Why I Use EZClaim – A Billing Expert Interview

Why I Use EZClaim – A Billing Expert Interview

If you’re thinking of investing in medical billing software, there’s no better person to give you the answers you need than Chelsea Graven, a revenue cycle director for Alert Medical Alarms. With over ten years in the medical billing industry, she’s been in numerous roles including billing and claims submissions. A longtime customer and champion of EZClaim since 2013, Chelsea has referred the software to many other partners because she knows firsthand not only how simple it is to use, but how effective the software is.

Recently, we found time to interview Chelsea about her start in the industry, why she continues to recommend EZClaim, and her advice on anyone starting out in medical billing.

EZCLAIM: Working with EZClaim’s medical billing software platform, what role does their software impact your work?                               

 

GRAVEN: “The company I currently work for was originally either submitting paper claims or billing through portals. EZClaim has allowed us to transition to electronic billing and it cuts the amount of time we spend in provider portals or filling out those forms. I would say seventy-five percent of the workload has been cut using EZClaim. Previously, it took one person three weeks to bill 6,000 claims. Now, we are billing 7,000 claims in a matter of minutes just by submitting and using the features within EZClaim, such as the recurring claim option.”

 

EZCLAIM: If you were going to share something with your colleagues about EZClaim, what would it be?                                                     

GRAVEN: “How spot on the name ‘EZClaim’ is. It’s exactly what it’s called, EASY. Other software programs do not accommodate the simple recurring billing that we need. EZClaim is the only software I have used that does that and makes it easy. Of all the billing software platforms I have used, EZClaim is the simplest to use and the most user-friendly.”

 

EZCLAIM: What would you say are some strengths needed to be an effective medical biller?                                                                       

GRAVEN: “Analyzing, troubleshooting, and resolving. There is a lot of that involved. You must be able to troubleshoot and independently find resolutions in order to be effective at billing. I think EzClaim has customized reporting capabilities that allow the companies to better follow current trends that they are seeing in claims, denials, and payments. Tracking the trends is what will lead to the troubleshooting, analyzing, and resolving of any issues, having customizable reporting makes all the difference to successful billers. You can’t fix something if you don’t know it’s wrong, EzClaim reporting brings all of that to the biller, so you don’t have to go looking for problems/solutions on top of your daily billing processes.”

 

EZCLAIM: Do you have any advice for anyone who is starting out in the medical billing industry?

 

GRAVEN: “EZClaim is my go-to for anyone who is doing medical billing and is wanting to learn and get into the industry because it is the simplest software to use. EZClaim makes it easy to grasp the electronic billing end-to-end process without feeling overwhelmed by the complexity of the software. I would say for anyone starting out the first thing I would do is find an electronic billing solution and a clearinghouse.”

 

EZCLAIM: Why did you get into the medical billing industry?                                                                                                                             

GRAVEN: “I actually fell into this industry by default. I was working on private pay collections for a company and at the time the state of Illinois in 2010 transitioned to manage care programs, and no one was really prepared for that. I was then asked to take on the role of billing manager. It grew so large that doing HCFA 1500 forms was not efficient, so I started looking for electronic billing solutions. What I enjoy most about the billing industry is closing the claims entirely. Getting that amount to zero dollars. Most people wouldn’t say it’s the money coming in, but for me, it’s the gratification for the end-to-end process of the revenue cycle. It’s all about getting the receivables closed.”

 

EZCLAIM: Final thoughts?                                                                                                                                                                                         

GRAVEN:With EZClaim, the value is beyond just the software. Yes, it’s easy to work with, but the IT team and all the people involved make the experience favorable.”

 [ The above answers were paraphrased as closely as possible to the original answers given by Chelsea Graven on October 22nd, 2021. ]


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.

 

 

 

4 Steps to Getting the Most Out of Your Data Analytics

4 Steps to Getting the Most Out of Your Data Analytics

As patients return to doctor’s offices and health systems around the country, healthcare organizations find themselves in uncharted waters, with a greater need than ever to make data-driven decisions that grow revenue. Per a recent report from KLAS, 63% of hospitals found themselves struggling with real-time data analytics.

It should come as no surprise then that investments in new analytics tech and training are on the rise. According to a report from the Society of Actuaries (SOA), 42% of surveyed healthcare executives reported an improvement in patient satisfaction since implementing predictive analytics, while 39% said they had cut costs. Since 2011, over $39B has been invested in digital health tech, including $7.48B in 2019 alone. It’s estimated that roughly 20% of that has been funneled into the development of technology-focused on managing health records and analytics. Furthermore, some models have estimated improving available data collection and analysis tech could save the healthcare industry roughly 25% of its total costs.

The question is, what can you do to unlock that potential within your own organization? There’s a deep well of data that each revenue cycle feeds into, which if properly analyzed, can help organizations operate at their most efficient and effective. Here are the four stages of data analytics workflows that are key to developing those actionable insights.

1. A trigger, or the point in your revenue cycle that sets up the call for deeper analysis
2. Interpretation of data to determine root causes and identify appropriate next steps
3. Intervention to improve specific metrics
4. Tracking of said metrics to chart success in achieving desired outcomes

Let’s examine what a successful version of each stage looks like.

1. Trigger
The trigger occurs when you notice something that needs further investigation. With the right analytics tool, you can easily access all of your key performance indicators, financial goals, and more, providing the visibility you need into your rev cycle. When something looks amiss or needs improving, you can drill down to the level that shows what’s really going on.

2. Interpretation
Even a wealth of data amounts to nothing without an efficient way to process and communicate key takeaways. You’ll need to equip your team with access to concise reports, smart visualizations, and relevant historical data in order to get them to the insights that drive action.

3. Intervention
Now is the time to take action. Intervention is ultimately tied directly to your ability to drill down into the data underlying problematic areas of your revenue cycle and clearly communicate takeaways with your team. Success at this stage depends on designing a plan based on your best understanding of underlying issues and the most effective way to address them.

4. Tracking
Your intervention plan is built on KPIs that naturally intertwine with the way you measure success across your revenue cycle. With proper implementation and tracking, running with the analytics cycle can become a simple addition to your everyday workflow. More than delivering on your initial goals, the true power of analytics is the ability to deliver repeat value on your initial investment.

A strong analytics solution does more than deliver a more fully developed picture of your rev cycle performance. It provides actionable business intelligence, cuts down on time between analysis and action, and lessens the strain on your IT department.
Beyond the actionable internal insights it can provide, analytics is also a key tool for helping you benchmark performance in comparison to peers in the industry. And with the right analytics solution, competitive analysis is a simple task, using automation that reviews customizable benchmarks for a tailored review of the claim, payment, and denial performance.

Looking for a truly comprehensive analytics solution to help improve performance and enhance your benchmarking capabilities? Find out how Waystar can help you harness the power of your data through analytics. Visit Waystar.com

Heading to AMBA in October? Visit Waystar and EZClaim while you’re there! Stay tuned for more event details.


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 WayStar ]

Medicare Revalidation is Critical to Maintaining Eligibility

Medicare Revalidation is Critical to Maintaining Eligibility

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.

After Pandemic Impact on Outsourcing RCM

After Pandemic Impact on Outsourcing RCM

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 ]