Jun 10, 2020 | Alpha II, Medical Billing Software Blog, Partner, Revenue, Webinar
Concerned about the claims process during COVID-19? Well, Alpha II remains on the forefront of the coding and billing changes during the COVID-19 public health emergency (PHE). They understand this is a confusing time for providers, practices, and hospitals.
Now more than ever, practitioners are relying on the revenue brought in by accurate claim submission. So, if you would like more up-to-date details, join us for our Bring Revenue Integrity to the Claims Process During COVID-19 webinar on June 16th at 1 p.m. ET, and learn how to recover revenue based on the waivers allowed under the PHE. Click here to register for the webinar.
We have also compiled a comprehensive COVID-19 billing and coding FAQ document of questions received during our highly-attended webinar series. Click here to download the resource.
As guidelines for coding and billing of COVID-19 services are revised regularly, Alpha II is implementing these critical changes to regulations and coding guidance—almost immediately.
Alpha II empowers precision across the revenue cycle process so you can experience reduced cost, improved cash flow, and increased revenue. Through its software-as-a-service (SaaS) solutions, Alpha II supports coding, compliance, claims editing, value-based quality reporting, and revenue analysis.
For more details about how Alpha II’s solutions can keep your coding, billing, and editing current, view our website or fill out our contact form to ask us a specific question.
Alpha II is a preferred partner of EZClaim, and their software is integrated into our medical billing software. For detailed product features or general information about EZClaim, visit our website at ezclaim.com/

Jun 10, 2020 | BillFlash, Electronic Billing, Medical Billing Software Blog, Partner
There are five things to consider as you reopen your medical office: Reevaluate your budget; Get your staff’s buy-in; How to actively bring patients back into the office; Continuing to use Telemedicine and other online tools, and be flexible.
As the curve flattens and restrictions around the country loosen up, medical practices are slowly reopening their doors for non-essential services. But reopening doesn’t mean business will resume as usual. Every industry is making changes as we navigate a “new normal.”
Many of those changes center on social distancing guidelines, but there are other matters to consider as well. Here are some details about the strategies to keep in mind as you reopen.
Reevaluate Your Budget
Government restrictions may be lifting, but medical practices are not going to bounce back immediately. Any financial goals you had in place for 2020 likely won’t be met this year.
Some budgetary adjustments will be necessary. Here are just a few ideas:
- Check in with vendors, landlords, and creditors to discuss any accommodations they may have for cash-flow disruptions
- Consider delaying payment of bonuses and other discretionary payments
- Seek aid from government economic relief packages and loans for small businesses and front-line workers. Stay informed on what your options are, as changes are ongoing.
This goes without saying, but make sure you’re up to date on patient billing and payments, too, including telemedicine visits. If you have patients who need extra time to pay their bills, EZClaim customers can set up a payment plan for them using BillFlash PlanPay.
Get Your Staff’s Buy-In
Before you start bringing patients back in, your entire medical staff needs to understand your new policies and be on board with enforcing them. They need to be reassured that their safety is a top priority, as well.
It’s been a difficult few months for front-line healthcare workers and will continue to be stressful in the months going forward. Do what you can to acknowledge their hard work and dedication.
Actively Bring Patients Back to the Office
Some people are eager to get out of their homes and into public spaces again, while others plan to shelter in place a while longer. Either way, your patients aren’t going to return in droves. Many are less comfortable going back to a doctor’s office, so be proactive about making your patients feel safe enough to return.
Americans have become experts on how viruses spread over the past few months, so anything you’re doing to clean and sanitize your office should be visible. Affixing physical distancing floor markers, procuring enough PPE for your staff, and installing hand sanitizer stations is a good start. Show your patients what you’re doing to protect them; simply telling them what you’re doing when they aren’t around won’t be enough.
As you communicate your new policies to patients, be aware that they may be feeling overwhelmed. Be transparent and connect with them on a personal level. Don’t be afraid to show your human side; otherwise, your office will be just another place with a long list of rules to follow.
Keep Using Telemedicine and Other Online Tools
The technology that got you through stay-at-home orders can continue to support you long term. Telehealth isn’t going away. Plus, patients will still want contactless payment options.
Evaluate what has worked over the last few months and incorporate them as part of your new normal.
For example, you may want to have a plan in place regarding which patients get priority with Telehealth. At-risk individuals will still need to stay home as much as possible, so make sure Telehealth will still be an option for them.
