Aug 19, 2021 | Partner
Designing a Superior Patient Experience
We live in a world of increasingly lofty consumer expectations—one where 44% of U.S. consumers will switch to a competitor following a poor customer service experience.
The medical industry is no exception to this trend.
In a study by PatientPop, 58 percent of Gen Z, Millennials, and Gen Xers, as well as 63 percent of individuals 55 and older, said that responsiveness to follow-up questions via email or phone outside of the appointment is critical or very important to overall satisfaction.
Patients want more than just excellent care from their healthcare providers. They expect easy access to medical records, convenient online scheduling and appointment reminders, prompt responsiveness, and painless ways to contact your office—24/7/365. And they’re also seeking compassionate and knowledgeable representatives who are willing to provide caring and accurate resolutions to their issues.
As a medical provider, you should not only focus on bringing in new patients but also continually strive to improve patient retention. Growth in customer retention rates by 5 percent can increase profitability anywhere from 25 to 95 percent, after all.
So how do you design an experience that increases patient satisfaction and retention? Let’s dive in.
1: Make Prompt Call Answering & Convenient Appointment Scheduling A Priority
As we mention above, patients want—and nowadays expect—your office to answer quickly as well as provide effective and swift resolutions to their health matters. But in a busy office, the staff is often focused on dealing with patients. Even front desk and administrative teams can become inundated with in-office tasks at a busy practice, leaving calls, messages, and emails unanswered.
A superior patient experience starts with prompt call answering and convenient appointment scheduling—a service that’s available to your patients whenever they need you, including weekends and holidays, and answers every call addresses delicate patient concerns with empathy, and schedules appointments quickly. If your staff is struggling to keep up with demand, consider outsourcing your phone answering and appointment scheduling. Not only will this improve patient satisfaction, but it also brings a sense of work-life balance to internal staff and allows you and your team to focus on what you do best; caring for patients.
2: Streamline and Perfect Your Patient Intake Process
The patient intake process is tedious, but it’s incredibly important to your operations, and speed and accuracy are vital. Streamlining and perfecting patient intake starts with leveraging the right software—one that makes it easy for patients to fill in their information and access their records, and provides all of the valuable data your practice needs to operate in an easy-to-navigate platform. For starters, your intake software should:
- Be encrypted for data transfer through the internet and HIPAA compliant
- Be intuitive and user-friendly
- Not require special software or hardware downloads or installation for the user
- Be portable into back-end systems
Your intake process should also be integrated with your electronic health records (EHR) software, and information should be updated and available in real-time for a smooth experience—for patients, admin staff, and providers—so that everyone is up-to-speed. Both technology and your process should remove redundancies from your workflow and streamline the intake experience.
3: Provide HIPAA-Compliant Live Chat & Text For Swift and Convenient Communication
Another great way to improve patient experience is via live chat and text, through which you and your staff can communicate with patients wherever they are, send appointment reminders, have two-way private and secure conversations, multitask as needed and be available when emergencies happen.
HIPAA-compliant chat and text messaging lets you communicate efficiently and accurately with patients and simultaneously safeguards electronically protected health information (PHI) while taking full advantage of the speed and flexibility of today’s communication technology.
Some of the many benefits of secure live chat and text in the healthcare realm include:
- Reduced response times, including in the off-hours and on weekends or holidays
- Ability to provide immediate recommendations for care and preliminary diagnoses
- Ability to send follow-ups, like reminding patients to take medications, which creates better relationships between you and your patients
- Secure PHI storage that acts as a record of past conversations, symptoms, or complaints to improve future care, diagnosis, and treatment plans
4: Leverage Technology and Software Integrations For Smarter Decision-Making
Technology and software integrations have transformed healthcare and are vital in any medical practice. Why? Because when you streamline your office functions and workflows, you improve all aspects of patient care and experience.
First, your office should be using an EHR (electronic health record) system. This system automates access to client information, helping to improve workflows and reduce incidences of errors by improving the accuracy and clarity of medical records. It should include all the key clinical data relevant to each patient’s care, including:
- Demographics
- Progress notes
- Problems
- Medications
- Vital signs
- Past medical history
- Immunizations
- Laboratory data
- Radiology reports
Communication data collected throughout your patients’ experience with your office—such as phone conversations, appointment scheduling, and reminders, and live chat and text transcripts—should also be sent to and recorded in your EHR system.
Finally, the right software can help you make better patient and business decisions. For instance, maybe you want to know the percentage of patient calls versus the percentage of calls from hospitals that come into your office. Or, maybe you want to know which hospitals call you the most or you want to know the main reasons patients call so you can use that information to improve patient care and education.
How The Highest-Performing Medical Practices Prioritize Patient Experience
Medical practices that provide a superior service experience are available to their patients 24/7, have a streamlined and accurate intake process, are tech-forward, and have omnichannel communication options that empower patients to reach out any time and from anywhere. But most medical practices don’t do it all on their own. The highest-performing medical providers leverage an outside service provider like Nexa to improve client satisfaction, increase retention and grow their revenue. Learn more about how Nexa can help your medical practice level up by visiting nexa.com/medical.
