Aug 15, 2022 | MedCycle Solutions, Partner
By Ann Knutson, CPC-A
The healthcare revenue cycle includes all administrative and clinical functions that involve capturing, managing, and collecting the provider’s/facilities revenue. The cycle includes three distinct parts of the practice/facility that’s referred to as the front-end, middle, and back end. Unfortunately, most of the time there is little coordination between the three areas which can lead to more claim denials and lost revenue for the practice/facility. Therefore, adding a revenue integrity team to your practice/facility dramatically improves operational efficiency, compliance measures, and reimbursement rates. Members of the team must have extensive knowledge of and be familiar with the complete healthcare revenue cycle.
In order to foster collaboration between all three areas of a practice/facility that affect the revenue cycle, specific training needs to be implemented for staff, along with coding and documentation education for providers.
Specific staff training includes:
- Keeping up to date on billing requirements, such as coding guidelines, billing regulations, and insurance payer policies.
- Reimbursement updates, such as data showing rate of reimbursement vs. denials/rejections.
- Key performance indicators, such as data regarding common billing or coding errors leading to claim denials and rejections.
- Job expectations, such as all billing employees must know every aspect and function of their job in detail.
Provider education involves:
- Chart reviews to verify proper documentation.
- Quarterly meetings regarding coding guidelines, payer rules, and the importance of medical necessity.
Furthermore, creating templates and tip sheets for billers, coders, and providers improves operational efficiencies, clean claim submission, and proper provider documentation. It also decreases claim denials and puts everyone in the practice/facility on the same page.
In addition, the collaboration between coders and the accounts receivable team is crucial to improving reimbursement rates, the outcome of claim appeals, and compliance with regulations. It can also help to reduce the number of claim denials and rejections. Plus, medical coders are able to share their expertise regarding regulations and proper coding with the Accounts Receivable (AR) team members. This helps the AR team with reconciling claim rejections and denials along with properly submitting appeals. On the other hand, the AR team can inform coders of the current codes or coding combinations that are being rejected or denied by payers. With this vital information, coders can make the required coding and billing changes as they enter the charges and submit the claims. This can greatly improve the rate of clean claims submission. (AAPC, 2021)
Therefore, it’s in the best interest of a practice/facility to implement a revenue cycle management team that is familiar with the entire revenue cycle, fosters collaboration between all areas of the practice/facility and providers, and maintains open communication between all departments in order to maximize revenue cycle efficiency and reimbursement. For assistance with maximizing your revenue cycle efficiency, please contact us at MedCycle Solutions.
For more information about maximizing revenue cycle efficiency, please visit www.aapc.com.
Ann Knutson, CPC-A is an Accounts Receivable Specialist at MedCycle Solutions, which provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com.
Jul 12, 2022 | MedCycle Solutions, Partner
Have you increased the amount of Telehealth visits with your patients?
If not, you and your patients may be missing out.
Over the past two years, the COVID-19 pandemic has changed the landscape of patient care and increased the need for providers to utilize virtual healthcare services. Due to the Public Health Emergency (PHE) policy update, many healthcare practices had to shut down, pause or augment their services with telemedicine to provide flexibility in patient support.
Here are four ways Telehealthcare has been implemented to provide safe, necessary care for patients while augmenting revenue.
- Stop the Spread of Contagions
With the need to quarantine, social distance, and reduce the risk for clinic staff and patients, many health practices adapted ways of providing non-emergency services. For patients with (possible) highly contagious diseases, such as COVID-19, many clinics ask patients to schedule virtual appointments to avoid possible infections and further outbreaks. This allows for keeping both the staff and patients as safe as possible while still receiving necessary treatment.
- Provide Essential Health Services
For those patients that suffer from White Coat Syndrome going to the doctor’s office causes a great deal of stress and anxiety. By allowing patients to access care in the comfort of their own home for managing chronic health conditions, routine services, prescriptions, and referrals for testing and labs, this allows for greater patient access. Plus, it has the added benefit of reduced overhead costs associated with cleaning and turning exam rooms.
- Provide Physical and Occupational Therapy Healthcare
Accidents happen. Whether motor vehicle accidents, workplace injuries, or trips and falls – PT and OT is imperative to keep patients mobile and progressing. Many providers offer hybrid services with virtual appointments for patients to keep them mobile while supervising and adapting exercises in their home environments.
- Provide Mental and Behavioral Healthcare
Mental and behavioral healthcare is one of many patient-care needs. This is especially true for long-term residential care. Many nursing home facilities transitioned to telemedicine during the COVID-19 pandemic.
The U.S. Department of Health and Human Services, via the Centers for Medicare & Medicaid Services (CMS) heavily promoted the switch to Telehealth as infection prevention and control measures. They’ve made digital resources available that offer behavioral health and best practice guides for long-term nursing homes, a telemedicine tool kit, as well as other guidance.
If you think your practice and patients can benefit from implementing telehealth visits stay tuned for our next article on 5 Resources for Implementing Telehealth & Telemedicine.
