It IS POSSIBLE to improve medical billing revenues, and here are a few ways to do just that.
Healthcare practitioners, whether established or just starting out, have many overwhelming tasks: Managing a practice; Seeing patients; Working to staying up-to-date on administrative tasks; The whole host of compliance at the federal, state, and local level; and Overseeing the billing.
One of these that can lead to loss of revenue is not properly managing the medical billing, which can also lead to HIPAA fines and rejected claims. However, there is a solution: a medical billing system that balances the budget and optimizes revenues of medical practice.
EZClaim, an expert in the medical billing software market since 1997, provides a solution that improves the efficiency of an office’s billing process in many ways. The following are the primary reasons.
Reduce Coding Errors
Medical procedures become codes, codes become claims, and claims become revenue. Any error in this process can make claims to be denied, your workload can be increased, and revenue can be lost. To help in avoiding errors, it is essential to use billing software that offers the easiest implementation and access to descriptive diagnosis and treatment codes. EZClaim’s medical billing solution offers ease-of-use in coding, billing, and strong partnerships with Clearinghouses which act as an additional ‘safety net’ for catching errors.
Most medical practices are a small team of people tackling a wide range of tasks, so when one cannot understand the function of the billing software, accessing reliable support is very important. EZClaim prides itself on having dedicated support experts available, and that was how the company was established. Founder and President Al Nagy has said, since day one, “We are a support company that happens to sell medical billing software.”
Maintain Industry Compliance
It is important to recognize that industry compliance and a practice’s revenue go hand-in-hand. Filing and batching inaccurate and non-HIPAA compliant claims can often be traced back to an outdated healthcare revenue management system. Conquering these tasks requires a focus on multiple fronts: A properly trained billing team, clear office procedures, patient payment policies, and a reliable medical billing company. These are all ways to help buttress against non-compliance and rejected claims.
Recently, a study was done that showed almost 80% of medical bills contain errors. These incorrect medical claims often end up as lost revenue originally, not to mention the additional cost of resubmissions and collections. One of the best ways to resolve this problem for your practice is to make use of both well-trained, experienced billers and coders, combined with a competent medical billing solution that aids in catching these errors. EZClaim software features a library of standard validation, the ability to add custom validation, and integrates with Alpha II for full claim scrubbing.
Errors will and do occur, so establishing a system for follow-up on all denials will close the loop and protect against lost revenue. Being consistent with the follow-up process, and having a medical billing solution that tracks these things will help close that gap.
Finally, probably the most important aspect that optimizes a practice’s revenue is to get paid. Portals and payment collection systems definitely help with this, but having collections integrated into the medical billing system is, of course, the best. EZClaim has pain-free payment processing integrated into their solution, called EZClaimPay. It solves all the problems associated with payment processing: Bank deposits, reconciliation, statements, changing fees, and ‘finger-pointing’ when there is a problem. EZClaimPay’s robust platform will greatly increase a practice’s collections success, and improve their revenue.
EZClaim is a medical billing and scheduling software company that provides a best-in-class product, with correspondingly exceptional service and support, and can help improve medical billing revenues. To learn more, visit their website, e-mail them at firstname.lastname@example.org, or call a representative today at 877.650.0904.
[ Photo credit: Studioarz ]
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/
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 email@example.com.
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: firstname.lastname@example.org
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 on 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)
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 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 email@example.com.
[Contributed by Sandy Giangreco Brown – Director of Coding and Revenue Integrity Health Care, CliftonLarsenAllen LLP]
One of our partners, Alpha II, is presenting a special webinar on COVID-19 billing changes on April 16, 2020, “COVID-19: Critical Coding and Regulatory Updates,” to provide the most up-to-date information on the coming changes to new procedures, diagnosis codes, telehealth updates, and changes to regulatory policies.
As guidelines for coding and billing of COVID-19 services are revised almost daily, rest assured Alpha II is working to implement these critical changes to regulations and coding guidance as quickly as possible by conducting near-daily promotions.
Here is a very brief summary of some of the updates we’ve implemented:
- Clarification of correct telehealth rendering POS and use of modifier -95
- Modification of diagnosis code edits for billing of COVID-19 symptoms from February 20 – March 31, 2020 and use of new diagnosis U07.1 for dates of service on or after April 1, 2020
- Addition of the new AMA CPT code 87635 effective March 13, 2020
- Addition of the new CMS CPT codes U0001 and U0002 retroactively effective February 4, 2020
- Modification for waiver of DME replacement requirements prior to March 1, 2020
- Modification for waiver of occurrence code 70 on SNF three-consecutive day stay validation prior to March 1, 2020
- Modification to LCD/NCD edits to relax rules related to respiratory-related devices and services
- Modification to Medicaid for temporary suspension to prior authorization rules in PHE areas effective March 1, 2020
You can get all the latest COVID-19 specific updates here: https://www.alphaii.com/landing/covid19
Alpha II is an EZclaim partner that provides “Claim Scrubbing” for our medical billing software system. View our website for more details on this: https://ezclaim.com/partners/