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 Nexa ]
Jul 26, 2021 | Partner, Trizetto Partner Solutions
Medicare is the largest payer for most practitioners, so it’s important that providers maintain current credentials. Medicare requires providers to revalidate every five years to verify credentials and ensure they meet Medicare qualifications. Providers must confirm or update information including the legal entity name, physical address, phone, fax, national provider identifiers, employer identification number, and board certifications and licenses if applicable.
While typically a straightforward process, if not completed correctly and on time, providers will be terminated from the program and required to reapply. Until a new application is processed and approved, which can take anywhere from 90-120 days, reimbursements will stop, disrupting the revenue cycle.
Occasionally, providers may receive off-cycle revalidation requests. These are typically triggered when anomalies are identified such as billing rates that are significantly higher than other providers in the same geography, billing for services not rendered, or billing patients for services that Medicare doesn’t allow.
To comply with Medicare revalidation requirements, providers need to know their revalidation schedule and make sure applications and supporting documentation are submitted through Medicare’s PECOS online application portal. Revalidation dates cannot be extended, so it’s important they’re submitted on time. Using a third party to navigate the nuances of Medicare revalidation and PECOS removes the burden from provider staff and ensures accurate and timely filing.
TriZetto Provider Solutions (TPS) offers an end-to-end credentialing service that includes continuous payer follow-up and insight into enrollment status. Our dedicated team takes provider data, verifies it for accuracy, and submits credentials for revalidation through PECOS. All Medicare-participating providers are subject to revalidation, and mistakes made before or during the process can result in loss of eligibility and other penalties.
Having nearly four decades of experience working with payers and providers, the TPS credentialing experts understand the importance of maintaining current credentials. Contact us to learn more about our Medicare revalidation services.
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.
Jul 22, 2021 | BC Medical Billing, Medical Billing Software Blog
After Pandemic Impact and Outsourcing Revenue Cycle Management
The impact of the COVID-19 pandemic will be felt in every industry for many months to come. For medical providers, they are facing some of the most challenging financial times they will or have known. Therefore, we understand that it is crucial for providers to re-access their business and look for ways to cut costs with minimal impact on their practice or their patients.
To compound the issues providers are facing, there has been a wave of changes in recent years with new coding and telemedicine requirements that are making it difficult for provider offices to remain independent. Add on the constant rise in the cost of living and expenses while insurance reimbursements continue to decrease, and the issues get worse and worse.
Many have decided that outsourcing to a complete revenue cycle management company could help alleviate some of the undue burdens, cut costs, and keep providers compliant with their coding and billing. Ultimately this allows providers to continue to focus on patient care, which is their goal. As providers, you understand that revenue cycle management is a crucial part of your physician’s office. If not managed properly, it could result in an office leaving thousands of dollars on the table in unclaimed revenue. Over the years, our free audit services have allowed providers to have a free, transparent, and unbiased assessment of how their accounts receivable department functions. We are always amazed at how many providers do their billing in-house, and sometimes even when they outsource, are not aware of how much money they have sitting in their accounts receivables. Getting this knowledge is the first step to increasing revenue and efficiency.
In-house medical billers and third-party outsourced revenue cycle management companies should be giving provider offices monthly aging reports to assess their financial forecast. Each accounts receivable bucket over 60 days should hover at approximately 1 0% or less of the entire revenue balance. If account receivable buckets are higher than 10%, providers may be leaving money on the table, and the account may not be getting worked as providers think they are. In efforts to avoid unpaid claims and a spike in accounts receivable, outsourcing your revenue cycle management to a third-party medical billing company, such as BC Medical Billing, could help providers in countless ways. Many practices recognize that keeping their revenue cycle management optimized is key in delivering regular practice operations; however, they are not always sure how to achieve that. Outsourcing may be the solution!
Outsourcing alleviates the practice from managing a new medical billing employee, paying a salary and benefits, completing training and onboarding protocols, and managing the lost time from a learning curve. Many providers feel that it is not a wise use of the back office executive personnel’s time to worry about finding coders in-house and then wondering if the charges are captured and billed correctly. Instead, the business office should be focusing on how to grow the providers and the physician practice.
Our free audits will help you determine if you have found the right solution for you. If not, we are always there to assist and always increase the provider’s revenue.
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 BC Medical Billing ]
Jun 22, 2021 | BC Medical Billing, Partner
The impact of the COVID-19 pandemic will be felt in every industry for many months to come. For medical providers, they are facing some of the most challenging financial times they will ever know. Therefore, we understand that is it crucial for providers to re-assess their business and look for ways to cut costs with minimal impact on their practice of their patients.
To compound the issues providers are facing, there has been a wave of changes in recent years with new coding and telemedicine requirements that are making it difficult for provider offices to remain independent. Add on the constant rise in the cost of living while insurance reimbursements continue to decrease, and the issues get worse and worse.
