Jun 17, 2022 | Partner, Trizetto Partner Solutions
We already know the trend toward automation in healthcare continues to grow each year. As technology continuously improves and the financial bar to entry lowers, the opportunities for healthcare providers and health plans to enhance operational processes grow as well. But even with the radical progress and the easier-to-use-than-ever healthcare operations software, many organizations fail to implement the solutions. It may be a lack of organizational enthusiasm or a simple need for more skilled internal technological expertise.
And while this is likely common knowledge at your organization, the amount of money wasted each year – driven by the absence of process automation – may not. Billions of dollars that could otherwise be spent on improving patient care and satisfaction, on building and rolling out new service lines, and generally improving healthcare operations are wasted every year. Billions.
The most recent CAQH Index reports $372 billion is spent yearly on administrative tasks throughout the US healthcare system. Of that amount, $39 billion of those administrative transactions are specifically tracked by the CAQH Index. “Of the $39 billion, the industry can save $16.3 billion, or 42 percent of existing annual spend, by transitioning to fully electronic transactions,” according to CAQH.
$16 billion in savings.
The current opportunity for savings driven by automated, electronic transactions within the healthcare industry is tremendous. That’s not to say the healthcare industry is doing nothing. CAQH found that healthcare organizations already save $122 billion annually thanks to process automation.
Even with the apparent success of automation, however, CAQH found the utilization, adoption, and growth of fully-automated processes year-over-year was stagnant or modest at best:
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- Eligibility and benefit verification remained steady at 84%
- Prior authorizations increased to 21% from 13%
- Claim status inquiry grew slightly to 72% from 70%
- Claim payment automation increased marginally to 71% to 70%
With the small and slow shift to the use of automated transaction processes in the healthcare industry, there’s a decided advantage–in time and money–to not automating many, if not all, backend operations. Doing so allows staff to focus on strategic initiatives, like building out new programs or service lines, rather than plodding through everyday tasks better tackled through repeatable processes supported by technology.
“The industry continues to make progress towards a more automated administrative workflow as transaction volume increases, new business needs and technology emerge, and health insurance benefit and payment models evolve,” CAQH explains in the report. Nevertheless, as mentioned earlier, the “progress” remains slow, like a river choked with debris.
Ironically, even as automated solutions become more abundant and easier to use, CAQH reports healthcare providers to perform more manual tasks today than in the past. With today’s technology-rich environment, there’s little reason for healthcare providers to input any type of care-related documentation by hand. That time can and should be better spent improving the healthcare experience for patients and their families.
It’s far past time to clear the detritus from the river. With the advantage of today’s technology, it’s easier to make the change when each of us plays a part in the cleanup.
Contact a TriZetto Provider Solutions representative today to learn more about automation-enabled technologies that can help drive efficiencies and increase revenue.
EZClaim is a leading medical billing and scheduling software provider that combines a best-in-class product with exceptional service and support. For more information, schedule a consultation today, email our experts, or call at 877.650.0904.
[ Contribution from the marketing team at TriZetto ]
Apr 5, 2021 | BillFlash, collections, Credit Card Processing, Denied Claims
With patient payment responsibility increasing each year, medical practices need to be extra diligent in collecting patient payments. This includes sending accounts to collections when necessary. Fortunately, there are steps you can take to make collections easier and more effective—both of which contribute to more revenue for your practice.
Here are three ways to improve your medical billing collections.
1. Be clear about your payment expectations
Make sure patients know when they will be expected to pay, and what payment methods you accept. Collecting copays before each visit is one of the best ways to avoid having accounts sent to collections, so making payment a part of the check-in process is a good idea. Post signs throughout the office to keep bills top of mind for patients. The more reminders you give patients about their payment responsibility, the less you will have to deal with collections.
2. Reach out to patients who have stopped paying
Keep an eye on delinquent accounts. If an account is approaching 30-60 days past due, it’s time to reach out to the patient. Try to have an empathetic conversation to see what you can do to help them pay off their bill. If they are experiencing financial difficulties, offer to adjust the payment terms to something more suitable to their situation. Even if it means you are only collecting part of their payment now, both the practice and the patient will be better off in the long run.