Another tool that has been valuable during the pandemic is contactless payments. COVID-19 has changed the way people are paying—for the good. They want the option to pay their bills online, or directly from their mobile devices. Some patients will even consider switching providers if another practice offers them online payment options their current provider doesn’t have.
EZClaim easily accommodates a variety of payment preferences with its BillFlash integration, from online SelfPay to sending pre-visit charges for telemedicine visits (LinkPay). Sign up for a demo here. You can try BillFlash, at no cost, for 30 days.
Be Flexible
Local outbreaks may still happen. Many households have lost income. Patients have different preferences and needs regarding where an encounter happens and how they pay.
Things are still changing by the week. As much as we all want a new, consistent normal, we need to be prepared to continue to make adjustments as needed. Ultimately, it is your patients and your practice’s financial health that will benefit from your ability to adjust to the times.
BillFlash, a fully integrated component and trusted partner of EZClaim, offers a variety of revenue cycle management services that have served EZClaim customers well for many years, as well as through the COVID-19 pandemic. For more information or to see a demo, contact BillFlash at 435-940-9123, email them at GetPaid@BillFlash.com, or visit their website at BillFlash.com.
For detailed product features or general information about EZClaim, you can either schedule a one-on-one consultation with our sales team, view a recorded demo, or download a FREE 30-day trial right now.
For general information about EZClaim, visit our website at ezclaim.com/
May 12, 2020 | Medical Billing Software Blog, Partner, Trizetto Partner Solutions
If you are a member of the MEDICAL BILLING COMMUNITY, the norms of the day-to-day have changed. With the recent COVID-19 pandemic and the ‘stay-at-home’ order, you may find yourself with either more time on your hands and/or an increase of claims with new patients. During this time, we want to offer you a couple of suggestions so that you can make the best use of the additional time you have, and also help you improve your billing processes.
The first thing to consider is to review your Accounts Receivable (AR)—to collect payments due you to INCREASE YOUR INCOME. According to the American Medical Association (AMA), claim denial rates range between 0.5% and up to 3% or more, and that 90% of claim denials are preventable. Some of the most common claim denial reasons can be rectified by correcting claim management workflows, including claim submission and patient registration procedures. The following are a few of the most common oversights for claim denial.
- Use EZClaim software to check automatically for missing information, including absent or incorrect patient demographic information and technical errors
- Make sure you do not have duplicate claim submissions
- Check that claims do not have services previously adjudicated
- Review for claims with services not covered by the payer
- Make sure the time limit for claim submission has not expired
Secondly, revisit and resubmit open claims. Surprisingly, 31% of providers still use a manual process to resubmit. Our partner, TriZetto Provider Solutions (TPS), has an Advanced Reimbursement Manager Pro (ARM) that has two great tools that can improve your ability to tackle collecting and repaying underpaid and overpaid accounts. Below are some key features that can be automated by their software, and will help to improve your billing processes:
- Identify common errors and payer trends
- Analyze contract performance
- Customize and assign work into queues
- Quickly access information from interactive dashboards
- Automate the appeal process
Thirdly, know that EZClaim and our partner TPS have worked together to bring you the most powerful medical billing software tools to solve claim denials. Our partnership not only simplifies the billing process but also helps resolve denied claims in an efficient way. In addition to that, our customer support team is available to help you learn best practices with these tools, and support you however you need it.
Finally, if you are frustrated with your current medical billing solution, investigate how EZclaim’s medical billing solution may work for you. You can either schedule a one-on-one consultation with our sales team or download a FREE TRIAL to check it out the software yourself. For additional information right now, contact EZclaim’s sales team at 877.650.0904 or send an e-mail to sales@ezclaim.com.
May 12, 2020 | Electronic Billing, EZClaim Premier, Features
A recent medical billing webinar on Telehealth that EZclaim hosted is now available to review.
On April 30th, EZClaim hosted a Telehealth Updates Webinar for our clients with guest speaker Sandy Giangreco Brown – Director of Coding and Revenue Integrity Health Care at CliftonLarsonAllen, LLP
We had one of the largest viewing audiences 101 active attendees in the session. Sandy shared informative billing codes and direct links to update hands-on information for billers actively coding Telehealth sessions. For those of you who missed it, we have provided on our website the recorded session ezclaim.com/webinars and can provide the presentation slides too! Just send a request to sales@ezclaim.com
We continue to get views of this presentation and look forward to hosting more hot topics with the CLA Team.
