Whether you are a person new to medical billing or someone who’s been in the business for years, launching a new medical billing practice can be hard. Understanding the market, connecting with new clients, and knowing how to master your processes are challenges that you often learn as you go. Despite these challenges, it is rewarding to be out on your own growing a new company. Before you jump, let us help you understand some essential keys that you can research upfront and prepare yourself to get one step closer to being successful.
1. ONE BILLING PLATFORM VERSUS MULTIPLE PLATFORMS: First and foremost you must make a conscious decision to either focus on being an expert on an individual medical billing platform, like EZClaim or tackling multiple platforms. There are pros and cons of both: being an expert can make you extremely efficient in your use of the software’s billing and, scheduling features, however, it can also limit your client base to only one set of software users. Whereas having a basic understanding of multiple platforms can allow you a larger base of medical offices while limiting your ability to truly understand how best to serve each individual client’s needs.
Pro tip: Start and master one trusted billing program, and grow your options as your billing business grows.
2. GET CLEAR ON THE CLEARINGHOUSE: A new billing company owner does not want to be held to just one clearinghouse as options are key here. Having the ability to work with any or many would be an essential piece to your billing services, however, you still want to know the best clearinghouses in the business. Understanding which clearinghouses provide the best products and services and being able to recommend those services to your client upfront will make your life easier and their business run smoother. For this very reason, EZClaim has built its software around partnerships and integrations with the best clearinghouses to make working with the one you need easy.
3. COMPLY OR DIE (HIPAA Compliance): The third key to any start-up is first understanding the importance of HIPAA Compliance. Medical billing firms literally can come crashing down with any missteps, mistakes, or misunderstandings of this essential piece of the puzzle. It goes without saying that if you are going to choose a billing software be sure that they have partnerships built around making sure you are protected. You are also responsible to make sure the data is protected so your customer and their patient’s data is safe.
HIPAA Hint: Check out Live Compliance for further details on the topic.
There are many options available out there for your new medical billing practice, and we recommend doing your research. Within that research, you will find that EZClaim ranks very high in performance and comes in at a great price.
To learn about EZClaim go to our about page, sign up for a demo, and/or download a trial for free today!
There are many commonly misunderstood aspects and nuances with the MIPS program, particularly in how points are earned. For a healthcare practice, it can be challenging to know exactly what to do to earn points, optimize the score, and protect their Medicare reimbursements. But, at the same time, the stakes have been raised every year and the final ruling of the program is even more complex than it has been in the past, further increasing the stress, burden, and financial risk for a healthcare practice.
The approach a practice takes to report for MIPS will greatly impact the results. Many do not understand or have awareness of, the different reporting methods available to them. Many Providers erroneously still think that a registry is the only reporting option available to them or that they are required to use a registry. Or, they think that their EHR covers their reporting obligation or that an EHR’s reports satisfy the MIPS requirements. These misperceptions and erroneous assumptions are detrimental to the financial interests of any practice.
There is a third reporting methodology that has been established and authorized by CMS, called CEHRT, or Certified EHR Technology (software). The CEHRT methodology assists CMS with their need for more valid data submitted through technology and to refocus Providers from merely using technology towards Providers leveraging technology to improve outcomes. Reporting via a CEHRT using software that has been certified by the ONC is a superior approach because it optimizes the points that could be earned and therefore, maximizes Medicare reimbursements for the practice.
Recently an RCM company CEO approached us at Health eFilings with the decision to use six of her clients to conduct a side-by-side comparison of the registry and Health eFilings (CEHRT) methodologies for reporting. In this manner, she intended to validate for herself whether a CEHRT or registry would generate the greatest ROI for her clients. The results of using Health eFilings’ MIPS Accelerator service, on average earned almost triple the points versus a registry for the same year for the same clients.
“Due to limited understanding and guidance, we weren’t aware of the differences of the reporting methodologies available for my clients. We believed there was greater opportunity, but the current registry methodology we had chosen didn’t demonstrate that for our clients.”