3. Automate what you can
The collections process is slow and cumbersome—if you’re doing everything manually. Software like BillFlash Integrated Collection Services saves your staff a lot of time by handling the manual processing for you. After that, all you need to do is approve which accounts to send to collections, based on the aging and amounts you prefer, and a collections expert will get to work collecting your revenue.
So, visit one of EZClaim’s partners, BillFlash, to learn more about how BillFlash Integrated Collection services can improve your medical billing collections.
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 BillFlash ]
Apr 5, 2021 | AMBA National Conference, Medical Billing Software Blog, MMBA Chapter Meetings, Support and Training
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.
EZCLAIM: When did you get into medical billing?
VICKY: “I started in 1994, and at the time we were working on a dinosaur of a system called, “Signature.” We would have to wait overnight to process the entire day’s work. Then we would return in the morning to see if there were any errors in the batch or denials in the claims, which meant being accurate in entering information was essential. Outside of that, we kept all our paperwork in filing cabinets, and they needed to be sorted and organized by date. If a date was off in the filing system it could take the better part of a day to find a patient’s claim. The difference between then and now is night and day. I am definitely thankful for technology.”
EZCLAIM: Why did you start Elite Medical Billing?
VICKY: “We started Elite Medical Billing because we wanted to be able to directly impact our medical practices with the services we provided, and we wanted the freedom to enjoy doing it for our clients. I also knew that I was experienced in the field, was competent at my job, and enjoyed doing what needed to be done to get practices paid. Once I honed those skills and knew we could do it. We hired a lawyer and an accountant, then formed our company.”
EZCLAIM: What are challenges in starting a company?
VICKY: “First, you have to understand the value of time management and delegation. You don’t want to bite off more than you can chew. It is good to know when you need to ask for help. Next, you want to find good staff. I look for people who have the right attitude about the job first and have the characteristics to be proactive and work hard. Then, I look for experience in the field, learning if they had hands-on experience with claims, denials, and coordination of benefits is part of that. At the end of the day, my staff are my [company], and fortunately, most of my staff have been with me from the beginning.”
EZCLAIM: Why did you choose EZClaim?
VICKY: “We had a client who needed software and, being a smaller company, we needed cost-effective software with strong tech support. When we searched on Google for “easy to use medical billing software,” we found EZClaim. We were won over by the first phone call. Since then, we have been reminded of how great a decision that we made. The simplicity by which you can enter the information, process new patients, and ‘claim them’ within minutes is invaluable. That combined with the great customer service—that answers our questions most often on the first call with detailed answers—and video tutorial support is why we will continue to use and promote the software.”
EZCLAIM: Are you a member of AMBA and MMBA?
VICKY: “We joined the MMBA and AMBA in 2016 to help us certify our billing company. That process and the training, testing, and materials were amazing pieces of helping us get established and grow. In addition, the expos, webinars, and online support offer an abundance of information. Of course, the annual expos are both informative and a great work trip for team building and fun. We make it annually to the MMBA, but our next big goal is to go to the AMBA in Las Vegas!”
EZCLAIM: Have some final thoughts to offer fellow medical billers and business owners?
VICKY: “As a medical biller and owner, you have to be willing to talk with physicians. You need to show them the vouchers and documentation of your work. And it is important to communicate how they bill and how they can be sure to properly classify to get paid. You need to review what they have done in the past and how they can improve in the future by training staff.”
“You can also add value by making them the good guy and yourself the bad guy when dealing with patients and getting paid. We allow patients to call us directly, we answer the questions, and tell them how much they have to pay—then we forward the call to the office. Remember, at the end of the day, you have to show them the money. They work hard and they deserve to get paid.”
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.
Jan 11, 2021 | Administrative Safeguards, HIPAA, Live Compliance, Partner
The “Organizational Assessment“ is one simple step to avoid becoming a victim of dark web breaches.
