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Medical Billing Insights – Interview with ABA Billing Service

Medical Billing Insights – Interview with ABA Billing Service

Are you working in the medical billing industry as a biller or an owner of a billing company? If so, the KEY medical billing insights and best practices that came out of our interview with Maura Jansen (VP of Operations) and Jennifer Withington (Director of Revenue) at Missing Piece Billing & Consulting Solutions will be VERY VALUABLE for you to consider.

Jennifer, an expert in understanding the problem-solving techniques and the investigative nature of medical billing, offers insights that both educate and inspire. Maura, an executive member of the billing community, also added an important perspective about EZClaim’s medical billing software. The following are some highlights from our interview.

EZCLAIM: When did you get into the industry?
JENNIFER
: “I worked in group homes for the waiver side of group aid and then I went to Missing Piece. Missing Piece primarily deals with ABA providers and provides early intervention rendered to children. For me, the move from waivers with adults to professional billing, indirectly assisting children, was attractive and I took to the billing side of things.”

EZCLAIM: What does that mean when you say you took to the billing side of things?
JENNIFER
: “Insurance doesn’t make a lot of sense when you first start. So, I took to the investigative side of making sense of medical billing claims. Figuring out what the payer’s rules are, reading their manuals, and figuring out the technical jargon with the purpose of preventing claim denials was attractive. I liked the puzzle of it.”

EZCLAIM: Are there things that you value in your work that offer meaning to what you do?
JENNIFER
: “It’s really when I know that if I do not intercede with the insurance company and get this paid the patient is going to be responsible for the balance. So, to help, I have taken things to the department of insurance, or I have gone ahead and filed that third letter of appeal and really taken the time to research it. Because I don’t want a parent who is already struggling with having a child with more needs than maybe the other children would have, I don’t want them struggling with a $25,000 bill. ABA is extremely expensive because it works. And so, if insurance doesn’t pay it then the only other funder is the parent. And my goal is that parents should not have to pay any more than they absolutely have to.”

EZCLAIM: What are some of the strengths that make you good at what you do?
JENNIFER
: “I am a good problem solver. I am good at taking a large problem and breaking it into smaller problems and knocking each one down until I solve the bigger issue. At the end of the day, that’s really what accounts receivable is.”

EZCLAIM: What would be an example of your problem solving on a day-to-day basis?
JENNIFER
: “So you always start with the denial and then you have to work back to the billing. For example, if I have a claim denied for services rendered from an out-of-network service provider, but we know we are in-network then my first problem is, are we actually in-network? Then, you go onto the next link which is did the payer recognize you as in-network? It becomes like a decision tree, if you get a ‘yes’ then you are probably done, and you get the claim processed. If it is ‘no’, then you have to start digging with the payers contacting reps, make calls, and supply them with documents to get down to why they don’t have your provider listed within the network. Once you solve that problem, then the claim should be able to be processed. It is either going to pay or deny. Then depending on which one it is, you apply the same technique.”

EZCLAIM: What would you offer someone who is considering entering the field?
JENNIFER
: “You should be good at processing and reading information because to get a claim paid you to have to know the rules of engagement. You need to be familiar with how to read a contract, how to read technical information about billing, and have to have a glossary of information about what you are billing. Those are the building blocks to get to know what you are doing.”

EZCLAIM: You work with EZClaim’s medical billing software platform, what role does their software providers and how does that impact your work?
JENNIFER
: “EZClaim really serves to eliminate these denials before they happen, which is the ultimate goal of any accounts receivable or billing. EZClaim has edits that we use. It alerts us if the system thinks the claim is a duplicate, for example. It also helps in the set-up of the claim. We load all the fee schedules in EZClaim’s procedure code library and that lets us monitor the charge rate, make sure all the points of billing are on the claim (i.e. correct code, modifier, and charge). They also make sure that the authorization is appended to the claim. And then after we have actually done the work of getting a claim in the system, we use EZClaim reports to audit our own billing. So, we use the EZClaim service report. It makes it easier for us and our providers to see what has been billed and make sure that the billing is correct.”

EZCLAIM: If you were going to share something with your colleagues in the field, what would you share about the software that makes your life easier?
JENNIFER
: “Number one, it is not the software itself, it’s the EZClaim staff.  Their customer service is far beyond what a normal billing software company provides. If I have a problem, or if I have a report, or if I have a data point that isn’t in any report, they are available and they are there for me. And if they don’t have a solution for the problem, they will provide me with a workaround. So, that is very valuable. That is why Missing Piece works so well with EZClaim because customer service is number one for us, too. They don’t just want to answer your question, they want to help you understand your question.”