Katy, RCM Company CEO
This side-by-side comparison highlights not only that a CEHRT is a superior method of reporting as Health eFilings was able to leverage technology to facilitate the ease, accuracy, and completeness of tracking and reporting, but it also maximizes a Provider’s MIPS score. Additionally, given the levels of Medicare reimbursements for these practices, the higher score resulted in their earning a positive payment adjustment, which significantly improved their bottom line. And, take note that if the Registry were to perform the reporting for the 2019 reporting period, these practices would not earn enough points to avoid the penalty of negative 7%.
Health eFilings with its proprietary ONC certified software has many advantages over any type of registry:
- Automatically extracts data from any EHR or billing system
- No staff or IT time required to comply
- Benchmarks performance versus peers based on CMS standards
- The proprietary algorithm evaluates 9 million combinations to select the best quality measures to optimize the score
- Earn 10% in bonus points for the Quality category
- eCQM deciles earn more points than registry deciles
- Almost all eCQM’s have a CMS benchmark versus less than 25% of registry measures
- Electronically submits the data to CMS
And, important to note that it’s NOT too late to comply for the 2019 reporting period as Health eFilings is able to support new clients, but time is of the essence. Reach out NOW if you or your client hasn’t reported for 2019—there is NO REASON to accept the 7% revenue hit.
Now EZClaim and Health eFilings want to ensure you can partner with the only complete, end-to-end MIPS compliance solution that saves you significant time and money. To learn more, click the following link: https://healthefilings.com/ezclaim
[ Article was written by Sarah Reiter, Vice President of Strategic Partnerships with Health eFilings ].
Top Three Reasons CEHRT Reporting Will Earn More Points and Maximize Reimbursements
Guest Author: Sarah Reiter of Health eFilings
The Medicare Access and CHIP Reauthorization Act (MACRA) and the program designed to implement the law, Merit-based Incentive Payments Systems (MIPS), have raised the financial stakes and the complexity of regulatory compliance for all healthcare systems. Simply put, healthcare organizations, like yours, have no choice but to engage and embrace the shift to value-based care to improve outcomes and therefore maximize your reimbursements.
And the method of reporting for the MIPS program can have a significant impact on your ability to earn points. Not all reporting methodologies are the same. There are BIG differences between MIPS reporting methods and what you don’t know could result in a 7% penalty increasing to 9% penalty for the 2020 Reporting Period, not to mention lost bonuses! The most effective, and most efficient, reporting methodology is known as Certified EHR Technology or CEHRT.
But why is CEHRT reporting the superior method? In this post, we will address the comparison of CEHRT reporting with the legacy “Registry” reporting method. Here are the top three reasons that working with a CEHRT, like Health eFilings, is the superior approach:
1. The software does all the work
Health eFilings’ ONC certified software is an “end to end electronic solution”. The software will extract, analyze and prepare the data in the most complete and accurate manner without requiring any administrative or IT support from you, the practice.
In contrast, registry reporting is fully a manual process and simply is a combination of purchased forms and a submittal vehicle. With a registry, the burden of all the administrative work is placed on staff and requires manual measure calculation and measure selection, all with no visibility to the measure benchmarks.
2. eCQMs earn more points
Health eFilings uses eCQMs (electronic Clinical Quality Measures) for purposes of reporting, and eCQMS offer more and better measures to optimize the points that can be earned. Almost all eCQMs have benchmarks that provide a clearer and more concise way to determine your performance and earn more points. As a point of insight, think of how points are earned as grading on a curve, where your actual performance percentage is irrelevant but what is relevant is the way that percentage compares to your peers, and my peers, it means all providers, regardless of specialty or geographic location, who submit data for that measure.
As a point of comparison, almost half of registry measures don’t have benchmarks which mean no matter how well you do on that measure, your score (or points earned) will be significantly limited, resulting in few overall points.