There’s no secret that the Dark Web is a scary place to lose your information. Medical records information sell anywhere from $1-$1000 by identity thieves! So, what if it affected your entire company?
What is a “breach” and where has the data come from?
A “breach” is an incident where data is inadvertently exposed in a vulnerable system, usually due to insufficient access controls or security weaknesses in the software. Data breaches are becoming more common and sometimes out of your control.
You can protect yourself and/or your organization by:
- Carefully monitoring where you store and enter your passwords can be extremely beneficial to help minimize the risk of a hack and keeping personal or patient information protected
- Routine password changes and monitoring where you store and enter your passwords can be extremely beneficial to help reduce the risk of becoming a victim to a hacker. Passwords should be long, unique in characters, capitalization, and alphanumerical
If you believe sensitive information about your organization was compromised, report it to the appropriate people within the organization, including network administrators, so they can be alert for any suspicious or unusual activity.
The web browser, Firefox, has a “Monitor” that will warn you by saying, “Your password is your first line of defense against hackers and unauthorized access to your accounts. The strength of your passwords directly impacts your online security.”
EZClaim’s partner, Live Compliance, can help. They aggregate breaches and enable you to assess where your personal data has been exposed. Dark Web scanning is built right into the Live Compliance portal, which allows a company to keep an eye on employees whose information was involved in a breach (and where the breach took place), and the suggested next steps to take.
What can I do to ensure this doesn’t happen to me or my organization?
Live Compliance can make checking off your compliance requirements extremely simple. It provides:
- Reliable and effective compliance
- Completely online, our role-based courses make training easy for remote or in-office employees
- Contact-free, accurate Security Risk Assessments are conducted remotely. All devices are thoroughly analyzed regardless of location. Conducting an accurate and thorough Security Risk Assessment is not only required, but is a useful tool to expose potential vulnerabilities, including those such as password protection.
- Policies and Procedures curated to fit your organization ensuring employees are updated on all Workstation Use and Security Safeguards in the office, or out of the office, all updated in real-time
- Electronic, prepared document sending and signing to employees and business associates
So, don’t risk your company’s future on dark web breaches. Contact one of EZClaim’s partners, Live Compliance, especially since they are offering a FREE Organization Assessment to help determine your company’s status. E-mail them, visit their website at LiveCompliance.com , or call them at 980.999.1585.
For more information about EZClaim’s medical billing software, e-mail, visit their website, or contact them at 877.650.0904.
[ Article contributed by Jim Johnson of Live Compliance ]
Oct 12, 2020 | Electronic Billing, Features, Medical Billing Software Blog
EZClaim Launches EZClaimPay, a new feature in its medical billing software that makes credit card processing painless!
EZClaim, a company with the mission of elevating its clients to stay in front of the ever-changing landscape of medical billing, announced today the launch of its credit card processing feature and service called, EZClaimPay.
EZClaim released the product in August 2020 as a solution to the ever-changing landscape of payment reconciliation. It was cited by customers as a timely response to a ‘pain point’—credit card payment processing—another example of EZClaim’s devotion to their mission.
Dan Loch, VP of Marketing commented that “EZClaim’s goal continues to be making life easier for medical billers at practices and billing firms. EZClaimPay is just one more feature within our mission of living up to that goal.” This feature will help companies get in front of the changes in medical transparency that are coming soon.
EZClaimPay provides for consolidated reconciliation (Payment reports; Chargeback management; and Reconciliation reports) and a single point of contact for support (Hardware; Software; and Payments).
EZClaim has developed a robust payments platform—tightly integrated with their software and support—to make accepting credit cards for payment PAINLESS! EZClaimPay makes software and payments better together.
For more details about EZClaimPay, view this web page: https://ezclaim.com/ezclaimpay/
ABOUT EZCLAIM:
EZClaim is a medical billing and scheduling software company that provides best-in-class customer service and support. To learn more, e-mail them at sales@ezclaim.com or call a representative today at 877.650.0904.