With the onset of COVID-19 came a great opportunity for clinics and hospitals to offer Telehealth and Communication Technology Based (CTSB) services. The Centers of Medicare and Medicaid Services, or CMS, have provided many updates to the available services that can be provided and billed to the patients to help practices not only stay afloat financially but also and most importantly, to keep their staff safe and provide excellent care to their patients!
There were new guidelines released even after this webinar on 4/30/2020 (which can be found here – https://www.cms.gov/files/document/se20016.pdf, and now includes audio-only Telehealth for services such as psychotherapy, tobacco cessation and medical nutrition counseling as well as diabetes self-management training. CMS is also increasing the payments for the Audio Only services from $14-$41 nationally to $46-$110.
As of April 30, 2020, in order to bill Telehealth, RHCs are now required to bill the G2025–CG–95 from January 27, 2020, to June 30, 2020. Then from July 1, 2020, to the end of the PHE, they will be billing the G2025 with an optional 95 modifier, per CMS SE20016 Medicare Learning Network Transmittal.
FQHCs will need to report three (3) codes for their Telehealth Services:
- G0467 (or other appropriate FQHC specific payment code)
- 99214–95 (or other FQHC PPS Qualifying Payment Code)
- G2025–95
CLA is on the frontlines and closely monitoring and analyzing activities related to Telehealth and other virtual health regulations
CMS Telehealth fact sheet, Frequently Ask Questions:
As your practice adjusts to Telehealth going forward, EZclaim’s medical billing solution can help you simplify patient billing and help you get paid for Telehealth visits. (Our recent medical billing webinar on Telehealth may just help you better understand the current situation).
So, to help you investigate how EZclaim’s medical billing solution may work for you, either schedule a one-on-one consultation with our sales team or download a FREE TRIAL to check out the software yourself. For additional information right now, contact EZclaim’s sales team at 877.650.0904 or send an e-mail to sales@ezclaim.com.
[Contributed by Sandy Giangreco Brown – Director of Coding and Revenue Integrity Health Care, CliftonLarsenAllen LLP]
Apr 13, 2020 | Medical Billing Software Blog, Trizetto Partner Solutions
On January 13th we posted part one on this topic of Eligibility in healthcare, in that, we touched on deductibles, co-pay, and max out-of-pocket pay. Now in part two, we review the impact of price transparency in healthcare and its importance to the healthcare team decisions.
Consumers are the most important member of the healthcare team and are better collaborators in their care when they know all the variables and their required responsibilities in the process.
The individual consumer’s healthcare team includes, along with themselves, the physician and their staff, the pharmacist, an insurance adviser, and possibly some gatekeepers as well. The communication of clear symptoms when a patient is diagnosed is the responsibility of that team along with building an understanding of the financial responsibility that goes with any medical solution. While providing answers, options and solutions is a provider’s responsibility, so is providing a cost for the provided care. Therefore, price transparency can be achieved when the cost for that care is presented in a clear and concise fashion so the patient can understand what they owe, why they owe it, and when it is due.
Ensuring your staff is educated on discussing the financial responsibility with the patient from the first appointment and forward will strengthen the healthcare partnership and assist in the collection process. Understanding the steps that occur post the upfront estimate can be beneficial to the team. This discussion can be bolstered by ensuring bills are clearly marked with the statement, “this is a bill”, also clearly listing what the patient is being charged for when the bill is due and offering details on the methods of payment that are accepted. This clarifies what insurance will cover for the patient and their own out-of-pocket cost, prompting them to share any concerns and constraints with payments upfront.
Estimating patient responsibility is one part of the reimbursement process that is used for transparency for patient billing. The estimates can be provided using a spreadsheet of prior reimbursement and your most commonly billed CPT codes. If you would like an automated and more accurate option then look into a software tool like the Patient Responsibility Estimator by our solutions partner, TriZetto Provider Solutions (TPS). Giving this to the patient at the time of checking in will assure they have a rough idea of the costs and allow the office to collect upfront if needed.
For more information on how EZClaim can help you with this journey, schedule time with our sales team. Ready to get started? Download your FREE 30-day Trial today!
[ Contribution by Brenda Smelser with the DMC ]