.
Implementing an automated denial and appeal management solution is quickly becoming the optimal path forward for most providers, even if many have apprehensions about committing to the switch. But as new innovations cut down on the resources and time needed to implement the tech, the time is quickly approaching where the switch will be easier, and more vital, than ever before.
Click here to find out how Waystar can help fully automate the process and help you recover more revenue while reducing the burden on staff.
Heading to AMBA in October? Visit Waystar and EZClaim while you’re there! Stay tuned for more event details.
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 Waystar ]
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