Many have decided that outsourcing to a complete revenue cycle management company could:
-
- help alleviate some of the undue burdens
- cut costs
- keep providers compliant with their coding and billing
Ultimately, this allows providers to continue to focus on patient care which is their goal. As providers, you understand that revenue cycle management is a crucial part of your physician’s office. If not managed properly, it could result in an office leaving thousands of dollars on the table in unclaimed revenue. Over the years, our free audit services have allowed providers to have a free, transparent, and unbiased assessment of how their accounts receivable department functions. We are always amazed at how many providers do their billing in-house, and sometimes even when they outsource, are not aware of how much money they have sitting in their accounts receivables. Getting this knowledge is the first step to increasing revenue and efficiency.
In-house medical billers and third-party outsourced revenue cycle management companies should be giving provider offices monthly aging reports to assess their financial forecast. Each accounts receivable buckets over 60 days should hover at approximately 10% or less of the entire revenue balance. If account receivable buckets are higher than 10%, providers may be leaving money on the table, and the account may not be getting worked as providers think they are. In an effort to avoid unpaid claims and a spike in accounts receivable, outsourcing your revenue cycle management to a third-party medical billing company, such as BC Medical Billing, could help providers in countless ways. Many practices recognize that keeping their revenue cycle management optimized is key in delivering regular practice operations; however, they are not always sure how to achieve that. Outsourcing may be the solution!
Outsourcing alleviates the practice from managing a new medical billing employee, paying a salary and benefits, completing training, and onboarding protocols, and managing the lost time from a learning curve. Many providers feel that it is not a wise use of the back office executive personnel’s time to worry about finding coders in-house and then wondering if the charges are captures and billed correctly. Instead, the business office should be focusing on how to grow the providers and the physician practice.
Our free audits will help you determine if you have found the right solution for you. If not, we are always there to assist and increase the provider’s revenue.
Apr 5, 2021 | Claim Status Inquiry, Claims, Denied Claims, RCM Insight
If a medical billing program has “scrubbing,” why did my medical billing claim still get denied? It is a common question that we are going to answer today.
First, let’s get a better understanding of the words we are talking about. In the medical billing world, validation and scrubbing tend to be used interchangeably. While they are similar – they are not actually the same. Understanding what you have and what you need will help you submit ‘clean’ claims.
According to Technopedia, data validation checks for the integrity and validity of data and ensures the data complies with the requirements. So, what requirements? Often people assume that this means payer requirements, but that is typically not standard. Validation rules are built into your practice management software and can be used for several points. Following are some common rules you may find in your program:
- Ensure NPI‘s and Tax IDs are the appropriate lengths
- Ensure patients date of birth is entered
- Ensure that a procedure code and place of service are present on each claim
While these scenarios are standard across the industry, there may be other situations that a validation rule can help. Some programs will allow you to create custom rules for your practice. A customized validation rule will allow you to create a rule for a payer requirement. For instance, you could create a rule to prevent the following:
- Do you have a code that always requires a modifier, but only for a specific payer?
- Work with pediatrics and always need the ‘relationship to insured’ to read something other than self
- How about insurance ID numbers that are a specific alpha-numeric combo, like 3 letters followed by 9 digits?
Keep in mind, if you are creating validation rules the program will make sure that the criteria are met based on the rule entered into your software. When creating custom rules, it is important to note that this will not verify payer billing guidelines. You will need to obtain information directly from your payer to create a rule that coincides with their policies.
Once any validation errors have been addressed your claims will go to the clearinghouse you are working with. Most clearinghouses offer claim scrubbing for an additional fee. Technopedia defines data scrubbing as the procedure of identifying and then modifying or removing incomplete, incorrect, inaccurately formatted, or repeated data.
Claim scrubbing is available in several ways. It may be used within your practice management system, your clearinghouse, or even a third-party vendor. Claim scrubbing services can vary greatly in what they are looking for.
Once the claim has left your practice management system it will likely go through at least 2 scrubbing programs—one with the clearinghouse and one with your payer, prior to accepting the claim for processing. When claims are found to have an error, these results are sent back through a Claim Status Report (ANSI 277 file or a human-readable text file). This report will include information about why the claim cannot be processed. This report will also indicate whether it is the clearinghouse or the payer that is rejecting the claim. If you have further questions about the rejection, you will need to contact the entity that has rejected it.
Checking the Claim Status Reports on a regular basis will help you correct the errors and resubmit in a timely manner. In addition, the information you have gathered from the rejections can be used to update internal processes or create customized validation rules to prevent future rejections for the same error–saving you time and money!
RCM Insight is a medical billing company that uses EZClaim’s medical billing software. For any details that have to do with claims validation and “scrubbing,” contact RCM Insight directly.
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 them today at 877.650.0904.
[ Contribution by Stephanie Cremean’s with RCM Insights ]