“The other thing that I find valuable is that their reporting modules are just a lot more robust than the other billing software companies that I have dealt with.”

EZCLAIM: Maura, do you have any thoughts from an administrative level that you can offer on EZClaim?
MAURA
: “Well, when we hire a new person we know that, even if this person has very little experience in the healthcare field, it’s going to be a quick and easy process for them to learn EZClaim… EZClaim has also made it kind of a joy to work with. We really value them as a partner. We love the service they provide, and we value them as a platform.”

ABOUT EZCLAIM:
EZClaim can also help you with medical billing insights since it is a medical billing and scheduling software company. It provides a best-in-class product, with correspondingly exceptional service and support. Combined, they help improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.

Medical Billing Service Has Used EZClaim for Over 15 Years

Medical Billing Service Has Used EZClaim for Over 15 Years

Deborah Rieser founded Spectrum Medical Billing Services in Anchorage, Alaska 15 years ago to make extra money to help with paying the family’s bills. Today, she owns a thriving medical billing service with a team of “twelve lovely ladies”—as she likes to refer to them—that services clients nationwide. Rieser originally selected EZClaim’s medical billing software platform—because of its pricing structure—to use for her medical billing service.

Over the years, since her original purchase, she has upgraded to each new EZClaim version, which adding new features and efficiencies.  Recently, she has made the transition to EZClaim Cloud, and continues to use it exclusively today.

With team members nationwide, Rieser prides herself on training her billers on properly classifying billing for medical offices so that there are minimal insurance denials. She is very particular about this since one of the reasons Deborah began billing was the insurance qualification struggles she had for her daughter with Autism. So, accurate billing is ‘personal’.

Recently, we found time to interview Rieser about her start in the industry, the ups and downs of being a business owner, and what hard-fought expertise she has gained that might help others considering to start their own medical billing service. 

EZCLAIM: When did you get into the medical billing industry and why?
RIESER: “I always had an entrepreneurial spirit, and I had an orchid business out of our house. Then my daughter, who was born with Autism, started working with an Occupational Therapist (OT),  and they came to me to help with billing. I thought about it, and after a few weeks, I took it on. That was back in 2005.

“At that time, my daughter had over 75 volunteers and therapists in the community work with her from age three to age five, and had 50-60 hours a week of therapy. Today, she is a sophomore in  university, has a boyfriend, is driving her car, and is thriving. From all of that, I have always felt the need to give back to the community for all their help. So, I used my business to take on other Pediatric, Occupational Therapy, Physical Therapy, and Speech Therapy clients, as well as, using my experience to help patients take care of their billing needs and get their bills paid by insurance.”

EZCLAIM: What are you passionate about when it comes to billing?
RIESER: “For me, the biggest thing that I am passionate about is seeing my clients [medical offices] getting paid from insurance claims. I also enjoy helping patients get properly classified during medical visits, so claims are accepted. I have learned a lot from the mistakes and errors that have led to denied claims. From my experience, I can help medical practices observe their approach to patients’ needs so that services qualify when billing insurance companies. Being able to offer that to my clients is very satisfying.”

EZCLAIM: What are some of the challenges you have had to overcome?
RIESER: “Originally, we grew word-of-mouth. I didn’t even want a website at first, but now I do have one. Going from one client to 65 is challenging because as your clients grow, your staff grows. Recently, I lost a client. You then have to decide what you’re going to do with your staff. The hardest part is that, for a business owner, your business consistently goes up and down. That fluctuation can be stressful. For me, I deal with that by going outdoors. My husband and I will go for a walk in nature and that will help relieve my stress.”

EZCLAIM: What advice would you offer others in the billing industry that have similar experiences?
RIESER: “If you’re starting your own business, make sure it’s one you love. Know that there will always be highs and lows. Also, be sure to price yourself accordingly. You can’t go too high or people will look elsewhere.

“I do want to step back and highlight that some of my billing practices only do 2-3 claims a week, and that’s why I love EZClaim. The price of the software. When I was growing, I was working on EZClaim “Advance,” which is being retired. So, when I started looking around at other software providers, they were billed on a ‘per provider cost.’ Fortunately, EZClaim “Cloud” billed based on the number of concurrent users, which worked for me.” 

EZCLAIM: How has your relationship with AMBA (American Medical Billing Association) benefitted you?
RIESER: “I just joined last year in 2019, thanks to EZClaim and Dan Loch’s referral. I love that group. I joined their Facebook group because they have very useful information for us billers. I recommended that my team members join as well. They are good at supporting US-based companies and put the focus on supporting the group.”