Mariellen Mezzacappa has a variety of experience in the medical field. She has worked for doctors, hospitals, pharmacies, and insurance companies. Her experience includes bill review and coding with a wide range from EAPG 3M, DRG, Workers Compensation to Appeals and coder Affidavits for Litigation. She provides verification of code selection for operation reports, documentation review, and credentialing. Additionally, she has worked on operation policies, compliance training, and project management.
MedCycle Solutions provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com.
Jan 15, 2022 | EZClaim
As we move into the new year, we wanted to take a moment to share the most popular articles of 2021. We’ve ranked them below so that you can be sure that you haven’t missed out on any resources that EZClaim clients have found useful in the past year.
Here are the most popular blog posts of 2021:
This interview was by far and away the most popular blog post over the past year. Jennifer and Maura provide some great insight and best practices, including their “investigative” approach to medical billing and the problem-solving skills that are necessary. Here is a summary of that article:
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.
Getting patient billing information quickly can be a big pain point, so it makes sense that this article was among the most read of the year. We walked through some tips and ticks for saving time including the EZClaim eligibility feature:
Can you add up the number of hours your billing team spent during any given week or month waiting on-hold with insurance companies to get patient billing information? Does your staff invest hours of their valuable time seeking out the smallest of details to get paid? Are you aware that integrated eligibility, through EZClaim’s medical billing software, can reduce that time on-hold to a fraction of the total?
It is estimated that the average biller can spend up to 2-hours on-hold just to get an insurance company on the phone. Add to that an average of 10 – 15 minutes to talk through a patient and most companies will only address one or two patients at a time.
In this interview with a medical billing expert and co-owner of Elite Billing Resolutions, Vicky Greenwood, we talk about dealing with the challenges in owning a billing company, some important skills that every medical biller needs, and the value of choosing the right medical billing software. In our time speaking with Vicky, we focused on topics that will aid, contribute, and help grow the skills of the medical billing community. We at EZClaim believe in highlighting the best practices in the industry and sharing those with the larger community. We encourage you to consider these insights, and then let us know what topics you would like to learn more about.
Double data entry is frustrating. Luckily there is a better way—integrating your EHR with EZClaim.
Are you or your staff having to enter every patient into your EHR program and then again into EZClaim? There is an easier way! Integrating your programs will put an end to duplicate data entry, saving your practice time and money!
So, what exactly is an interface and how does it work? An interface is a way for two programs to share information. For EZClaim clients, the interface can be set up to share data from your EHR program to EZClaim. Your EHR can give you specifics on how to send the data to EZClaim.
Minimizing and preventing claim denials is a challenge that providers are increasingly running up against. We put together four strategies to address this growing problem:
Reducing claim denials has long been a challenge for providers. In the worst case, denied claims end up as unexpected—and sometimes unaffordable—bills for patients. The challenge only seems to be growing. A recent survey conducted by the American Hospital Association (AHA) found that 89% of respondents had seen a noticeable increase in denials over the past three years, with 51% describing the increase as “significant.”
Minimizing loss will be top of mind for providers as the COVID-19 pandemic continues to put a strain on their resources, and minimizing or preventing denials will need to be a core part of that strategy. With that in mind, we’re offering four tips to help guide revenue cycle strategies for better denial reduction in 2021.
There you have it, the most popular posts on the EZClaim blog in 2021. We look forward to keeping you up to date on everything medical billing in the new year!
Nov 24, 2021 | EZClaim
In a post-2020 world, consumers now expect every purchase and transaction they make to be personalized, digital, and simple. Groceries can be delivered and paid for with one click of a button. You can try on clothing virtually, get fitted for glasses, and even visit your doctor through your mobile device. To remain competitive, consumer-driven industries have had to create new and innovative ways to engage customers.
The healthcare industry has seen this shift as patients are behaving more like consumers in their healthcare interactions. Switching to a customer-centric mindset can be tricky for the healthcare industry as balancing patient communication and adhering to HIPAA and other regulations is essential. However, these new expectations have opened the door for the medical billing industry to innovate and move forward.
For the medical billing industry, consumers are asking for simplicity and convenience, but they still want choices. According to Healthcare Finance, fewer patients are paying their medical bills by check as the shift to online payment accelerates. It is important for the medical billing industry to understand that while a large segment of older Americans still pays bills through the mail, in-person, or by check, there are growing numbers of patients who prefer an online and mobile bill payment option.
As a solution to the ever-changing environment of payment reconciliation, in 2020 EZClaim launched EZClaimPay with the following features:
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- Allows medical staff to text and email patients with payment reminders
- Allows patients to make payments on their mobile devices or online
- Save credit cards online for fast easy patient payments
- Gives patients the ability to save and print their own receipts
- Patient payments made online import directly to your EZClaim Billing program
- Collect payments 24-hours a day with no change to your “schedule”
In a rapidly changing world that is becoming more technology-based, the medical billing industry must keep up with current consumer trends. EZClaimPay is an excellent tool to keep your practice cutting edge and offers your patients the latest in bill-paying options.
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.
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 ]