3. End-to-end electronic solution and earns bonus points
CMS has determined that the data submitted via technology is more complete and accurate, and because of this, CMS is incentivizing clinicians and practices by awarding them bonus points toward their MIPS score when they use a CEHRT like Health eFilings.
However, a registry is not a CEHRT and does not meet CMS’s definition of technology and as such does not provide verified accurate and complete data. Therefore, a registry provides no opportunity for any bonus points for the practice.
So, when complying with MIPS, it’s critical to utilize the reporting method that optimizes the points that could be earned and leverages technology to facilitate the ease, accuracy, and completeness of tracking and reporting to maximize the score. Reporting via a CEHRT like Health eFilings is the best approach because it optimizes the points that could be earned and therefore, maximizes Medicare reimbursements.
Beyond the inherent benefits of leveraging technology, working with Health eFilings has many advantages versus any other reporting methodology:
- Seamless integration with any EHR or billing system
- No IT or Administrative resources needed from the practice
- Tracks and reports for all MIPS categories
- Earn bonus points because Health eFilings is an “end to end electronic solution”
- A proprietary algorithm evaluates 9 million combinations to select the best quality measures to optimize the score
- Electronically submits all data to CMS
Is there anything I can still do for 2019 reporting?
Even though the end of the 2019 reporting period is quickly approaching, you do not need to accept that you must take the automatic penalty for this year. Health eFilings can support you with reporting for the 2019 reporting period and also advise you on your situation to set you up to be ready for the start of the 2020 reporting so you are able to optimize your score.
If you would like to stay up to date with recent happenings at EZClaim and more interesting articles, please click here to visit our blog page!
2019 MIPS Reporting
2019 MIPS Reporting – Guest Author: Sarah Reiter of Health eFilings
The Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law on April 16, 2015, and is driving the transition in healthcare from a volume to a value-based care model. CMS programs such as MIPS require providers to transition to a value-based care model or else face significant financial risks and even reputational harm. The stakes have been raised every year and it is even more complex than it has been in the past, further increasing the stress, burden and financial risk to providers. For a provider, it is critical to understand the impact that the reporting methodology has on one’s MIPS score and to choose the best methodology and reporting partner.
Within this new framework of the MIPS program, all healthcare practices regardless of size or specialty must evolve their approach to reporting to assure their financial viability. However, most do not understand or have awareness of, the different reporting methods available to them. Many providers erroneously still think that a registry is the only reporting option available to them or that they are required to use a registry. Or, they think that their EHR covers their reporting obligation. This misperception and general lack of awareness of the other reporting methodology is detrimental to the financial interests of any practice. And, furthermore, for the 2019 Reporting Period, it is likely the first time that traditional, legacy reporting systems (registry or EHR) may be unable to fulfill enough of the reporting criteria to avoid the minimum score penalty.
The other reporting methodology, known as Certified EHR Technology or CEHRT, has emerged as the superior reporting methodology. Reporting through a CEHRT dramatically improves the efficiency and effectiveness of the MIPS reporting process especially when done using ONC certified software. Also, a CEHRT utilizes eCQMs (electronic Clinical Quality Measures), which are a better way to optimize the points that can be earned. When the process utilizes ONC certified software and is, therefore, an end-to-end electronic solution, CMS awards significant bonus points toward the provider’s MIPS score.
Health eFilings, a CEHRT, is the best choice for a reporting partner. Our cloud-based ONC-certified software fully automates the process and does all the work with no IT resources, administrative support, and workflow changes. Health eFilings’ service is an end-to-end electronic solution that will save significant time, be a turn-key submission process and maximize the financial upside for providers.
And, finally, an important and timely addendum: While the 2019 reporting period is quickly coming to a close, Health eFilings can support you with reporting for 2019 so that you will avoid the automatic 7% penalty for not complying. But, time is of the essence, reach out NOW to connect with Health eFilings.
If you would like to stay up to date with recent happenings at EZClaim and more interesting articles, please click here to visit our blog page!