EZCLAIM: What would you tell people who are wondering if EZClaim Cloud is right for them?
RIESER: “The transition to EZClaim Cloud was easy. I was worried about the providers and the tax ID’s, but it all was very smooth. I would add that customer support was very helpful. As daunting as moving things over felt, it was very smooth. I attribute that to the planning and support.”

EZCLAIM: What would you say would be a strength of someone who is good at billing and coding?
RIESER: “It is important to be a very good communicator, professional, out-going, and enjoy what you do. One must be able to communicate with providers over denials, success, celebrations, and always keep talking with the staff and the providers. Also, always try to put yourself in the patients’ shoes by offering patience and compassion. Lots of times patients don’t understand their benefits and why they are denied. So, try to explain in layman’s terms. They understand better and appreciate that. It ends up being a good connection with the patient, and benefits you as the biller, too.”

EZCLAIM: Final thoughts?
RIESER: “I am grateful to EZClaim for their services.  As a business owner, you have to monitor expenses and things can add up fast. So, I am thankful for EZClaim Cloud and its pricing structure. That has helped Spectrum Medical Billing Services to grow and thrive.”

[ The above answers were paraphrased as closely as possible to the original answers given by Deborah Rieser on November 25, 2020 ].


ABOUT EZCLAIM:
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, visit EZClaim’s website, e-mail them, or call a representative today at 877.650.0904.

Getting Paid for Telehealth Visits

Getting Paid for Telehealth Visits

Telemedicine was already growing in popularity prior to the onset of the Coronavirus pandemic. So, as the adoption rate increases, EZClaim clients may have questions about sending telemedicine charges and getting paid for Telehealth visits.

Telehealth challenges can range from issues with technology to getting paid. With Telehealth becoming the norm for many doctor-patient visits, it is important to have a thoughtful approach in place regarding collecting patient payments. To stay in business, you have to get paid for the work you are doing. So, establishing a process for Telehealth consultations is vital to your business, and it should be a top priority to build a successful program from beginning to end.

The answers to the following questions will help set the baseline for how to collect patient payments for
Telehealth visits:

  • What is my process for charging for copays?
  • How and when do I collect outstanding balances?

For example, if you collect payment before an in-person visit, you should collect payment before a Telehealth visit, too. There is no need to re-create your process completely. Just change what is needed to match your current in-office routine.

Sending Charges Before a Telehealth Visit

A simple way to send pre-visit charges to patients is to provide them with a link that takes them directly to the payment site. EZClaim’s medical billing solution is integrated with BillFlash LinkPay, which enables customers to provide payment for the upcoming visit. So, before the Telehealth session begins, the practice simply sends a link to their patient via an e-mail or text, making the appointment confirmation and the payment processing part of the check-in process. After the payment transaction is complete, it will immediately show up on the practice’s BillFlash report. LinkPay is designed to be easy to use and doesn’t require patients to remember a login or a chart number.

Here’s how EZClaim enables the process through BillFlash:

  1. Prior to Telehealth visit, the patient is sent a link to pay through LinkPay, and another link to join the Telehealth call
  2. The patient pays the required amount through LinkPay, which is immediately confirmed and processed
  3. The patient joins the Telehealth session
  4. Results and follow-up are completed electronically
  5. Insurance billing is completed
  6. The patient receives a paper statement or eBill notification for any remaining balance
  7. The patient is directed to pay the remaining balance online at MyProviderLink.com

Automate What Can Be Automated

With so many changes taking place in healthcare, a great way to help protect the financial stability of your practice is to automate what can be automated. This saves your staff time and decreases your cost of doing business.

One way to do this is to set up automatic payment plans for patients, particularly for those who have been hit hard by the economic impact of COVID-19. A payment plan is a good way of keeping the revenue flowing in, and it shows your patients that you are compassionate and willing to help them through these unprecedented times.

BillFlash also securely stores payment information, so patients will not need to re-enter their information every time they pay a new bill.

As you continue to adjust to Telehealth going forward, BillFlash can simplify patient billing and payments significantly and help getting paid for Telehealth visits.

So, for a LIMITED TIME (during May 2020), EZClaim customers can try BillFlash statement and eBill services for FREE for 30 days. Click on this link for more details about BillFlash or try it out for the next month.

For additional information, call BillFlash at 435-940-9123, or contact EZclaim’s support team at 877.650.0904 or support@ezclaim.com.

[Contributed by James Easley VP, Marketing NexTrust Inc.]