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-19webinar on June 16th at 1 p.m. ET, and learn how to recover revenuebased 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 atezclaim.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 anAdvanced 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 thatEZClaim and our partnerTPS 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, ourcustomer 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 eitherschedule a one-on-one consultationwith our sales team ordownload a FREE TRIALto check it out the software yourself. For additional information right now, contact EZclaim’s sales team at877.650.0904or send an e-mail firstname.lastname@example.org.
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 sessionezclaim.com/webinars and can provide the presentation slides too! Just send a request to email@example.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)
CLA is on the frontlines and closely monitoring and analyzing activities related to Telehealth and other virtual health regulations
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).
Telemedicine was already growing in popularity prior to the onset of the Coronavirus pandemic. So, as the adoption rate increases, EZClaim clients may have questions about sending telemedicine charges and getting paid for Telehealth visits.
Telehealth challenges can range from issues with technology to getting paid. With Telehealth becoming the norm for many doctor-patient visits, it is important to have a thoughtful approach in place regarding collecting patient payments. To stay in business, you have to get paid for the work you are doing. So, establishing a process for Telehealth consultations is vital to your business, and it should be a top priority to build a successful program from beginning to end.
The answers to the following questions will help set the baseline for how to collect patient payments for
What is my process for charging for copays?
How and when do I collect outstanding balances?
For example, if you collect payment before an in-person visit, you should collect payment before a Telehealth visit, too. There is no need to re-create your process completely. Just change what is needed to match your current in-office routine.
Sending Charges Before a Telehealth Visit
A simple way to send pre-visit charges to patients is to provide them with a link that takes them directly to the payment site. EZClaim’s medical billing solution is integrated with BillFlash LinkPay, which enables customers to provide payment for the upcoming visit. So, before the Telehealth session begins, the practice simply sends a link to their patient via an e-mail or text, making the appointment confirmation and the payment processing part of the check-in process. After the payment transaction is complete, it will immediately show up on the practice’s BillFlash report. LinkPay is designed to be easy to use and doesn’t require patients to remember a login or a chart number.
Here’s how EZClaim enables the process through BillFlash:
Prior to Telehealth visit, the patient is sent a link to pay through LinkPay, and another link to join the Telehealth call
The patient pays the required amount through LinkPay, which is immediately confirmed and processed
The patient joins the Telehealth session
Results and follow-up are completed electronically
Insurance billing is completed
The patient receives a paper statement or eBill notification for any remaining balance
The patient is directed to pay the remaining balance online at MyProviderLink.com
Automate What Can Be Automated
With so many changes taking place in healthcare, a great way to help protect the financial stability of your practice is to automate what can be automated. This saves your staff time and decreases your cost of doing business.
One way to do this is to set up automatic payment plans for patients, particularly for those who have been hit hard by the economic impact of COVID-19. A payment plan is a good way of keeping the revenue flowing in, and it shows your patients that you are compassionate and willing to help them through these unprecedented times.
BillFlash also securely stores payment information, so patients will not need to re-enter their information every time they pay a new bill.
As you continue to adjust to Telehealth going forward, BillFlash can simplify patient billing and payments significantly and help getting paid for Telehealth visits.
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!
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